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CMPA members call for support on end-of-life care

End-of-life care was the focus of the recent Canadian Medical Protective Association (CMPA) annual meeting in Halifax.

Similar to the Canadian Medical Association’s General Council meeting that it followed, the CMPA event involved a lengthy and passionate debate on the role of physicians in offering assisted dying and focused on the rights and responsibilities of individual physicians.

A member motion submitted by Dr. Todd Howlett, chief of medical staff at Dartmouth General Hospital, NS dealt with the association’s obligation to defend members in matters that conflict with physicians’ “freedoms of conscience, religion and professional judgment.”

Presented as a separate item, was a call for the CMPA to “engage with other stakeholders to express members’ concerns about mandatory obligations that interfere with those freedoms.”

Both motions were adopted, despite resistance from some in attendance.

While the two recommendations encompass a variety of medical procedures and situations, discussion at the meeting focused on physician-assisted dying.

While some voiced personal concerns about referring patients for assisted dying, others stressed the importance of physicians acting on behalf of the patient and not overriding their patients’ requests with their own beliefs.

This discussion was followed by an end-of-life care panel moderated by Globe and Mail columnist André Picard. Four medical experts led the conversation, offering potential solutions to improve end-of-life care in Canada.

Panelist Dr. James Downar, a palliative care physician in Toronto, said all present and future physicians should be trained in end-of-life care. He added there must also be a shift in the discourse surrounding assisted death so that it’s less taboo and more commonplace.

Dr. Douglas Grant, registrar of the College of Physicians and Surgeons of Nova Scotia, reminded members that regardless of their own views and concerns they must abide by the laws set out by the Supreme Court of Canada when dealing with patients who request assisted death.

To reassure members, CMPA Executive Director and CEO Dr. Hartley Stern reiterated the organization’s central mandate — to protect and support its members, while setting out clear guidelines for medical practice.

He said the CMPA has participated in policy discussions to ask for greater clarification on assisted death, from the language to the referral process, as this is sure to be one of the most pressing issues physicians across the country will face in the coming months.

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