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report released today by the Canadian Association for Community Living (CACL) indicates that far more robust safeguards are needed to protect vulnerable persons in a system for physician-assisted suicide than those recommended by a Provincial/ Territorial Expert Advisory Committee. CACL's report points to evidence from other jurisdictions, which suggests a system that relies on one or two physicians to assess a person's vulnerability will not be able to screen out those cases where people are coerced into making the request, or are suicidal for reasons other than suffering caused by their condition.
The need for vulnerability assessment by independent, qualified professionals is also highlighted in evidence recently reported by the Federal External Panel which reported on this issue earlier this month.
CACL's report reviews research and recommendations on vulnerability assessment, suicide prevention protocols as recommended by health care agencies in Canada, and practice guidelines by the US National Cancer Institute. Its findings suggest that most current Canadian proposals as well as the recently introduced system in Québec fall far short of measures needed to protect vulnerable persons.
The report recommends steps for a vulnerability screening and assessment process for all patients requesting physician-assisted suicide or voluntary euthanasia; while also protecting the principle of individual choice and autonomy for those considered legally eligible and who are able to make a reasoned and non-ambivalent request. It recommends that an advance independent review body must authorize the decision rather than leaving it in the hands of physicians, which the report finds would compromise physician duties to do everything possible to identify and address a person's causes of suffering.
Michael Bach, CACL Executive Vice-President, said: The Supreme Court of Canada clearly called for a system that balances protection of the principle of autonomy, with protecting those who are vulnerable to being induced to commit suicide. We've heard a lot about what is needed for the autonomy side of the equation in a system for physician-assisted suicide, and relatively little about what measures are needed to deliver on the Court's requirement that vulnerable persons be protected. We hope this report will begin to fill this gap."