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The coroner’s office would still need to be notified of all medically assisted deaths, but proposed Ontario legislation would eliminate the requirement to investigate every one.
It would make assisted dying less intrusive for the patients’ families while protecting the coroner’s functions of reporting, monitoring and oversight, said Dr. Dirk Huyer, Ontario’s chief coroner.
“It’s a way to ensure that we know what’s going on without intensively investigating every one of the cases.”
The legislation, introduced on Wednesday, aims to clarify how assisted dying is to be implemented in Ontario.
After the federal assisted dying Bill C-14 received royal assent in June, the provinces were left to implement the legal mechanisms to track the deaths. Parliament has jurisdiction over criminal law, but provinces legislate other aspects, such as how the cause of death is recorded on a death certificate.
April Poelstra was with her father, Jack Poelstra, on July 27 when he received a medically assisted death in Smiths Falls. Poelstra said she was speaking to the coroner on the phone within five minutes of her father’s death.
“It’s just not a time that anyone wants to be on the phone,” she said. “Even if it had been postponed for just a few more hours. I just wanted to be with my family. It would have been helpful to have a little more time.”
The coroner’s involvement in assisted deaths has been a cause for concern for those seeking an assisted death and their advocates. Dying with Dignity Canada has been concerned that the requirement to report would have a chilling effect on patients and physicians.
On March 17, Superior Court Justice Paul Perrell authorized Ontario’s first physician-assisted death in the case of an 81-year-old Toronto cancer patient known only as “A.B.”
The patient and family were concerned that A.B.’s body would be seized and possibly be subject to an autopsy under the Coroners Act. Lawyers for A.B. argued that A.B.’s underlying disease should be named as the cause of death. The judge ruled that A.B.’s doctors were not obliged to notify the coroner’s office.
Among the proposed measures in the legislation introduced this week is to continue the requirement in the Coroners Act that the coroner’s office be notified, and allow the coroner to determine whether to investigate.
Assisted death would also not apply to another part of the Coroners Act, which requires the coroner to investigate any death from any cause other than disease.
Five questions must be answered when someone dies: the identity of the deceased, the date of death, the location of death, the medical cause of death and by what means. Causes include natural causes, accident, homicide, suicide or “undetermined.” As it stands, assisted deaths are recorded as suicides, with drug toxicity as the means.
While assisted deaths do not fit under the category of natural deaths, they are a “unique category of non-natural death,” he said. “We recognize the complexities.”
If the legislation passes, the attending clinician would provide the cause of death on the death certificate. The cause of death will be up to the physician or nurse practitioner’s professional opinion. No new “cause” category would be added, said Huyer.
A department would be created within the provincial coroner’s office specifically for the purpose of receiving reports on assisted deaths. The details have not been determined.
Huyer said reporting, monitoring and oversight are an important role of his office — especially in the case of assisted death, which represents a significant shift for society. He feels the proposed legislation is a “good response” to those issues.
“It balances the need of the public to have information with consideration for the patients in a time of great difficulty.”
Poelstra said she will be pleased if the law is changed. “It would be less stressful.”
Among the measures in Ontario’s Medical Assistance in Dying Statute Law Amendment Act:
• The Workplace Safety and Insurance Act would be amended to clarify that a person who received medical assistance in dying is considered to have died as a result of their underlying injury or illness. Benefits such as insurance payouts and workplace safety benefits are not to be denied only because of a medically assisted death.
• Health care professionals and those who assist them would be protected from civil liability when lawfully providing medical assistance in dying. The proposed immunity would not apply to claims based on alleged negligence.
• The Freedom of Information and Protection of Privacy Act, as well as the Municipal Freedom of Information and Protection of Privacy Act would be amended to strengthen privacy protections for health care providers and facilities by excluding identifying information.
• The Coroners Act would be amended to require that the coroner be notified about all medically assisted deaths and allow the coroner to determine whether to investigate. The requirement under the act to investigate any death from any cause other than disease would not apply to medical assistance in dying.
By the numbers:
About 300: Assisted deaths anticipated in Ontario in the first year, based on population and other jurisdictions where assisted death is permitted.
162: Assisted deaths in Ontario between June 17, when the law came into effect, and Dec. 8
15: Assisted deaths in Ottawa in that time period
Less than 5*: Assisted deaths in Renfrew County
Less than 5: Assisted deaths in Lanark County
Less than 5: Assisted deaths in Leeds Grenville
Less than 5: Assisted deaths in Prescott-Russell
*If the number in any jurisdiction is very small and this threatens identify someone who has died, the coroner’s office reports the number as “less than five.”
查看原文...
It would make assisted dying less intrusive for the patients’ families while protecting the coroner’s functions of reporting, monitoring and oversight, said Dr. Dirk Huyer, Ontario’s chief coroner.
“It’s a way to ensure that we know what’s going on without intensively investigating every one of the cases.”
The legislation, introduced on Wednesday, aims to clarify how assisted dying is to be implemented in Ontario.
After the federal assisted dying Bill C-14 received royal assent in June, the provinces were left to implement the legal mechanisms to track the deaths. Parliament has jurisdiction over criminal law, but provinces legislate other aspects, such as how the cause of death is recorded on a death certificate.
April Poelstra was with her father, Jack Poelstra, on July 27 when he received a medically assisted death in Smiths Falls. Poelstra said she was speaking to the coroner on the phone within five minutes of her father’s death.
“It’s just not a time that anyone wants to be on the phone,” she said. “Even if it had been postponed for just a few more hours. I just wanted to be with my family. It would have been helpful to have a little more time.”
The coroner’s involvement in assisted deaths has been a cause for concern for those seeking an assisted death and their advocates. Dying with Dignity Canada has been concerned that the requirement to report would have a chilling effect on patients and physicians.
On March 17, Superior Court Justice Paul Perrell authorized Ontario’s first physician-assisted death in the case of an 81-year-old Toronto cancer patient known only as “A.B.”
The patient and family were concerned that A.B.’s body would be seized and possibly be subject to an autopsy under the Coroners Act. Lawyers for A.B. argued that A.B.’s underlying disease should be named as the cause of death. The judge ruled that A.B.’s doctors were not obliged to notify the coroner’s office.
Among the proposed measures in the legislation introduced this week is to continue the requirement in the Coroners Act that the coroner’s office be notified, and allow the coroner to determine whether to investigate.
Assisted death would also not apply to another part of the Coroners Act, which requires the coroner to investigate any death from any cause other than disease.
Five questions must be answered when someone dies: the identity of the deceased, the date of death, the location of death, the medical cause of death and by what means. Causes include natural causes, accident, homicide, suicide or “undetermined.” As it stands, assisted deaths are recorded as suicides, with drug toxicity as the means.
While assisted deaths do not fit under the category of natural deaths, they are a “unique category of non-natural death,” he said. “We recognize the complexities.”
If the legislation passes, the attending clinician would provide the cause of death on the death certificate. The cause of death will be up to the physician or nurse practitioner’s professional opinion. No new “cause” category would be added, said Huyer.
A department would be created within the provincial coroner’s office specifically for the purpose of receiving reports on assisted deaths. The details have not been determined.
Huyer said reporting, monitoring and oversight are an important role of his office — especially in the case of assisted death, which represents a significant shift for society. He feels the proposed legislation is a “good response” to those issues.
“It balances the need of the public to have information with consideration for the patients in a time of great difficulty.”
Poelstra said she will be pleased if the law is changed. “It would be less stressful.”
Among the measures in Ontario’s Medical Assistance in Dying Statute Law Amendment Act:
• The Workplace Safety and Insurance Act would be amended to clarify that a person who received medical assistance in dying is considered to have died as a result of their underlying injury or illness. Benefits such as insurance payouts and workplace safety benefits are not to be denied only because of a medically assisted death.
• Health care professionals and those who assist them would be protected from civil liability when lawfully providing medical assistance in dying. The proposed immunity would not apply to claims based on alleged negligence.
• The Freedom of Information and Protection of Privacy Act, as well as the Municipal Freedom of Information and Protection of Privacy Act would be amended to strengthen privacy protections for health care providers and facilities by excluding identifying information.
• The Coroners Act would be amended to require that the coroner be notified about all medically assisted deaths and allow the coroner to determine whether to investigate. The requirement under the act to investigate any death from any cause other than disease would not apply to medical assistance in dying.
By the numbers:
About 300: Assisted deaths anticipated in Ontario in the first year, based on population and other jurisdictions where assisted death is permitted.
162: Assisted deaths in Ontario between June 17, when the law came into effect, and Dec. 8
15: Assisted deaths in Ottawa in that time period
Less than 5*: Assisted deaths in Renfrew County
Less than 5: Assisted deaths in Lanark County
Less than 5: Assisted deaths in Leeds Grenville
Less than 5: Assisted deaths in Prescott-Russell
*If the number in any jurisdiction is very small and this threatens identify someone who has died, the coroner’s office reports the number as “less than five.”
查看原文...
