Dear colleagues,

It’s been over a year since I wrote to you on the topic of medical assistance in dying. Around that time, we outlined our commitment to providing you with supplemental educational materials. Today’s message is a status update on that work. It’s also an opportunity for you to link to some of those resources and to help guide the efforts of our Royal College Ethics Committee by answering a few focused questions.

New bioethics cases and progress on other resources
Here are some of our earlier commitments and our progress.

We will provide and/or connect all Fellows who are interested in learning more about this area of care with educational resources such as…

Our promise
Our progress
  • information on medical assistance in dying procedures, including legal obligations and protections
  • the Canadian Medical Association’s forthcoming online module on medical assistance in dying and end-of-life care
  • new cases within our bioethics curriculum to provide direction and illustrate ethical principles relevant to medical assistance in dying and other end-of-life care options
Two new cases have been made available. They were written by Angel Petropanagos, a postdoctoral fellow at NTE: Impact Ethics

– 5.3.1 Conscientious Objection to Medical Assistance in Dying (MAID)

  • This case addresses the conscientious objection of a physician to participate in MAID.

– 5.3.2 Providing Medical Assistance in Dying (MAiD)

  • This case addresses the ethical issues relevant to a typical patient who meets the MAID eligibility criteria.

This topic is part of our Royal College Ethics Committee’s ongoing work.

  • specific workshops and other educational modules on this theme
New workshops for residents and clinical supervisors on medical assistance in dying were developed by our Continuing Professional Development team at the Royal College. They will be launched this fall (2017).


Our contribution to the Expert Panel on Medical Assistance in Dying
Another one of our commitments was to continue to support our partners. One example is our forthcoming contributions to the Expert Panel on Medical Assistance in Dying. This panel is currently seeking input to help inform their panel deliberations. They’ve reached out to us, and other groups and organizations from across Canada affected by, or involved in, medical assistance in dying. We will be sharing our resources with them.

Additional information about the project and this expert panel can be found on the Council of Canadian Academies’ website. Dr. Mona Gupta, FRCPC, chair of our Royal College Ethics Committee, participates on the panel. Dr. Ross Upshur, FRCPC, a member of our ethics committee and of our Health and Public Policy Committee, is also a panelist.

Brief poll to help guide our Ethics Committee’s next steps
Federal legislation legalizing medical assistance in dying across Canada received royal assent last June; physicians in Quebec have been navigating this new care parameter since late 2015 (link to details on Quebec’s end-of-life care legislation). Regardless of the Canadian jurisdiction, we remain committed to linking medical specialists with related educational materials – either College-led efforts or contributions/supports from others.

To assist us with these efforts, I would appreciate if you would take a few moments to provide input via a brief poll. The information collected will help guide the next steps for our Royal College Ethics Committee with relation to this theme. We will also share these poll results with the Expert Panel on Medical Assistance in Dying, in case it may be of use.

For example, one possible way forward is to expand our bioethics curricula on medical assistance in dying (MAID). Our Ethics Committee is already contemplating the creation of new cases like

  • MAID in the context of a severe chronic disability/disease where death is not clearly imminent,
  • the impact of participation in MAID on members of the health care team,
  • disclosing the choice of MAID to families,
  • the lack of palliative care in the context of MAID, and
  • capacity assessment at the end of life.

On what areas of medical assistance in dying legislation and regulation are you seeking direction? Hopefully you will answer our poll to provide that information.

Best wishes, sincerely,

Andrew Padmos, BA, MD, FRCPC, FACP

Chief Executive Officer