Justice committee  If I could just respond to that. Part of the problem in this debate is the definition of referral. When we talk about referral, we're talking about a formal referral, which is essentially a recommendation. If patients are in a facility that is not able to provide assisted death on the premises, then our moral beliefs allow us and physicians within that facility to facilitate a transfer of the patient to the facility of their choice where they can get access to that procedure.

Justice committee  It is very similar. It was based upon that legislation.

Justice committee  Thank you, Cardinal Collins. Members of our coalition support the right of patients to refuse or discontinue treatment at end of life, allowing the underlying illness to take its course. We wish to make it clear that should Parliament legalize medical aid in dying, we will not in any way obstruct patients who decide to seek that procedure, and we will never abandon our patients.

Physician-Assisted Dying committee  We've done studies looking at the various countries that have legalized this. Generally speaking, the problem you have is that when a patient comes to a doctor and they say that they want to die, many different factors could be contributing to that. Many of those could be dealt with.

Physician-Assisted Dying committee  Unfortunately, if you look at what's happening in these countries, doctors just get a slap on the wrist.

Physician-Assisted Dying committee  I'm with the cardinal on this. I spent some time a year and a half ago with Dr. Theo Boer, who is the medical ethicist in the Netherlands. He was on a euthanasia commission there, and their job was to review cases. He indicated that they went through every one of the so-called safeguards that were available in the Dutch statute, and he explained to me about cases that he had where doctors had circumvented them.

Physician-Assisted Dying committee  They get a letter telling them. What I'm trying to say is that once you accept the idea that state-sanctioned killing of patients is morally acceptable and you open it a crack, it becomes almost impossible to find a place to stop that process.

Physician-Assisted Dying committee  Thank you for the question. It's a very good one. I think there needs to be more.... Our proposal is not to simply send someone to the Yellow Pages, far from it. Our doctors are committed to the life and well-being of their patients, so they would want to maintain the physician-patient relationship.

Physician-Assisted Dying committee  To answer that quickly, I would say that it's misreading the Carter decision to say that it requires individual physicians or facilities to provide the service. What it says is that Canadians have the right to this, but it doesn't say that they have a right to it from every individual institution or individual doctor.

Physician-Assisted Dying committee  This happens all the time in medical care. There are certain procedures that are only provided in certain places. It's up to government. The departments of health cannot shirk their responsibilities here. If this is something that the Supreme Court has mandated, then the departments of health have to find ways to provide these services.

Physician-Assisted Dying committee  Yes. Our legal brief has five different options in all. Just as in some of the provincial college documents, doctors who choose to do euthanasia are protected against discrimination on the part of faith-based institutions, so also we would ask that doctors who do not want to do euthanasia be also protected.

Physician-Assisted Dying committee  Yes, the proposal which we will leave behind was one that we discussed at length with the Canadian Medical Association, and which they have approved. It basically shows the physicians articulating their conscience issue around assisted suicide and euthanasia with the patient, having the dialogue and discussion with the patient, giving the patient information about all viable options, but then simply stepping back from the process and allowing the patient to have direct access to an assessment for assisted death.

Physician-Assisted Dying committee  We differ slightly from the recommendations of the provincial-territorial expert advisory group. They suggested that it would be the physician's responsibility to inform the third party. Our feeling is that it would be unacceptable for us to have to take that responsibility and that the actual patient could be the one to contact.

Physician-Assisted Dying committee  Thank you, Cardinal Collins. Ladies and gentlemen of the committee, His Eminence has provided you with some insight into our concerns about how legalizing physician-assisted suicide or euthanasia will impact vulnerable patients. Provided they can consent, people with disabilities such as rheumatoid arthritis and paraplegia, or those with mental health difficulties could qualify for assisted death according to the criteria set down by the courts.