March 20th, 2018
VPS Blog Addresses Vulnerability, Monitoring and the Moral Core of Medicine

Last month, Advisors to the Vulnerable Persons Standard released a comprehensive report, " Towards a More Robust Monitoring Regime for Medical Assistance in Dying; Submission to The Federal Minister of Health". The report highlights critical omissions from the government's regulatory proposal that undermine the foundational commitments in the preamble to Canada's MAiD law.

This week, the VPS continues to spotlight the issue of MAiD monitoring with a new Blog commentary in the series " Why Monitoring Matters". This week's featured column, by VPS advisor Sister Nuala Kenny, is titled " Vulnerability, Monitoring and the Moral Core of Medicine". In it, Dr. Kenny elaborates on the philosophical underpinnings of medicine and articulates her experience of medicine "as a moral endeavour". 

From this foundation, Dr. Kenny reflects upon MAiD as both a consequence of and a catalyst for the erosion of conscience in medical practice. "Conscience", she writes, "is about forming the moral core of our acts and decisions. Without conscience development, sensitivity to the suffering of patients and families and recognition of those most vulnerable to requesting MAiD is compromised." 

Dr. Kenny's essay affirms the emphasis of the VPS submission on physician responsibility for protection of autonomy, understanding suffering, non-discrimination and provision of options. Noting that there will be bureaucratic pressures to "simplify paperwork" and fixations on privacy that threaten to erase all signs of institutional abuse and social neglect, she issues a clear call to a higher ethic of moral agency. A monitoring system rooted in physician responsibility, she argues, "may reawaken clinicians to the moral core of their practice". 

The VPS Blog, " Why Monitoring Matters" will continue in the coming weeks to feature guest commentators from medicine, ethics, law, social policy and human rights, providing Canadian lawmakers and the broader public with a range of insights and perspectives on the importance of robust MAiD monitoring.

There are many reasons for Canadians to be concerned that the government's proposed regulations do not adequately address the challenge of MAiD monitoring. We encourage VPS supporters to write to the Honourable Ginette Petitpas Taylor, Minister of Health, and explain, from your own perspective, why Canada's system for MAiD monitoring must be strengthened in order to protect persons in vulnerable circumstances.

Interview with Ing Wong Ward - CBC Radio, Metro Morning, March 7, 2018. A widely respected disability activist and former journalist speaks candidly about the tendency to regard disabled citizens as heroic and inspirational. In a wide ranging and thought-provoking conversation, in which she draws from her own experience with a terminal diagnosis, Ing Wong Ward offers a disability perspective on bravery, resilience, mortality and what it means to live with dignity.

Highlighting recent peer-reviewed research and scholarship of interest to VPS supporters.

The federal government's proposed regulations for monitoring MAiD would collect information only from practitioners directly involved in the assessment or provision of MAiD. Unless the regulations are amended, other attending physicians and primary health care providers will have no opportunity to offer their insights about the patient's suffering, or about external pressure that might undermine the patient's autonomy.

The Vulnerable Persons Standard was developed by a group of more than forty advisors with expertise in medicine, ethics, law, public policy and needs of vulnerable persons. The Standard is a series of evidence-based safeguards intended to help ensure that Canadians requesting assistance from physicians to end their life can do so without jeopardizing the lives of vulnerable persons who may be subject to coercion and abuse. 

To learn more about the Standard and the many Canadians and organizations endorsing the Standard, please visit us at
Vulnerable Persons Secretariat

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