Justice committee  We need to have an understanding about natural death being reasonably foreseeable. Are we talking two weeks, a month, three months, six months, a year? Greater clarity around that would be important. If we're talking about a six- to 12-month window, there is lots of room there, and that deterioration may be much less predictable.

Justice committee  The concerns relate to geographic limitations, rural environments, remote environments where such access could be more of an issue. At the same time, we need to accept the reality that there is support currently available to providers and patients in remote environments through Telehealth and other mechanisms of this nature, but there is no doubt that access in rural and remote areas of our country is a concern for us.

Justice committee  That is a good question that's been discussed earlier today. On the one hand, it's important for us to respect the principle of autonomy. At the same time, assisted suicide will differ from euthanasia in that once the prescription is given, the respect for autonomy has been given, the caring relationship of a provider and a patient may be altered in that the responsibility to proceed in this regard is left entirely to the patient.

Justice committee  I believe crafting the legislation to require two independent medical opinions is important. It would hopefully help to mitigate this and provide greater...“comfort” is not the right term, but it would give us some parameters of reassurance to operate under. As I mentioned, what happens if during the two weeks after the patient makes a request, the patient's condition deteriorates?

Justice committee  I am not aware that I spoke to that directly in this presentation. We do recognize that the medical providers who will be involved in this procedure certainly will need to have appropriate training. We're working very hard in a collaborative manner with the Canadian Medical Association and the Royal College of Physicians and Surgeons of Canada to develop professional development that will enable those who chose to get involved in this procedure to do so.

Justice committee  Thank you very much. The College of Family Physicians of Canada is the national body responsible for establishing the standards for the training, certification, and lifelong education of family physicians. In this regard, we do welcome Bill C-14, an act to amend the Criminal Code and to make related amendments to other acts.

Physician-Assisted Dying committee  I don't, but go ahead.

Physician-Assisted Dying committee  We believe physicians have a responsibility not to abandon. If a physician finds himself or herself in a position of not being able to conclude the process, that physician can still do the exploration that is discussed in this document. If the wish of the patient is still to proceed, then the physician ought to either refer to another physician or provide sources of referral that the patient can access in such a way that the patient is not left having to fend for himself or herself at this important time of life.

Physician-Assisted Dying committee  We support that tool as a consultation vehicle that is part of this important decision.

Physician-Assisted Dying committee  We are on the record as saying yes, and I still believe this is important. That really is around equity. I believe that a federal process would strengthen equity for Canadians around this issue.

Physician-Assisted Dying committee  The guidelines that are probably best known, as we referred to earlier, are the ones that exist in Quebec. I would say, based on everything that I've heard from my colleagues in Quebec, there is a sense that they are appropriately framed. Guidelines are emerging as they are issued by the licensing authorities in other provinces.

Physician-Assisted Dying committee  We support having two physicians, with the most responsible provider being that first person who can view the request in the larger context as described, and then a second consultation by another physician.

Physician-Assisted Dying committee  I personally would not feel that it necessarily needs to be a specialist. Perhaps only in instances where there may be questions with regard to the competence or capacity of the individual would there be a need for more specific, specialized expertise.

Physician-Assisted Dying committee  We really believe that physician-assisted dying is the responsibility of family physicians. That said, I would not say that it is exclusively their responsibility. For instance, nurse practitioners who are working in more rural or remote regions should also be authorized to provide that assistance, especially if their professional body is prepared to include the process in their scope of practice.

Physician-Assisted Dying committee  You expect an answer from a family doctor in a minute or less. Some of the segments of the paper produced by the college that speak to dignity have also been covered by my colleagues from the Alzheimer Society in terms of the slippery slope that we are on, and yet, at the same time, we need to stand up and be counted and listen to what Canadians have told us.