Physician-Assisted Dying committee  You can have two people with the exact same symptomatology and experience, and one may have capacity to make a decision and the other one might not. This is why I'm saying it comes back to the principles of capacity assessment.

Physician-Assisted Dying committee  You're actually hitting on issues we struggle with in medicine and psychiatry all the time between the principles of autonomy and beneficence. As physicians, we want to take care of patients. The patient also has his or her own autonomy to make decisions. The tricky part with me

Physician-Assisted Dying committee  Again, not necessarily. The issue of capacity is specific to each question.

Physician-Assisted Dying committee  There's a difference between imposing a treatment and saying that a person lacks capacity to get a treatment.

Physician-Assisted Dying committee  At that point in time, if the person lacked capacity, that is true. If the person were deemed to lack capacity, that is true. There is a model called the recovery model. In that model, patients want to be able to make their own decisions, even if they're mistakes. The idea is t

Physician-Assisted Dying committee  Those decisions we are already making. We already make those kinds of capacity decisions.

Physician-Assisted Dying committee  You asked a question about the federal versus provincial roles. Certainly, as far as the Criminal Code goes, that would seem to be a federal role, but the operationalization of how these things actually play out may be jurisdictional, depending on the resources available. The gui

Physician-Assisted Dying committee  To some extent that question is already answered in practice on the ground because psychiatrists are not involved in all competency assessments, and that includes ones that have life-and-death consequences. For example, in oncology, if a patient wishes to decline chemotherapy o

Physician-Assisted Dying committee  I can't make a blanket statement answering that, because it would need to be assessed on a case-by-case basis to understand how that news has affected the patient. I've seen people react with all sorts of ranges of reaction when they learn that they have a terminal illness. It ne

Physician-Assisted Dying committee  I think that on some of these questions, I would probably defer to my colleagues at the CMA, because they're the ones who would be providing more guidance on the issues when mental illness is not present.

Physician-Assisted Dying committee  I don't have the best answer for you on that right now. It's the most challenging question right now: what threshold should be required for defining something as “irremediable”?

Physician-Assisted Dying committee  “Grievous” suggests a degree of severity. “Irremediable” is on or off. It either is or is not. It's a dichotomous definition, whereas most of the things we do in medicine, and certainly these assessments—

Physician-Assisted Dying committee  By introductory document, do you mean the speaking notes?

Physician-Assisted Dying committee  We can provide it afterwards, but we didn't prepare it in advance for circulation.

Physician-Assisted Dying committee  No, those are different. You can clearly have a wish for something, but that doesn't necessarily imply that you have capacity or competence for it. The other issue I'll point out is that capacity assessments—in medicine, we often call them that—are specific to what is being asse