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The College of Physicians and Surgeons of Alberta (CPSA) just made a big announcement.
It has dropped plans to force doctors and other healthcare workers to participate in medically and morally problematic procedures such as abortion, assisted suicide (MAiD), and “gender-affirming” interventions by requiring them to make an “effective referral.”
This is a big win for all Alberta doctors and healthcare workers.
And, this win was made possible because so many of you took the time to contact the CPSA letting them know why this proposed policy update was a bad idea. It was also great to see so many excellent groups coming together to oppose this terrible proposal. When we work on a common goal, we achieve great things!
The Alberta Committee for Conscience Protection is calling on us to write to the College of Physicians and Surgeons Alberta (CPSA) with comments on their Consultation on the current Standard of Practice on Conscientious Objection. This consultation is open until January 10, 2024.
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The Conscientious Objection standard was last reviewed in 2016. Amendments to this standard are intended to better outline expectations for regulated members in navigating ethical dilemmas relating to personal beliefs and patient beliefs. The addition of a preamble, glossary and directions provide more context around when and how regulated members can decline to provide treatment and what must be provided for the patient to ensure they continue to receive high quality care. |
What’s changed?
- Addition of a preamble and glossary to provide context for the standard and more detailed definitions;
- Inclusion of clarifying language to better communicate the balance between a regulated members’ right to limit health service based on reasons of conscience, cultural belief or religion and patients’ rights to timely access to safe, high-quality care;
- Section added to clearly break down permitted and prohibited actions with a focus on reducing risk of harm and maintenance of respect for patient;
- Expansion of the related standards of practice and addition of companion resources to better support regulated members.
One of the concerns expressed by the Alberta Committee for Conscience Protection is around "effective referral". The glossary of the Model Practice Standard proposed by Health Canada defines:
Effective referral: taking positive action to ensure the person requesting MAID is connected in a timely manner to a non-objecting, available, and accessible physician or nurse practitioner, other health-care professional, or [name of agency, program, office responsible for patient navigation] that provides the health service (eligibility assessments for, and provision of, MAID) or connects the person directly with a health-care professional who does. ‘Timely manner’ means such that the person will not experience an adverse clinical outcome or prolonged suffering due to a delay in making the connection. [Note to users: delete this definition if the regulatory authority uses wording of effective transfer of care instead of effective referral]
Effective transfer of care: a transfer made by one physician or nurse practitioner in good faith to another physician or nurse practitioner who is available to accept the transfer, accessible to the person requesting MAID, and willing to provide MAID to that person if the eligibility criteria are met. [Note to users: delete this definition if the regulatory authority uses the wording of effective referral instead of effective transfer of care]
For further information, please read the points below and the drafts at https://cpsa.ca/physicians/standards-of-practice/consultation/consultation-028/028-conscientiousobjection (you can also read comments from other Albertans there and add your own). Feedback may be provided via survey, email or the comment form on each page.
Alberta Committee for Conscience Protection
Talking Points on the College of Physicians and Surgeons of Alberta (CPSA)
Draft Standard of Practice on Conscientious Objection Consultation 028
As many of you are aware, the CPSA has invited comments on their Consultation on the current Standard of Practice on Conscientious Objection. This consultation is open to CPSA members, partner organizations, other healthcare professionals and Albertans until January 10, 2024. We are hoping that we can send a clear message to the CPSA Council that the introduction of the term “effective referral” that was added to the draft policy is not acceptable to many physicians and concerned members of the public. This new term is borrowed from the Model Practice Standard proposed by Health Canada, and in Alberta we already have a solid framework for patients to access services they are looking for without requiring an “effective referral.”
We propose the following revisions to the draft Standard of Practice:
- Section 1.f. could be revised as “Proactively maintain a non-judgmental approach and be aware of resources to provide for frequently requested services they are unwilling to provide.”
- Section 2.c. should be removed due to lack of clarity.
- If a patient were to experience pain while waiting for MAID, this could be claimed an adverse clinical outcome. Although the procedure sought out should not be impeded as in 2c, there are a lot of subjective possibilities that could emerge from so-called "exposures" from "delayed effective referral."
- Specifically, “adverse clinical outcomes” and “delayed” are not objectively defined and are open to wide subjective interpretation.
- "Delayed" is not clearly defined either and in many ways the seeking of care is dependent on what the patient decides to do after visiting a provider.
- Many psychiatrists have warned that it will be extremely difficult for physicians to discern which patients are making a fully informed, consensual decision to pursue MAID and which are not.
Other talking points
- It needs to be clearly stated, whether in this policy or for the understanding of the draft standard committee, that a member who declines to provide a service (e.g. MAID) or a referral for the same (while still providing resources) is doing so because they believe it is in the best interest of the patients. Their care of the patient compels them down this path. A sober second thought on the part of a provider who wants to provide a variety of different perspectives may allow a patient to see their concerns from a new or different angle and can be a source of support for that patient.
- Many from the disability community have called for safe spaces where they know the practitioner sees their life as worth living and wouldn’t agree to end their lives when they are at a low point.
- Since "effective referral" has been introduced in other provinces, many providers have left, retired early, or sought registration in Alberta because of our more reasonable conscience objection standard. Adopting this language from other provinces potentially exposes our system to further loss of providers who would be frustrated with the addition of this wording.
- It should be emphasized that the Supreme Court gave its assurance that nothing in its original ruling on the constitutionality of MAID “…would compel physicians to provide assistance in dying.” Participation through an effective referral would directly involve physicians in MAID to which many of us are opposed.
- The government and College does not want to micro-manage the doctor-patient relationship but does expect non-judgmental professionalism adhering to obligations
- Based on opinion polling, many Canadians are concerned about compelling physicians to do something they are not comfortable with, e.g. "54 percent of Canadians give “quite a lot” or a “great deal” of weight to the concern that the confidence of patients in doctors could be compromised, given that patients look to doctors “to heal, comfort, and fight for them.” Sixty-three percent of visible minorities share this concern.
- This is not about competing rights but about mutual freedoms. It is not about limiting access but about redirection to different resources. In reality, patients' and physicians' rights are not opposed. The patient and physician work together as a team and navigate medical decisions in a shared decision making framework.
- Conscience is not an expression of a physician’s personal preference, it is a judgment based on what the physician feels is in the patient’s best interest. Patients and physicians disagree on a regular basis on a large number of issues, and these usually do not come to the point of conflict; they are usually resolved in professional and friendly ways.
- Physicians are not solely responsible for ensuring access to medical assistance in dying. CMAJ February 20, 2018 190 (7) E181; DOI: https://doi.org/10.1503/cmaj.180153
- "The responsibility to ensure access to MAID does not rest with an individual physician, but with society. Recognizing this, most provinces have developed access programs for MAID... When it comes to MAID, balancing the rights of physicians and patients is not an easy task, but both deserve protection."While this standard emphasizes the right of a physician, it also needs to consider the fact that many patients want providers whose values fit with theirs, and a large group of patients want to be served by providers who decline to offer certain procedures like MAID. Finding the right physician fit requires a diverse medical system with a variety of different providers with different opinions.
The above talking points are for reflection and to help formulate comments in your own words, using resources and references that you are familiar with. Please complete the online form here (https://cpsa.ca/physicians/standards-of-practice/consultation/consultation-028/028-conscientiousobjection/), or by email on the same page.
– Alberta Committee for Conscience Protection
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Together with the Canadian Conference of Catholic Bishops (CCCB), Bishop McGrattan is urging the faithful to continue to oppose the expansion of MAiD in Canada. The CCCB has just issued an Open Letter to the Government of Canada and a Message to the Catholic Faithful on May 9 re: Permitting Persons Living with Mental Illness to Access Euthanasia/Assisted Suicide. We ask you to share the Bishop's message and provide your parishioners with access to the CCCB letters below.
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Written by Calgary Pastoral Centre
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In November 2021, the Canadian Conference of Catholic Bishops (CCCB) launched Horizons of Hope: A Toolkit for Catholic Parishes on Palliative Care. The launch marked the culmination of a four-year process whereby the CCCB partnered with experts from Pallium Canada, Dominican University College, the Canadian Catholic Bioethics Institute, Catholic Health Alliance of Canada, and the Congregation of the Sisters Saint Joseph in Canada. This partnership ensured the development of a high-level resource that will benefit Catholic parishioners eager to grow in their understanding of palliative care and Church teaching on end-of-life questions. Promo Video - English | French
This toolkit seeks to offer support and formation for parishioners with faith communities to assist them when faced with the illness and death of loved ones, particularly through the lens of palliative care, faith and Compassionate Communities.
The toolkit is available in French and English. Key features include a detailed facilitator's guide, four modules organized in a step-by-step learning process, videos, and take-home resources. The entire toolkit is available on the CCCB website at https://www.cccb.ca/faith-moral-issues/suffering-and-end-of-life/horizons-of-hope-a-toolkit-for-catholic-parishes-on-palliative-care.
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7 proven ways to protect against cognitive decline
If you’re nearing old age, or have a family history of dementia, you’ve probably started to wonder, “What can I do to keep my mind healthy as I grow old?”
Of course, there’s only so much anyone can do to protect against cognitive decline. Genetics and other factors outside our control play such a big role.
But it turns out there are certain things that do make a difference. Researchers have identified some straightforward strategies to stave off cognitive decline as a person grows older.
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And it turns out, keeping church and prayer commitments is an important part of it.
Here are 7 things you can do now to protect your brain as you age. (You might be pleasantly surprised to find that you’re already doing some of them!)
- Take a walk
Regularly going on a walk is one of the most reliable ways to keep your brain sharp as you age. Enjoy a scenic forest path, or simply stroll your neighborhood!
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Spend time with your friends
While you’re walking, invite a friend along. Maintaining strong social networks is
linked to slower cognitive decline.
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Read a book
Frequent reading is
protective of cognitive function in later life. Consider joining or starting a book club to get the benefits of friendship and reading at the same time!
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Spend time with your family
Living near family as you age imparts 4 to 6 years of extra life expectancy, and it’s good for your grandchildren or great-grandchildren, who have lower rates of mortality and lower rates of disease. This is called the
“grandmother effect.”
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Keep holy the Sabbath
Belonging to a faith-based community and attending services about 4 times a month
“is worth between four and 14 extra years of life expectancy.” Who knew going to church was
so good for you?
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Talk to God
Praying regularly is
associated with lower risk of mild cognitive impairment.
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Eat fish and vegetables
A Mediterranean diet has been associated with longevity for a long time. Now
researchers have found that it’s specifically the prevalence of fish and vegetables in this diet that is so beneficial.
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- Blessed are you who listen to your patients, especially those with constant complaints, for you possess the ears of Christ.
- Blessed are you who see the hurts of your patients, especially those overlooked by others, for you possess the eyes of Christ.
- Blessed are you who speak kindly to your patients, especially those plagued by fear or anger, for you possess the mouth of Christ.
- Blessed are you who touch your patients gently, especially those bruised by insensitivity, for you possess the hands of Christ.
- Blessed are you who think prayerfully of your patients, especially those alone and discouraged, for you possess the mind of Christ.
- Blessed are you who show love to your patients, especially those with chronic illness, for you possess the heart of Christ.
- Blessed are you who walk tirelessly to your patients, especially those with repeated calls, for you possess the feet of Christ.
- Blessed are you who persevere in your ministry, especially with compassion to all patients, for you possess the healing presence of Christ, and yours is the kingdom of heaven.
(Caring for the Sick and Elderly; A Parish Guide by Sr. Marie Roccapriore MPF)
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- Blessed are those who sleep poorly because they are worried about their loved one or because their loved one wakes in the middle of the night and needs help, for theirs is the kingdom of heaven.
- Blessed are those who mourn because their loved one, though still alive, is slipping away because of dementia, for they will be comforted.
- Blessed are the meek who force themselves to speak up and speak out to make sure their loved one receives the help he or she needs, for they will inherit the land.
- Blessed are those who hunger and thirst for answers to why this is happening to their loved one and how much longer it will go on, for they will be satisfied.
- Blessed are those who show mercy, kindness and compassion to their loved one, for they will be shown mercy, kindness and compassion.
- Blessed are those who keep clean a loved one who is physically or mentally unable to keep himself or herself clean, for they will see God.
- Blessed are those who help their loved one find moments of peace, for they will be called children of God.
- Blessed are those who are misunderstood, not appreciated, and taken for granted in their role as caregiver, for theirs is the kingdom of heaven.
- Blessed are those whose caregiving efforts are unjustly criticized—or who are falsely accused of not caring about others—because of your love for your care-receiver and your love for God, who has asked you to help His beloved son or daughter. Rejoice and be glad, for your reward will be great in heaven.
Monica Dodds
(catholicherald.com/stories/Thebeatitudes-and-a-prayer-for-caregivers, 26621)
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The League is a proud supporter of the Canadian Blood Services Partners for Life program. New and regular blood donors are asked to consider registering for the program under the League’s unique partner identification number (CATH011269). Visit www.blood.ca/joinpartnersforlife for more information. Encourage members to donate and use the identification number.
Source: https://cwl.ca/communique-02-education-and-health
Following is a step by step guide to registering as a member to your Partners for Life team:
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The Diocese has a video series on the Catholic Response to Medical Assistance in Dying (MAID), presenting Bishop William McGrattan, Dr. Eric Wasylenko and Fr. Cristino Bouvette. Both Bishop McGrattan and Dr Wasylenko presented on this subject at our 2018 Diocesan CWL Convention.
Moral Theology of Catholic Decision Making
The legalization of Euthanasia in Canada is of concern to all Catholics, not only those employed in the medical profession. As euthanasia (often termed Medical Assistance in Dying or MAID) involves the intentional taking of a person’s life, it presents a challenge for all who are committed to upholding the dignity of life and protecting the most vulnerable in our society. In a thoughtful and considered presentation which is of significance to all who are committed to living the Gospel message faithfully, Bishop William McGrattan of the Diocese of Calgary, Alberta, identifies the many spiritual concerns which flow from the legalization of euthanasia – including many you may not have previously considered.
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At the CWL 96th Annual Calgary Diocesan Convention, held at the Badlands Community Facility in Drumheller, Alberta from May 4, 5 & 6, 2018, over 150 members responded to two questions on supporting palliative care. The responses are varied and are important to share with all CWL members in the Diocese of Calgary. Some of these ideas presented are already being implemented by a council and some are planned for the future. All of our councils could consider attempting one or two, as we use this list to challenge ourselves and our councils. They are numbered, not to rank importance, but to make it easy for you to share your thoughts with others.
WAYS MY COUNCIL COULD SUPPORT HOSPICE PALLIATIVE CARE INITIATIVES IN OUR COMMUNITY:
- Prayer service for palliative persons.
- Participate on pastoral care team.
- Raise funds for palliative care.
- Take turns visiting.
- Offer a cross for a palliative care room.
- Advocate for mental health support for family.
- Donate comfort items.
- Donate personal items.
- Take sacraments to hospice.
- Offer to pray with a person when visiting.
- Pray as a council for palliative care.
- Visit and share a meal with person (if possible).
- Bring in a pet (if possible).
- Take person outside – walk or wheel around.
- Volunteer as a palliative care worker.
- Consider an annual donation to palliative care.
- Support the CWL initiative to lobby the government for better and more facilities for palliative care – write letters, send cards, participate in “12 hours of prayer for palliative care”.
- Provide spiritual support to a person – rosary, prayer cards, music, Divine Mercy Chaplet.
- Participate if the hospice in your community hosts an event for the public.
- Participate in education about palliative care (speakers, discussions, etc.) in your council, church and community
- Provide “treats” or cards of encouragement for staff of palliative care facilities, share appreciation.
- Sponsor a Mass of thanksgiving for those who serve in palliative care whether in a facility or in their homes.
- Make lap quilts or prayer shawls.
- Focus on those in care without family in the area.
- In 2’s or 3’s visit a palliative care centre.
- As a council, do a tour of a hospice (if possible).
- As a Council, make up a list of resources (211 can help) and have this list available for families with someone in palliative care or caregivers.
- We can publicly make our feelings as a large organization known.
- Speak about palliative care to family, friends, acquaintances, whenever the topic comes up. Don’t be afraid to speak up.
- Our Council makes “worry dolls” for Agape Hospice. Those are given to children as they visit either a parent or grandparent who is a patient.
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