In a prestigious medical journal, doctors from Toronto’s Hospital for Sick Children have laid out policies and procedures for administering medically assisted death to children, including scenarios where the parents would not be informed until after the child dies.
The article appears just three months before the Canadian Council of Academies is due to report to Parliament on the medical consensus about extending voluntary euthanasia in circumstances currently forbidden by law. The Canadian Council of Academies is specifically looking at extending so-called assisted dying to patients under 18, psychiatric patients and patients who have expressed a preference for euthanasia before they were rendered incapable by Alzheimer’s or some other disease.The Sept. 21 paper written by Sick Kids doctors, administrators and ethicists was published in the British Medical Journal’s J Med Ethics and backed by the University of Toronto’s Joint Centre for Bioethics.
In a flowchart that outlines how a medically induced death would occur at Sick Kids, authors Carey DeMichelis, Randi Zlotnik Shaul and Adam Rapoport do not mention conversation with family or parents about how the child dies until after the death occurs in the “reflection period.”
Patient confidentiality governs the decision about whether or not to include parents in a decision about an assisted death, the authors said. If capable minors under the age of 18 stipulate they don’t want their parents involved, doctors and nurses must respect the patients’ wishes.
“Usually, the family is intimately involved in this (end-of-life) decision-making process,” they write. “If, however, a capable patient explicitly indicates that they do not want their family members involved in their decision-making, although health care providers may encourage the patient to reconsider and involve their family, ultimately the wishes of capable patients with respect to confidentiality must be respected.”
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