Public Release: 

Physician-assisted death should be listed on medical certificates of death in Canada

Canadian Medical Association Journal

Physician-assisted death should be recorded on medical certificates of death in Canada in the event that assisted dying becomes legal, according to an analysis in CMAJ (Canadian Medical Association Journal).

There is no uniform medical certificate of death used across Canada, although all of the 12 provinces and territories included in the analysis require that immediate cause of death and underlying and other antecedent cause(s) of death be stated.

The authors recommend that in the event of legal assisted death, the physical consequences of the injection or consumption of lethal drugs should be listed as the immediate cause of death. The medical condition that made the person eligible for physician-assisted death, such as lung cancer, should be listed as the underlying cause of death and injection or consumption of lethal drugs as a subsequent antecedent cause.

"Although some questions will arise from the decriminalization of physician-assisted death ..., questions about medical certificates of death can and should be answered by reference to and reliance on established principles and practice," write Dr. Jocelyn Downie, Faculties of Law and Medicine, and Kacie Oliver, Faculty of Medicine, Dalhousie University, Halifax. "It should highly desirable that the approach to medical certificates of death taken in the context of physician-assisted death be harmonized with the vital statistics registrars across all provinces and territories."


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