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Better palliative care essential as Canada considers medically assisted death for youth, pediatricians say

The Canadian Paediatric Society is urging improved palliative care for children and youth as a key part of preparing for the possibility of legalizing medical assistance in dying for certain patients under age 18.

“Medical assistance in dying is something that has been legislated [for adults] and stated [as] needing to be accessible … but there isn’t the same ‘oomph’ for saying that all Canadians need good access to palliative care,” said Dr. Dawn Davies, chair of the society’s bioethics committee and a pediatric palliative care physician in Edmonton, in an interview with CBC News.

Dr. Dawn Davies

Dr. Dawn Davies, lead author of a new report from the Canadian Paediatric Society, says pediatricians in Canada are divided over the prospect of extending the option of medically assisted death to terminally ill patients under 18. (Canadian Paediatric Society)

“Where the issue of medical assistance in dying is ever raised by a child, you know, we would advocate that that should automatically be a referral for pediatric palliative care.”

When Bill C-14, the law governing medically assisted dying for adults, was passed in June 2016, it included a requirement that the ministers of justice and health initiate an independent review on whether “mature minors” — youth under age 18 but deemed capable of giving consent — should be eligible for medically assisted death. That review is expected to be presented to Parliament by December 2018.

Davies, who is chairing the working group on mature minors as part of that review, is the lead author of a report released by the Canadian Paediatric Society on Thursday. The report made the palliative care recommendation and also summarized the results of surveys asking pediatricians about their views on making assisted death available to terminally ill young patients, and whether they had received any inquiries or requests about it.

Much like broader Canadian society, pediatricians are divided on the issue, Davies said.

17 minors asked for assisted death

Almost half the respondents surveyed (46 per cent) said they were in favour of extending assisted death to mature minors “experiencing progressive

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