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Welcome to our case series about Physician Assisted Dying. 

This is a complex issue. This case series is designed to stimulate discussion and illustrate some of the challenges we may face. 

For the purposes of this case, we will assume that legislation is now in place that allows PAD. 

You are a family physician who also covers at a small long term care residence.  One of your elderly patients, Mrs Kobiyashi Maru, with multiple chronic conditions including unresolvable severe pain and disability due to spinal stenosis, decides that physician assisted death is her desired route to die.

This facility, in accord with its mission and values, does not allow its non-physician staff to participate in any aspects of PAD.  Knowing that you and the patient are planning this mode of death (allowable under new provincial legislation), staff members – including aides, RNs, bereavement workers and pastoral care workers - are expressing concerns in case they need to respond to some aspect of the patient’s care prior to, during or immediately after the act of becoming dead via PAD.  They do not wish to abandon the patient and family in any way, but they are worried regarding their organizational commitments and worried for their jobs.