On Aug. 14, 2015, the Ontario Ministry of Health and Long-Term Care announced a new provincial/territorial expert advisory panel on physician-assisted dying. The OCFP certainly welcomes ongoing discussion and debate on the important issues relating to end of life and physician-assisted dying, and we are optimistic that the new provincial/territorial expert advisory panel will move this discussion forward.

Family physicians, together with other health-care professionals and volunteers, play a significant role in providing end-of-life care in Canada, and since the Supreme Court of Canada ruling was issued in February many family physicians have been waiting to hear what this will mean for them, their patients and families. The expert advisory group will provide advice about policies, practices and safeguards that need to be in place when physician-assisted dying is legalized in provinces and territories.

OCFP members have been actively engaged for years in shaping how hospice palliative care can be improved in Ontario.

• In 2009, the OCFP and Cancer Care Ontario produced a summary of results from a strategy development workshop on improving high-quality hospice palliative care.
• OCFP Past President Dr. Sandy Buchman represented the OCFP on the Quality Hospice Palliative Care Coalition of Ontario and together with many other partners helped to develop a roadmap for an integrated system of palliative care in Ontario through the Declaration of Partnership - Advancing High Quality, High Value Palliative Care in Ontario. Dr. Buchman was also the Lead for Primary Care Engagement Palliative Care with Cancer Care Ontario advancing the work identified in the Declaration.
• A clinical council launched in 2014 and co-chaired by Dr. Denise Marshall and Dr. Jeff Myers made great headway to develop provincial clinical standards - Essential Provincial Clinical Standards (PCSs), review of clinical tools, best practices and changes needed in the clinical environment to ensure patients and families can access programs and services. See OCFP President Dr. Cathy Faulds' May Newsbrief for more details.
• More recently, the OCFP held meetings with Dr. Buchman, Dr. Marshall, Dr. Myers and Cancer Care Ontario to identify opportunities to support palliative care education for family physicians.
• The OCFP is also collaborating with Pallium Canada to support the delivery of Learning Essential Approaches to Palliative and End-of-Life Care (LEAP) training. LEAP courses will be offered soon by the OCFP.
• In early August 2015, Dr. Cathy Faulds and members of the OCFP team attended stakeholder sessions with Parliamentary Assistant John Fraser to discuss palliative care with a focus on equitable access and integration, supporting service capacity and public awareness. Participants reinforced the need to continue to implement the roadmap set out in the Declaration of Partnership.

The OCFP looks forward to working with the participating provinces and territories to bring the family medicine perspective to this critical debate and we will work with our colleagues at the Ontario Medical Association and Section on General and Family Practice, the College of Physicians and Surgeons of Ontario and other partners to ensure we provide you with up-to-date information as this issue progresses.

Additionally, in the fall of 2015 the CFPC will release a guide for reflection on ethical issues concerning assisted suicide and euthanasia. Not only do we hope that this paper will give family physicians some needed guidance, but that it can help inform the deliberations of the new provincial/territorial expert advisory group.

Members of the expert advisory group include patient, health care, ethics and legal experts from across Canada. The group is expected to complete its final report before the end of 2015. Federal, provincial and territorial governments have until February 2016 to implement responses in advance of the Supreme Court's decision taking effect.

Expert advisory group members:

• Dr. Jennifer Gibson (Co-Chair) - Director of the University of Toronto Joint Centre for Bioethics
• Maureen Taylor (Co-Chair) - Physician Assistant in Infectious Diseases and Medical Journalist
• Dr. Doug Cochrane - Patient Safety and Quality Officer for British Columbia and Chair of the BC Patient Safety and Quality Council
• Dr. Jocelyn Downie - Professor in the Faculties of Law and Medicine at Dalhousie University
• Ruth Goba - Interim Chief Commissioner of the Ontario Human Rights Commission
• Dr. Nuala Kenny - Professor Emeritus of Bioethics at Dalhousie University and Former Ethics and Health Policy Advisor to the Catholic Health Alliance of Canada
• Arthur Schafer - Director of the Centre for Professional and Applied Ethics at the University of Manitoba
• Dr. Trevor Theman - Registrar of the College of Physicians and Surgeons of Alberta
• Dr. Karima Velji - President of the Canadian Nurses Association and Integrated Vice President, Mental Health Services, for London Health Science Centre and St. Joseph's Health Care London