MANDEL: London, Ont. doc 'cautioned' for assessing patient for MAID outside Tim Hortons
· Toronto Sun
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It’s almost as frightening as a drive-thru, on-demand service for medical assistance in dying.
Dr. James MacLean, of London, Ont. has been cautioned by the College of Physicians and Surgeons (CPSO) and agreed to an undertaking of six months supervision over concerns about his administration of MAID — including assessing a 45-year-old patient outside a Tim Hortons in St. Thomas and personally driving him to the site in London where he provided him with the drugs that ended his life — despite his family’s objection.
Even more disturbing was his provision of MAID to a cancer patient without one of the usual three medications because he couldn’t find it in his briefcase and the MAID kit he’d ordered from the pharmacy wasn’t ready in time. After pronouncing the man dead and leaving the home, MacLean was called back after the patient suddenly started breathing. The doctor returned to administer more drugs, including the missing neuromuscular-blocking medication, and pronounced him a second time.
Imagine the horror of that patient’s family in witnessing the botched process in what was supposed to be a dignified way to die.
According to a March report by the CPSO’s Inquiries, Complaints and Reports Committee, the two MAID complaints against MacLean led to an investigation by an independent assessor who found he “did not meet the standard of practice of the profession, displayed a lack of judgment, and that his conduct exposes or is likely to expose patients to harm or injury in five out of twenty charts reviewed.”
It sounded like the doctor was too quick to sign off on MAID: the assessor found he was “proceeding with assessments and provisions in a manner that undermines the independence of secondary assessors and risks coercion and making clinical assumptions without adequate corroboration when assessing a patient for MAID.”
The assessor also found he should have waited for the proper MAID kit from the pharmacy and he failed to maintain professional boundaries and engaged with patients and families “in ways that can be perceived as coercive or unprofessional.”
Nearly 5,000 MAID deaths in Ontario in 2024
First legalized in Canada in 2016, there were just under 5,000 MAID deaths in Ontario in 2024. Only medical practitioners can assess and approve an application and to be eligible, the person must either be suffering from a serious illness, disease or disability that causes unmanageable physical or mental suffering.
Another controversial track — for those who suffer from mental illness alone — has been delayed until March 2027.
Thomas Dillon, according to his obituary, was a former skydiver who died peacefully on Jan. 29, 2024 in his 46th year. His family told the Globe and Mail they didn’t believe he should have qualified for MAID.
In its decision, the committee said Dillon suffered from inflammatory bowel disease, associated surgeries, and mental health concerns. After he applied for MAID, MacLean and a nurse practitioner assessed him outside a coffee shop and found him eligible under Track 2, which is designed for people whose death is not reasonably foreseeable, but who suffer intolerably from a grievous and irremediable medical condition.
Not surprisingly, the committee was concerned about the doctor’s choice of assessing Dillon in public, finding this “reflected a lack of the level of formality and care expected when assessing requests for MAID.”
They were also “troubled” by MacLean’s many texts with Dillon that followed — including negative commentary on his family being opposed to him choosing MAID — and the doctor’s decision to personally drive him to the MAID location.
“Taken together, these actions created a risk that the Respondent’s involvement could be perceived as influencing the Patient,” especially with someone who had mental health issues, the committee said.
As for the cancer patient’s first failed MAID attempt, the committee said MacLean blamed stress, including the last‑minute and urgent request for his attendance and the substantial number of people present.
The committee concluded MacLean should be formally cautioned as he lacked insight into how certain aspects of his care and conduct required further improvement — but MacLean, who has declined media requests for comment, can continue to provide medical assistance in dying.