Dr. James MacLean, a physician from London, Ontario, has been formally cautioned by the College of Physicians and Surgeons of Ontario (CPSO) following two troubling cases involving medical assistance in dying (MAID). The doctor agreed to a six-month supervision undertaking after concerns were raised about his conduct, including assessing a 45-year-old patient outside a Tim Hortons and personally driving him to the MAID site, despite family objections.
Botched MAID procedure
In a more disturbing incident, MacLean provided MAID to a cancer patient without one of the three required medications, as he could not locate it in his briefcase and the pharmacy kit was not ready. After pronouncing the patient dead and leaving the home, he was called back when the patient suddenly began breathing. He returned to administer additional drugs, including the missing neuromuscular blocker, and pronounced the patient dead a second time.
An independent assessor found that MacLean's conduct fell below professional standards in five out of 20 charts reviewed, displaying a lack of judgment and exposing patients to harm. The CPSO's Inquiries, Complaints and Reports Committee noted that MacLean appeared too quick to approve MAID, undermining the independence of secondary assessors and risking coercion.
Assessment at Tim Hortons
Thomas Dillon, a 45-year-old former skydiver, was assessed by MacLean and a nurse practitioner outside a coffee shop. Dillon suffered from inflammatory bowel disease and mental health issues. The committee criticized this public assessment as lacking the required formality and care. MacLean also exchanged numerous texts with Dillon, including negative comments about the patient's family opposing MAID, and personally drove him to the MAID location, which the committee found could be perceived as influencing the patient.
Dillon's family told the Globe and Mail they did not believe he should have qualified for MAID. MacLean can continue to provide MAID despite the caution, but his practice will be monitored.
