The College of Physicians and Surgeons of Ontario (CPSO) imposed “extensive oversight and monitoring requirements” on Dr James MacLean’s practice in Ontario, Canada, following two complaints
A doctor who euthanised a man with Crohn’s disease after giving him a quick medical assessment outside a fast food restaurant has been suspended.
Dr James MacLean, from London, Ontario, in Canada, was investigated by police following allegations that he improperly administered Medical Assistance in Dying (MAID) the country’s assisted dying procedure, to two patients. He is said to have assessed one of the two, Thomas Dillon, after offering a medical assessment outside a Tim Horton’s fast food restaurant.
Mr Dillon was assessed by the doctor in June 2023, and found eligible euthanasia under MIDA “track 2”, reserved for patients who aren’t expected to die immediately but are suffering from an incurable condition.
Dr MacLean is now under “extensive oversight” reportedly exchanged dozens of texts with Mr Dillon about the plans, and even drove his patient to a morgue on the day the procedure was done.
Mr Dillon died in June 2024 inside an industrial unit holding facility housing human cadavers being prepared for burial after being administered a lethal cocktail of drugs, according to a committee at the College of Physicians and Surgeons of Ontario (CPSO) cited by the Globe and Mail.
The committee found that the doctor’s frequent text messages to Mr Dillion and his decision to drive the patient to the morgue “created a risk that (MacLean’s) involvement could be perceived as influencing the patient”.
A second complaint submitted to the CPSO detailed the case of a cancer patient receiving end-of-life care who had signed a “waiver of final consent” allowing him to receive MAID as his natural death was reasonably foreseeable. The man lost capacity and became unresponsive before the chosen date, and Dr Maclean was called to the home, arriving with a MAID kit.
At the home, the college said, the doctor administered a sedative, then surgery drug propofol, which induces comas in high doses that are so severe they halt breathing.
He was also meant to administer a neuromuscular-blocking drug in his kit, but was unable to find it, the commitee heard. They were also told that shortly after administering the propofol, the doctor was unable to detect a heartbeat and pronounced the patient dead, and he then left their property. But he was forced to return when “the patient resumed spontaneous breathing”, administer more medication and a paralyzing agent he had not used before, and again pronounce his death.
The college committee said MacLean advised the stress of the situation had caused the initial MAID failure, but the patient’s family later complained about MacLean’s professionalism and communication.
Dr MacLean was verbally “cautioned” before the committee with respect to the complaints, and his practice has been subject to mandatory clinical supervision for at least six months. The agreement is part of an “undertaking” with the college, which will also see his MAID patient charts, MAID-related mandatory professional education, consent, documentation, professional boundaries and professional behaviour.
College spokesperson Mickey Cirak said in a statement: “The undertaking imposes extensive oversight and monitoring requirements on Dr MacLean’s practice.
“The measures include mandatory clinical supervision for a minimum of six months, frequent supervision meetings, ongoing review of his MAID patient charts, regular written reports to (the College of Physicians and Surgeons of Ontario) from the clinical supervisor, and completion of mandatory professional education relating to MAID, consent, documentation, professional boundaries, and professional behaviour.”
Dr MacLean said in a statement to the Globe and Mail: “Due to the rules regarding privacy and my professional responsibilities to the CPSO regarding confidentiality of complaint investigations, I am unable to respond.”
