Doctor disciplined after assessing patient's assisted suicide eligibility at a coffee shop

A Canadian physician has been placed under supervision following concerns from medical regulators after he assessed a patient who applied for Medical Assistance in Dying at a coffee shop and failed to administer a neuromuscular-blocking medication to a second patient. 

The College of Physicians and Surgeons of Ontario (CPSO) placed Dr. James MacLean of Ontario under three months of moderate supervision followed by three months of low supervision because of concerns related to his conduct in two separate 2024 cases involving individuals seeking to hasten their deaths through physician-assisted suicide.

While the patients' names were not disclosed in public documents, The Globe and Mail reported last week that one patient was a 45-year-old man named Thomas Dillon who had Crohn's disease. Medical records also show that Dillon had a history of alcohol abuse, depression and suicidal ideation.

MacLean and a nurse practitioner determined that Dillon's Crohn's disease made him eligible for MAID.

According to medical records and the college's decision, which Dillon's family provided to The Globe and Mail, MacLean conducted Dillon's eligibility assessment outside a Tim Hortons coffee shop on June 27, 2023.

The doctor also exchanged dozens of text messages with Dillon and drove him in January 2024 to the location in London, Ontario, where he would undergo the procedure that ended his life.

MacLean administered the lethal medications at a facility where cadavers are prepared for transport to funeral homes, according to the report.

In Dillon's case, the Inquiries, Complaints and Reports Committee expressed concern about MacLean "discussing sensitive MAID-related matters in an informal public setting."

The committee also stated that the doctor's text messaging with Dillon "went beyond" what was expected to arrange the procedure. In addition, the committee said MacLean's decision to drive Dillon to the location raised concerns about professional boundaries.

"Taken together, these actions created a risk that [MacLean's] involvement could be perceived as influencing the patient," the committee stated.

In the second case, CPSO said MacLean administered an anesthetic to a 67-year-old cancer patient but failed to administer the neuromuscular-blocking medication typically used in assisted death because he could not locate it in his briefcase.

After administering the anesthetic, MacLean pronounced the patient dead because he could not detect a heartbeat. The doctor left the patient's home, but the patient later resumed spontaneous breathing.

MacLean returned and administered additional medication, including the neuromuscular-blocking agent. He then pronounced the patient dead a second time.

The committee found that some aspects of MacLean's conduct "departed from these expectations," citing his failure to administer the full medication protocol.

"Taken together, these issues raised serious concerns about [MacLean's] judgment, adherence to procedure, and patient safety in the provision of MAID," the report stated.

In both cases, however, CPSO determined that MacLean "demonstrated some appropriate reflection" in his responses to the complaints and "committed to implementing certain changes," while emphasizing the need for improvement.

"The committee therefore concluded that [MacLean] would benefit from a discussion with his peers and that it was appropriate to caution [MacLean] with respect to his MAID practice," the report concluded.

Canada's expansion of its MAID laws has received significant criticism, including from the United Nations Convention on the Rights of Persons with Disabilities. In an April 2025 report, the convention said it was "extremely concerned" about 2021 amendments to Canada's Criminal Code enacted through Bill C-7.

In 2021, Canada passed legislation expanding physician-assisted suicide eligibility to some individuals who do not have a terminal illness, including those suffering from chronic pain.

According to the Canadian government's November 2025 report, "Sixth Annual Report on Medical Assistance in Dying in Canada," 16,499 people ended their lives through medically assisted suicide in 2024. The report states that medically assisted suicides accounted for 5.1% of all deaths in Canada that year.