As from April 15, 2026, the following is imposed as a term, condition and limitation on the certificate of registration held by Dr. James Richard Lawrence Maclean in accordance with an undertaking and consent given by Dr. Maclean to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
(“Undertaking”)
of
DR. JAMES RICHARD LAWRENCE MACLEAN
(“Dr. MacLean”)
to
COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
(the “College”)
A. PREAMBLE
(1) In this Undertaking:
“Code” means the Health Professions Procedural Code, which is Schedule 2 to the Regulated Health Professions Act, 1991, S.O. 1991, c. 18, as amended;
“Discipline Tribunal” means the Ontario Physicians and Surgeons Discipline Tribunal of the College;
“ICRC” means the Inquiries, Complaints and Reports Committee of the College;
“IEP” means “Individualized Education Plan”;
“MAiD” means Medical Assistance in Dying;
“OHIP” means the Ontario Health Insurance Plan;
“Ontario Physicians and Surgeons Discipline Tribunal” means the Discipline Committee established under the Code;
“Practice Location” or “Practice Locations” means each and every location at which Dr. MacLean practices, delegates, or has privileges, including, but not limited to, any hospitals, clinics, offices, and any Out-of-Hospital Premises and Independent Health Facilities with which he is affiliated, in any jurisdiction;
“Public Register” means the College’s register that is available to the public.
(2) I, Dr. MacLean, certificate of registration number 32654, am a member of the College.
(3) I, Dr. MacLean, acknowledge that following two public complaints and a report regarding my standard of practice, the College conducted investigations bearing File Numbers CAS-475255-Q6L1G8, CAS-475217-D7Q0J7, and CAS-470580-J6P3Q0 (the “Investigations”) into my care of patients in my general medicine practice, including the provision of MAiD.
(4) I, Dr. MacLean, acknowledge that I entered into an undertaking with the College, dated October 1, 2025 (“the October 2025 undertaking”), in lieu of the ICRC making an order under section 25.4 of the Code. This Undertaking replaces and supersedes the October 2025 undertaking.
(5) I, Dr. MacLean, acknowledge that, in addition to accepting this Undertaking, the ICRC will also require me to appear before a panel of the ICRC to be cautioned.
B. UNDERTAKING
(6) I, Dr. MacLean, undertake to abide by the provisions of this Undertaking, effective immediately.
(7) Clinical Supervision
(a) I, Dr. Maclean, undertake to maintain a log (the “MAiD Patient Log”) of all patients for whom I act as the primary assessor for the provision of MAiD and/or to whom I intend to provide MAiD, in the form attached hereto as Appendix “A”.
(b) I, Dr. MacLean, undertake to practise under the guidance of a clinical supervisor or clinical supervisors acceptable to the College (the “Clinical Supervisor” or “Clinical Supervisors”), for at least six (6) months (“Clinical Supervision”).
(c) I, Dr. MacLean, undertake to remain free of any conflict of interest with the Clinical Supervisor.
(d) I, Dr. MacLean, acknowledge that I have reviewed the Clinical Supervisor’s undertaking, attached hereto as Appendix “B”, and understand what is required of the Clinical Supervisor. The Clinical Supervisor will, at minimum:
(i) Facilitate the education program set out in the IEP, attached hereto as Appendix “C”;
(ii) Review the materials provided by the College and have an orientation session with me, including to discuss the objectives for the Clinical Supervision;
(iii) Meet with me at my Practice Location, or another location approved by the College, once every two (2) weeks for a minimum of three (3) months (“Moderate Level Supervision”);
(iv) After a minimum of three (3) months of Moderate Level Supervision, if my Clinical Supervisor recommends and the College approves a reduction in the level of supervision, my Clinical Supervisor will meet with me at my Practice Location, or another location approved by the College, once every month for a further three (3) months (“Low Level Supervision”);
(v) Review at least fifteen (15) of my patient charts at every meeting. All charts selected for review must involve patients for whom I have completed a primary assessment for the provision of MAiD and/or to whom I intend to provide MAiD (“MAiD charts”), as identified in the MAiD Patient Log. If I have seen fewer than fifteen (15) such patients since the previous supervision meeting, the Clinical Supervisor shall review all MAiD charts that I have prepared since the previous meeting. For clarity, Moderate Level Supervision shall not end until a minimum of ninety (90) MAiD charts have been reviewed, and Low Level Supervision shall not end until an additional minimum of forty-five (45) MAiD charts have been reviewed;
(vi) Discuss any concerns arising from the chart reviews;
(vii) Make recommendations to me for practice improvements and ongoing professional development and inquire into my compliance with the recommendations;
(viii) Perform any other duties, such as reviewing other documents or conducting interviews with staff or colleagues, that the Clinical Supervisor deems necessary to my Clinical Supervision;
(ix) Submit written reports to the College at least once every month for three (3) months during Moderate Level Supervision, or until the College approves a reduction in the level of supervision to Low Level Supervision, and then once at the end of the three (3) months of Low Level Supervision, or every three months if Low Level Supervision exceeds three months, including a final report at the conclusion of Supervision. The Clinical Supervisor shall submit reports more frequently if the Clinical Supervisor has concerns about my standard of practice; and
(x) Remain free of any conflict of interest with me.
(e) I, Dr. MacLean, undertake to cooperate fully with the Clinical Supervision of my practice, conducted under the terms of this Undertaking and Appendix “B” to this Undertaking, and to abide by the recommendations of my Clinical Supervisor, including but not limited to, any recommended practice improvements and ongoing professional development.
(f) I, Dr. MacLean, undertake to ensure that Appendix “B” to this Undertaking is signed and delivered to the College within thirty (30) days of the date I execute this Undertaking.
(g) I, Dr. MacLean, undertake that if a person who has given an undertaking in Appendix “B” to this Undertaking is unable or unwilling to continue to fulfill its provisions, I shall, within twenty (20) days of receiving notice of same, obtain an executed undertaking in the same form from a similarly qualified person who is acceptable to the College and ensure that it is delivered to the College within that time.
(h) I, Dr. MacLean, undertake that if I am unable to obtain a Clinical Supervisor on the provisions set out under sections (7)(f) and/or (g) above, I will cease assessing for and providing MAiD until such time as I have obtained a Clinical Supervisor acceptable to the College.
(i) I, Dr. MacLean, acknowledge that if I am required to cease assessing for and providing MAiD as a result of section (7)(h) above this will constitute a term, condition or limitation on my certificate of registration and that term, condition or limitation will be included on the public register.
(8) Professional Education
(a) I, Dr. MacLean, undertake to participate in and successfully complete all aspects of the detailed IEP, attached hereto as Appendix “C”, including all of the following professional education (the “Professional Education”):
(i) Review, reflection, and discussion with my Clinical Supervisor of the following policies and other self-study materials:
1. Medical Assistance in Dying, College policy;
2. Legal Requirements: Medical Assistance in Dying, College document,
3. Advice to the Profession: Medical Assistance in Dying, College document,
4. Consent to Treatment, College policy;
5. Medical Records Documentation, College policy;
6. Professional Obligations: Maintaining Appropriate Boundaries, College document;
7. Professional Behaviour, College policy;
(ii) Any additional professional education recommended by my Clinical Supervisor.
(b) I, Dr. MacLean, acknowledge that the College will determine, in its sole discretion, whether I have successfully completed the Professional Education.
(c) I, Dr. MacLean, undertake to complete this requirement within three (3) months.
(d) I, Dr. MacLean, acknowledge that a report or reports may be provided to the College regarding my progress and compliance with the Professional Education.
(e) I, Dr. MacLean, acknowledge that if any of the self-study resources listed above become unavailable, substitution requests will be reviewed by the College and the College will determine in its sole discretion whether substitution is appropriate.
(9) Assessment of Practice
(a) I, Dr. MacLean, undertake that, approximately six (6) months after the completion of the Clinical Supervision set out in section (7) above and Appendix “B” to this Undertaking, and the completion of the Professional Education set out in section (8) above, I will submit to an assessment of my practice (the “Assessment”) by an assessor or assessors selected by the College (the “Assessor” or “Assessors”). I acknowledge that the Assessment will include a chart review of a minimum of fifteen (15) charts, and may include direct observation of my care, interviews with me, colleagues and co-workers, feedback from patients, and any other tools deemed necessary by the College
(b) I, Dr. MacLean, undertake to cooperate fully with the Assessment, conducted under the terms of this Undertaking.
(c) I, Dr. MacLean, acknowledge that my Clinical Supervisor may receive and review the findings of the Assessor, and may discuss with the Assessor any issues or concerns arising from the Assessment.
(d) I, Dr. MacLean, acknowledge that the results of the Assessment will be provided to me and reported to the College and the Assessment may form the basis of further action by the College.
(10) Monitoring
(a) I, Dr. MacLean, undertake to inform the College of each and every one of my Practice Locations within five (5) days of executing this Undertaking. Going forward, I further undertake to inform the College of any and all new Practice Locations within five (5) days of commencing practice at that location.
(b) I, Dr. MacLean, undertake that I will submit to, and not interfere with, unannounced inspections of my Practice Locations and patient records by a College representative for the purposes of monitoring my compliance with the provisions of this Undertaking.
(c) I, Dr. MacLean, give my irrevocable consent to the College to make appropriate enquiries of OHIP and/or any person who or institution that may have relevant information, in order for the College to monitor my compliance with the provisions of this Undertaking.
(d) I, Dr. MacLean, acknowledge that I have executed the OHIP consent form, attached hereto as Appendix “D”.
C. ACKNOWLEDGEMENT
(11) I, Dr. MacLean, acknowledge that all appendices attached to or referred to in this Undertaking form part of this Undertaking.
(12) I, Dr. MacLean, acknowledge and undertake that I shall be solely responsible for payment of all fees, costs, charges, expenses, etc. arising from the implementation of any of the provisions of this Undertaking.
(13) I, Dr. MacLean, acknowledge that I have read and understand the provisions of this Undertaking and that I have obtained independent legal counsel in reviewing and executing this Undertaking, or have waived my right to do so.
(14) I, Dr. MacLean, acknowledge that the College will provide this Undertaking to any Chief of Staff, or a colleague with similar responsibilities, at any Practice Location (“Chief of Staff” or “Chiefs of Staff”).
(15) I, Dr. MacLean, acknowledge that a breach by me of any provision of this Undertaking may constitute an act of professional misconduct and/or incompetence, and may result in a referral of specified allegations to the Discipline Tribunal of the College.
(16) I, Dr. MacLean, acknowledge that this Undertaking constitutes terms, conditions, and limitations on my certificate of registration for the purposes of section 23 of the Code.
(17) Public Register
(a) I, Dr. MacLean, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. MacLean, acknowledge that, in addition to this Undertaking being posted in accordance with section (17)(a) above, the following summary shall be posted on the Public Register during the time period that this Undertaking remains in effect:
Following two public complaints and a report regarding Dr. MacLean’s standard of practice, College investigations were conducted into Dr. MacLean’s care of patients in his general medicine practice, including his provision of MAiD. As a result of the investigations:
Dr. MacLean will practise under the guidance of a Clinical Supervisor acceptable to the College for a minimum of 6 months.
Dr. MacLean will engage in professional education in the assessment of patients for, and the provision of, Medical Assistance in Dying (MAiD), medical record keeping, professional boundaries, and professional behaviour and communication.
Dr. MacLean’s practice will be assessed by an assessor selected by the College within 6 months of the end of the period of Clinical Supervision and the completion of the professional education.
(c) I, Dr. MacLean, acknowledge that this Undertaking remains in effect until the College determines its terms are satisfied.
D. CONSENT
(18) I, Dr. MacLean, give my irrevocable consent to the College to provide the following information to any person who requires this information for the purposes of facilitating my completion of the Professional Education and to all Clinical Supervisors, and/or Assessors:
(a) any information the College has that led to the circumstances of my entering into this Undertaking;
(b) any information arising from any investigation into, or assessment of, my practice; and
(c) any information arising from the monitoring of my compliance with this Undertaking.
(19) I, Dr. MacLean, give my irrevocable consent to the College to provide all Chiefs of Staff with any information the College has that led to the circumstances of my entering into this Undertaking and/or any information arising from the monitoring of my compliance with this Undertaking.
(20) I, Dr. MacLean, give my irrevocable consent to any persons who facilitate my completion of the Professional Education, and to all Clinical Supervisors, Chiefs of Staff and Assessors, to disclose to the College, and to one another, any of the following:
(a) any information relevant to this Undertaking;
(b) any information relevant to the provisions of the Clinical Supervisor’s undertaking set out at Appendix “B” to this Undertaking;
(c) any information relevant to the Assessment;
(d) any information relevant for the purposes of monitoring my compliance with this Undertaking; and/or
(e) any information which comes to their attention in the course of providing the Professional Education and which they reasonably believe indicates a potential risk of harm to my patients.
Terms and conditions imposed on certificate by: Member