As from October 1, 2025, 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;
“ICR Committee” means the Inquiries, Complaints and Reports Committee of the College;
“MAiD” means Medical Assistance in Dying;
“Primary Assessment” means an assessment carried out with the intention of subsequently providing MAiD to the patient if they are found eligible and consent to proceed;
“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 the College has received information regarding my standard of practice and that the College is conducting an investigation, bearing File Number CAS-475255-Q6L1G8, into the information. I am aware of the College’s concern about protecting the public.
(4) I, Dr. MacLean, acknowledge that the College has accepted this Undertaking in lieu of making an Order under section 25.4 of the Code at this time.
(5) I, Dr. MacLean, acknowledge that this Undertaking does not preclude the ICR Committee from making an order at a later date in accordance with the Code.
(6) I, Dr. MacLean, acknowledge that this Undertaking continues in force until the matters currently being investigated are disposed of by a panel of the ICR Committee or the Discipline Tribunal.
B. UNDERTAKING
(7) I, Dr. MacLean, undertake to abide by the provisions of this Undertaking, effective immediately.
(8) Clinical Supervision
(a) I, Dr. MacLean, undertake to maintain a log (the “MAiD Patient Log”) of all patients for whom I complete a primary assessment 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”), (“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) Meet with me at my Practice Location, or another location approved by the College, once every two weeks;
(ii) At each meeting, review and discuss the patient chart and treatment plan for each patient in my MAiD Patient Log who, since the previous meeting, I have found eligible for MAiD and/or to whom I intend to provide MAiD. For greater clarity, for each patient, such review need only occur once, after I find the patient eligible for MAiD and/or form the intention to provide MAiD;
(iii) Discuss any concerns arising from the chart reviews;
(iv) 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;
(v) Submit written reports to the College at least once every month, or more frequently if the Clinical Supervisor has concerns about my standard of practice; and
(vi) Remain free of any conflict of interest with me.
(e) I, Dr. MacLean, undertake not to provide MAiD to a patient unless my Clinical Supervisor has reviewed the relevant patient chart and approves of my treatment plan.
(f) I, Dr. MacLean, undertake to cooperate fully with the Clinical Supervision of my practice, conducted under the term of this Undertaking and Appendix “B” attached, and to abide by the recommendations of my Clinical Supervisor, including but not limited to, any recommended practice improvements and ongoing professional development.
(g) I, Dr. MacLean, undertake to ensure that Appendix “B” to this Undertaking, is signed and delivered to the College within twenty (20) days of the date I execute this Undertaking.
(h) 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.
(i) I, Dr. MacLean, acknowledge that if I am unable to obtain a Clinical Supervisor on the provisions set out under sections (8)(g) and/or (h) above, I will cease assessing for and providing MAiD until such time as I have obtained a Clinical Supervisor acceptable to the College.
(j) I, Dr. MacLean, acknowledge that if I am required to cease assessing for and providing MAiD as a result of section (8)(i) 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.
(9) 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 to any other activity the College deems necessary in order to monitor my compliance with the provisions of this Undertaking.
C. ACKNOWLEDGEMENT
(10) I, Dr. MacLean, acknowledge that all appendices attached to or referred to in this Undertaking form part of this Undertaking.
(11) 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.
(12) 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.
(13) 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”).
(14) 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.
(15) I, Dr. MacLean, acknowledge that, in the event of a referral to the Discipline Tribunal and in the event of an appeal of any Order of the Discipline Tribunal, if the Discipline Tribunal has directed the Registrar to revoke, suspend, or impose terms and conditions on my certificate of registration, that Order will take effect immediately despite any appeal.
(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:
The College has received information regarding Dr. MacLean’s standard of practice and is conducting an investigation into the information. During the investigation and in the event of a referral to the Discipline Tribunal:
Dr. MacLean must practise under the guidance of a Clinical Supervisor acceptable to the College. Dr. MacLean must obtain the review and approval of his Clinical Supervisor prior to providing MAiD.
D. CONSENT
(18) 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.
(19) I, Dr. MacLean, acknowledge that I have executed the OHIP consent form, attached hereto as Appendix “C”.
(20) I, Dr. MacLean, give my irrevocable consent to the College to provide the following information to all Clinical Supervisors:
(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.
(21) 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.
(22) I, Dr. MacLean, give my irrevocable consent to all Clinical Supervisors and Chiefs of Staff 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”;
(c) any information relevant for the purposes of monitoring my compliance with this Undertaking.
Terms and conditions imposed on certificate by: Member