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Dr. James  Downar - University Health Network. Toronto, ON, CA

Dr. James Downar Dr. James  Downar

ICU physician | University Health Network

Toronto, ON, CANADA

Specialist in palliative care and medical ethics





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Last Right: Dr. James Downar




James Downar is a Critical Care and Palliative Care Staff Physician at the Toronto General Hospital. He graduated from McGill Medical School and completed residency programs in Internal Medicine, Critical Care Medicine, and Palliative Care Medicine at the University of Toronto. He also completed a Master’s degree in Bioethics at the Joint Centre for Bioethics at the University of Toronto. His research interests focus on communication and decision-making for seriously ill patients, as well as expanding the role of palliative care in the critical care environment and for non-cancer illnesses. He is the current chair of the Postgraduate Education Committee of the Canadian Society of Palliative Care Physicians.

Industry Expertise (5)

Health and Wellness Research Health Care - Services Health Care - Providers Health Care - Facilities

Areas of Expertise (5)

Palliative Care Medical Ethics End of Life Care Critical Care Internal Medicine

Education (3)

University of Toronto, Joint Centre for Bioethics: M.Sc., Bioethics

McGill Medical School: Residency, Internal Medicine, Critical Care and Palliative Care

McGill Medical School: MD, Medicine

Affiliations (2)

  • Canadian Society of Palliative Care Physicians : Chair, Postgraduate Education Committee
  • Critical Care Canada : Scientific Faculty

Media Appearances (4)

'Physician-assisted death is going to become legal': Canada's right-to-die debate almost over, doctors say

National Post  online


The debate “is about to become obsolete,” said Dr. James Downar, a critical care and palliative care physician at Toronto General Hospital. “Physician-assisted death is going to become legal in Canada in the very near future by one means or another and crucial questions need to be answered,” he said, including when does suffering become “intolerable” and how long must it last before doctor-assisted death could be granted? Would psychological or “existential” angst be grounds for seeking a lethal injection?

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Dr James Downar: death is as precious as life

BestEndings  online


He seems far too young to be dedicated to minimizing suffering at life's end, but that is, indeed, Dr Downar's mission. His three specialties are inter-related: critical care, ethics and palliative care. Palliative care changes the focus from cure to comfort. This sensibility doesn't fit with the military language often used in healthcare situations: battling, fighting, giving up, winning, losing. Dr Downar's take puts that tough language into 'life's end' perspective...

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Saving Death is as Important as Saving Life Says UHN Palliative Physician

UHN  online


Dr. James Downar is a thoughtful, engaged and passionate teacher. Especially about death—or palliative care to be precise. When he first started medical school at McGill, Dr. Downar stated definitely in his goals that he was not interested in palliative care. But working with palliative care physicians and caring for dying patients convinced him otherwise. Dr. James Downar.jpgAfter graduating in 2002, he now has three specialties: palliative care, critical care and ethics. He brings all three together in his work at the ICU and on the palliative care service at TGH...

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Teaching doctors a new approach to the end-of-life process

The Globe and Mail  online


Designed by James Downar, a critical care and palliative care physician at Toronto General Hospital, the unique program is part of a growing push among members of the medical community to revamp the way doctors, patients and families approach the end-of-life process. Many patients die uncomfortable, sometimes painful, deaths in the intensive care unit when they could have benefited from the support of palliative care. The reluctance to confront the inevitability of death and continuing to pursue aggressive treatment can do unnecessary harm to patients and relatives during what is already an extremely difficult period, according to Dr. Downar...

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Event Appearances (2)

Non-beneficial Treatment in Canada following the Resouli Decision

PEI Palliative Care Conference and Long Term Care Conference  Summerside, PEI


Oral Ketamine for Chronic Pain

CANMAT Mood & Brain Conference  Toronto, ON.


Articles (5)

Why Do Patients Agree to a "Do Not Resuscitate" or "Full Code" Order? Perspectives of Medical Inpatients Journal of General Internal Medicine


BACKGROUND The majority of patients who die in hospital have a “Do Not Resuscitate”(DNR) order in place at the time of their death, yet we know very little about why some patients request or agree to a DNR order, why others don't, and how they view ...

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What should we say when discussing “code status” and life support with a patient? A Delphi analysis Journal of Palliative Medicine


Background: Patients and clinicians often find it difficult to discuss wishes regarding cardiopulmonary resuscitation (CPR) or “code status.” Some authors have published effective communication styles, but there are currently no published guidelines for the ...

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Perceptions of "futile care" among caregivers in intensive care units Canadian Medical Association Journal


Background: Many caregivers in intensive care units (ICUs) feel that they sometimes provide inappropriate or excessive care, but little is known about their definition of “futile care” or how they attempt to limit its impact. We sought to explore how ICU staff define medically ...

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Bench-to-bedside review: high-frequency oscillatory ventilation in adults with acute respiratory distress syndrome Critical Care


Abstract Mechanical ventilation is the cornerstone of therapy for patients with acute respiratory distress syndrome (ARDS). Paradoxically, mechanical ventilation can exacerbate lung damage–a phenomenon known as ventilator-induced lung injury. While new ...

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Strepococcal Meningitus Resulting from Contact with an Infected Horse Journal of Clinical Microbiology


ABSTRACT We report a case of group C streptococcal meningitis in a woman with a history of close animal contact as well as head trauma as a result of a kick by a horse. Blood and cerebrospinal fluid cultures grew Streptococcus equi subsp. zooepidemicus, as did a ...

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