Canada's doctors are taking a stand against smoking marijuana, medicinal or otherwise.

Chris Simpson, president of the Canadian Medical Association and a cardiologist, said the group has a long-standing opposition to smoking because of the health problems it can cause and there should be no exceptions.

The motion adopted by delegates to the CMA general council meeting on Wednesday said the group opposes the "smoking of any plant material," but the debate revolved principally around marijuana.

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Deborah Hellyer, a respirologist from Windsor, Ont., argued that "smoking one joint is the equivalent to smoking 10 cigarettes" so physicians have an obligation to take a stand.

But Ashley Miller, a physician from St. John's, said doctors should not be taking a "prohibitionist tone" when the reality is that many people smoke marijuana, for recreational or medicinal purposes.

"I want the CMA to take a more evidence-based, harm-reduction approach, not an ideological one," she said.

Similarly, John Ludwig, a physician in Omemee, Ont., said the anti-smoking stance of Canada's doctors is well-known and it should not be used as a backhanded way of opposing medical marijuana.

Atul Kapur, president of Physicians for a Smoke-Free Canada, said there is no good evidence for the use of marijuana for medical purposes, but what is clear is that smoking is not the way it should be used.

"We shouldn't be supporting something harmful, and smoking is harmful," he said.

Robin Cox, a Calgary anesthesiologist, took a similar position. "'Smoke anything you want' is the wrong message to send to the public," he said.

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In the end, two-thirds of CMA delegates approved of the motion opposing smoking all plant materials.

The Canadian Medical Association represents Canada's 80,000 doctors. Its general council, often referred to as the "Parliament of Canadian medicine," sets policy on behalf of the organization.

Delegates on Tuesday also rejected a call to support presumed consent for organ donation – meaning the law would presume everyone who dies wants to donate their organs and tissue, unless they explicitly object.

Claudie Dandurand Bolduc, a medical student from Montreal, said that "physicians have a duty to ensure that organs are available" and countries that have presumed consent, such as Spain, have a donor rate that is 30 per cent higher than Canada's.

But Ted Boadway, who chaired the citizens' panel on increasing organ donation in Ontario, said that approach has been studied and does not have the support of Canadians. "People want you to respect their wishes. They don't want us to presume anything," he said.

David Gass, an adviser to the Nova Scotia Department of Health and Wellness, said that while the push for presumed consent is well-intentioned, it could backfire.

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He said the CMA's ethics committee debated the issue extensively and "we're not convinced there is social support for presumed consent.

"Obviously we want to increase organ donation, but we don't want to take a position that will be perceived negatively," Dr. Gass said.