TORONTO -- The Supreme Court's unanimous decision to allow doctor-assisted death in Canada has many physicians in the country warily reviewing the landmark ruling.

Dr. Chris Simpson says the decision is not a surprise to the Canadian Medical Association, which he leads.

Simpson says his organization has done a lot of work studying laws in other jurisdictions where assisted death is permitted.

The CMA will ask for a role in helping to frame the new law that the federal government has been tasked with creating.

He says Canada's doctors want a seat at the table to ensure the legislation is drafted in a way that protects vulnerable people.

Dr. Marc Beauchamp, president of Living with Dignity, a group that opposes assisted death, says the ruling is a disappointment and a source of severe and deep concern for like-minded doctors.

Beauchamp expressed concern that in the future, people with terminal illnesses will be pressured to end their lives rather than allow them to follow their natural course.

The CMA membership used to be firmly opposed to assisted death, but that objection has softened over time. A 2014 survey of 5,000 doctors found that 45 per cent favoured legalizing physician-assisted death. However, only 27 per cent said they would likely or very likely participate if the act was decriminalized.

The Supreme Court acknowledged that doctors need to have the right to be conscientious objectors and cannot be made to assist deaths if doing so would offend their beliefs.

Simpson admitted the death-bed plea for a change in the law by the late Dr. Donald Low has had an influence on the evolution of the association's policy.

Low, a prominent infectious diseases specialist and one of the leaders of Toronto's response to the 2003 SARS outbreak, died of a brain tumour in September 2013. Shortly before his death he recorded a video calling for a change in the law.

Simpson said the video was shown at a CMA medical council "and you could have heard a pin drop in the room."

"I have no doubt that having one of our colleagues, particularly a really respected colleague like Don, it probably did (make a difference). It certainly made me stop and think," he said.

"I think it was a really important part of the process of change that we've undergone. A touchstone."