Since the Supreme Court of Canada’s landmark decision in Carter v. Canada, and the federal government’s subsequent bill permitting doctors and nurse practitioners to legally end the lives of terminally ill patients who fulfill certain criteria, we’ve been following developments in medically assisted dying in Canada. This week we explore Health Canada’s newly published draft regulations on monitoring medical assistance in dying.
The Purpose of the Newly Introduced Regulations
The regulations are intended to provide the government with a better idea of how many Canadians are obtaining such assistance and in what circumstances they are doing so. The regulations recognize that in the Carter decision, the Supreme Court noted that risks associated with physician-assisted death could be mitigated through a system of carefully monitored safeguards. The subsequent legislation outlines the safeguards intended to balance competing interests.
The new regulations note that a “pan-Canadian monitoring system” used to collect and then analyze requests for medical assistance in dying in Canada, as well as the provision of that assistance, is critical to fostering public trust and providing transparency about the implementation of the new legislation.
New Proposed Requirements for Medical Practitioners, Nurse Practitioners, and Pharmacists
The proposed regulations would require medical practitioners, nurse practitioners, and pharmacists to file reports containing certain information related to requests for medical assistance in dying, and for the provision of that assistance.
At least once a year, an overall report presenting aggregate data obtained under the proposed regulations would be published on the Government of Canada website.
Medical Practitioners and Nurse Practitioners
Under the regulations, “practitioners” (i.e. medical practitioners and nurse practitioners) would be required to file reports about written requests they received for medical assistance in dying. The reporting requirements and timelines would vary depending on:
- Whether the practitioner referred the request to another practitioner;
- Whether the patient withdrew their request;
- Whether the practitioner determined that the patient was, or had become, ineligible for medical assistance in dying;
- Whether the patient died from a cause other than medical assistance in dying; or
- Whether medical assistance in dying was provided.
Pharmacists who dispensed a substance required for medical assistance in dying would also be required to report basic information about themselves, the patient, the practitioner who administered the substance, and the date and setting in which the substance was administered.
Online consultations about the proposed regulations are underway between now and February 13 with the goal of creating final regulations by summer 2018.
Reactions to the proposed regulations have varied. Dying with Dignity Canada has said that it supports a national monitoring system, but wants Health Canada to work with its provincial and territorial counterparts to streamline the process. A spokesperson for Dying with Dignity Canada noted that every assisted death case requires hours of paperwork for the practitioners involved, including reports to the local hospital, the coroner, and the province. Any added administrative workload might prompt the few clinicians who provide medical assistance in dying to stop or might discourage others from providing the assistance. The organization worries about barriers to access for Canadians who want to avail themselves of their right to medical assistance in dying, especially in more remote locations.
We will continue to follow developments in this matter, and will blog about updates as they become available.
At Wise Health Law, we focus on health and administrative law. We assist health professionals, health organizations, and national and provincial health professional associations to find solutions to their legal and regulatory issues. Contact us online, or at 416-915-4234 for a consultation.