The province is tapping Albertans on the shoulder to find out how they envision physician-assisted dying.
The provincial government released a survey Monday to collect input on topics such as competence, the requirement of a reflection period, age eligibility, advanced directives, safeguards to protect vulnerable Albertans, location and type of service and whether publicly-funded institutions should be allowed to opt out.
Health care is a shared provincial-federal jurisdiction. While the federal government’s legislation, which comes into effect June 6, will amend the Criminal Code and make it a Canadian’s legal right to access physician-assisted suicide under certain circumstances. It’s up to each province and territory to determine how the service will be provided within their jurisdiction.
Through its health care laws, Alberta will have some say over who can access or provide the service, where the service will be offered (in a hospital, a facility or at home) and when it can be requested (through an advanced directive or when the patient wishes to die), as well as whether the service should be made available at all publicly available institutions.
“At the end of the day, we really wanted to hear from Albertans on this issue so that the guidelines that we put forward here in our province are ones that are reflective of the values here in our province,” said Associate Minister of Health Brandy Payne.
Payne said the province will absolutely allow for conscientiously objecting physicians to opt out of providing the service – this is their Charter right – but wants to hear from Albertans on the issue of publicly-funded faith-based institutions.
The special joint committee report released last week recommended that the federal government work with provinces and territories “to ensure that all publicly funded health care institutions provide medical assistance in dying.”
Covenant Health, which operates 71 out of the 90 hospice beds in the Edmonton region – and all 12 in St. Albert – as well as 1,500 of the region’s long-term care beds, publicly announced in the fall that it would not provide physician-assisted dying to patients in its care, since the practice goes against the Catholic tradition of neither prolonging dying nor hastening death.
Covenant Health receives more than 80 per cent of its funding from Alberta Health Services.
In an emailed statement, president and CEO Patrick Dumelie wrote that Covenant Health “will continue to meet its legal and service obligations” while “collaborating with others as a partner in an integrated health system to co-ordinate care according to the policy and direction set by government.”
He indicated that patients who request physician-assisted dying would be transferred to another institution for assessment, “as we do with other services that are not provided at our sites.”
There’s also the question of a physician’s duty to refer. The province wants to hear what Albertans think of the special joint committee’s recommendation for an effective referral regime, which critics argue infringes on the Charter rights of physicians, versus the implementation of a third party resource that would connect patients to physicians that offer the service.
“Ultimately, our goal within Alberta Health is to ensure access to the service for Albertans, while balancing protecting the rights of both physicians and vulnerable Albertans,” said Payne.
Another common concern said Payne, is whether a reflection period should be required. Some jurisdictions where physician-assisted dying is legal require a reflection period. In the Netherlands, the request must be made several times; in Quebec, where medical aid in dying has been legal since December, there is a 15-day wait period to ensure the decision is well-thought out.
The province will be collecting feedback from the public until March 31, 2016. Visit health.alberta.ca/initiatives/physician-assisted-death to complete the survey.