Too onerous, too cumbersome, and possibly not quite respectful enough of privacy, are some of the responses from the CBA’s End of Life Working Group to a Health Canada consultation on a monitoring regime for those seeking a doctor’s assistance to end their lives.
The Medical Assistance in Dying Act passed in June 2016 acknowledges the importance of a comprehensive monitoring system to collect and analyze data about the demand for medical assistance in dying, and to monitor trends.
A year later, Health Canada is only now holding consultations on regulations for such a monitoring regime. The CBA’s End of Life Working Group, which called earlier this year for Health Canada to take immediate action, has made a submission with its comments on the consultation.
“The proposals for provider reporting are quite onerous, and we encourage harmonization to minimize the need to report to multiple authorities and to avoid duplicate information,” says the Working Group, which is made up of members from a number of CBA Sections.
The Working Group makes a number of suggestions for the information the monitoring system should capture: requests made but refused for conscientious reasons of the practitioner or institution; anyone who was initially approved but disqualified prior to treatment; more precise criteria and supporting rationale for specific additional information about the patient – for example, the committee sees no reason for asking about the patient’s marital status; the manner and the cause of death; any barriers to accessing MAID; and consultations with scientists to ensure the right questions are being asked.
The proposed 10-day window for filing a report is too short for most health-care practitioners even with the help of technology, and the proposed reporting process overall is too cumbersome, the Working Group says. It suggests a standardized periodic approach may be more feasible.
Finally, the Working Group suggests the Health Minister prepare a privacy impact assessment of the proposed regulations, and that privacy commissioners in all jurisdictions be given a chance to weigh in.
“MAID is not a rare occurrence,” the Working Group says. “Even the incomplete data in the Minister’s interim report identifies just under a thousand MAID deaths in a one-year period. We query the need for identifying information about persons who request MAID.”