The CBA’s End-of-Life Working Group has some concerns about the implications for medical professionals in the proposed Monitoring of Medical Assistance in Dying Regulations published in December.
The regulations require medical practitioners and nurse practitioners who receive a written request for MAID, and pharmacists who dispense the drugs, to disclose certain information so governments can track how it is being used.
The CBA Working Group sees problems both with the specific kinds of information requested and the fact that the information is being compelled on threat of criminal sanctions.
“The proposed regulations will compel disclosure of potentially self-incriminating information that could eventually be used in a professional regulatory investigation, a civil suit or a criminal prosecution,” the Working Group says in a letter to Health Canada. “There are no notice requirements or procedural safeguards in the proposed regulations.”
In fact, the Working Group says the regulations seem to conflate “monitoring” – the collection of information for analysis – with “oversight” – the review of cases to determine compliance with the law. Monitoring is not defined in the proposed regulations.
“The CBA Working Group’s opinion is that section 14 supports disclosure of personal information for enforcement and compliance purposes, whether prosecution under the Criminal Code or disciplinary action by professional regulatory bodies.” It urges the Minister to address this problem before proceeding with the regulations.
The current approach will not only create a “significant disincentive” to doctors and others asked to deliver medical assistance in dying, it will also have “a subsequent chilling effect on a patient’s right to autonomy.”
The Working Group has a number of concerns with the types of information being gathered for monitoring purposes – and with then allowing that personal information, for example, health numbers and street addresses or the marital status of those who requested MAID – being shared with individuals or organizations for research purposes.
“The Privacy Act does not authorize disclosure of information that identifies an individual unless there is no other reasonable means to achieve the objectives of the research. We recommend that data be stored in a format that facilitates removal of this information when disclosing records for research or statistical analysis purposes.”