Sask. ready as doctor-assisted dying becomes legal at midnight

As of Tuesday, medically-assisted dying will be legal across Canada and Saskatchewan Minister of Health Dustin Duncan says the province will be following the lead of the Supreme Court's Carter decision.

"I respect and the government respects the Carter decision. We will be ensuring the Carter decision is respected in Saskatchewan," said Duncan.

The Supreme Court of Canada gave the federal government until the end of today to pass new legislation on doctor assisted death, but Bill C-14 — the Liberals' proposed bill on assistance in dying — is still undergoing scrutiny in Parliament. That means on Tuesday, the Supreme Court's original ruling, known as the Carter decision, becomes the law, which means doctors can't be prosecuted under the Criminal Code if they help a patient suffering from a "grievous and irremediable" illness to die.

Saskatchewan is following guidelines set out by the College of Physicians and Surgeons.

"We are waiting for the federal legislation to be passed and then we'll make a determination of whether we think, as a province, that satisfies the province or whether we're going to go further than that," said Duncan.

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Drugs covered, referral system in the works

On Monday, Duncan said the province will cover drugs needed for medically-assisted death and it will set up a referral system for patients if their doctor objects to taking part.

"We'll ensure that the patient won't have to go on a deep search to find a physician that has agreed to provide the service," Duncan said.

The Minister of Health was not ready to say if every health region would offer medically-assisted death.

Physicians have their direction

The College of Physicians and Surgeons of Saskatchewan issued the advice in November of last year in the event that there were no laws covering the act. 

• Missed deadline on medically assisted dying leaves doctors divided 
• Health minister warns of 'patchwork approach' without new doctor-assisted death law 

How will doctors in Saskatchewan be expected to act if someone requests medically-assisted dying?

"It's very close to I think what the proposed legislation says," said Brian Salte, the associate registrar and legal counsel for the college.

• The guidance has an expectation that two physicians be involved in the assessment of patients before the decision is made 
• The guidance says there should be a "cooling off period," Salte said. Patients shouldn't receive medical assistance in dying immediately but should express that over a period of time "to avoid the possibility that somebody makes an impetuous decision."

This is all part of the national document from the national college given to physicians across Canada. 

Salte: Lack of legislation creates gaps

"There are a couple of other things that are somewhat troublesome."

Salte identified two particular issues.

• It's not clear that pharmacists and nurses and others who might be involved in this are also exempt from the provisions of the criminal code. "We think that's probably the case, but the legislation would have made that absolutely clear, if the legislation had passed," he said.
• Salte said there is no precedence for nurse practitioners to be involved in assessing patients, but they would be involved if the legislation was adopted in its current form.

Finally, Salte is concerned that physicians won't have the same protection without legislation. Under the legislation there is what he refers to as "good faith protection" which means a physician or other individual who participates in good faith in medical assistance in dying is not subject to prosecution, even if somebody should later disagree with the assessment they made.

"That is an important protection I think for anybody who is involved in this whole new and developing issue in Canada."