Provincial Autonomy in Implementing Federally-Legislated Euthanasia Measures

November 28, 2024 TruthUSA

News Analysis

While the policies around Medical Assistance in Dying (MAID) are legislated by the federal government, two provinces have recently taken steps in the administration of euthanasia, each with different priorities.

The province of Quebec is expanding the procedure, allowing patients to make advance requests for MAID before becoming unable to consent due to their medical conditions. Quebec argues that Ottawa has been slow to act on this issue. However, this move puts Quebec’s MAID policy in conflict with federal law as it goes against the Criminal Code’s definition of murder.

On the other hand, Alberta has launched an online survey to gather feedback from residents on MAID laws due to concerns about the lack of oversight in expanding the euthanasia regime. Premier Danielle Smith’s office opposed Ottawa’s plan to extend MAID eligibility to individuals with mental illness. The survey aims to gauge public support for new legislation and decision-dispute mechanisms for families regarding MAID.

While the federal Criminal Code governs MAID, provinces can influence its administration by increasing oversight, amending regulations, and potentially regulating funding, according to legal experts.

Isabel Grant, a professor at the Allard School of Law, stated, “MAID is legislated under the federal Criminal Code, but the administration of criminal law falls under provincial jurisdiction.”

“Provinces have jurisdiction over health, and MAID is part of health, not criminal law, so this becomes an area of provincial jurisdiction,” explained Grant.

When Canada first legalized MAID in 2016, it only applied to terminally ill individuals. In 2020, Bill C-7 was passed to allow MAID for Canadians where natural death is not “reasonably foreseeable.”

Although there were plans to expand MAID eligibility to include those with mental illness, this expansion was delayed until 2024 and then further to 2027 to ensure preparedness within the medical system.

Provincial Jurisdiction

Quebec passed a law in 2023 allowing advance MAID requests from individuals with serious illnesses, effective October 2024. Federal Health Minister Mark Holland is still evaluating Quebec’s proposal.

Grant noted that Quebec’s decision to remove the consent requirement for certain procedures conflicts with the federal Criminal Code, but without a legal challenge, the implications remain undecided.

Quebec’s Health Minister Sonia Bélanger affirmed the province’s jurisdiction in legislating healthcare regarding MAID expansion.

Holland emphasized that despite provincial actions, the criminal code on advance requests remains unchanged, and enforcement is left to provincial prosecutors.

However, provinces like Quebec have instructed prosecutors not to pursue health professionals following provincial legislation on MAID.

Alberta’s Survey

Alberta’s online survey aims to gather public opinions on MAID limitations. Grant pointed out that Alberta has flexibility in administering MAID laws and can bring clarity and set safeguards within its jurisdiction.

Provinces like Alberta can amend regulations to restrict MAID by imposing conditions or ensuring strict adherence to Criminal Code criteria, potentially facing legal challenges.

Pejovic from the Justice Centre for Constitutional Freedoms suggested that provinces could regulate medical professionals’ licences to prevent certain MAID practices.

Canada has seen a significant increase in assisted death rates, and issues related to MAID have gained international attention in recent years.

A report from Ontario highlighted that low-income individuals are more likely to access euthanasia.

Supporting Quebec’s call for MAID expansion, Bélanger emphasized the importance of moving forward on this issue.

Janz, a disability ethics specialist, expressed concerns about the high risk of suicide contagion among disabled individuals due to Canada’s MAID legislation.

Janz proposed creating MAID-free zones to provide safe spaces for those who fear being offered euthanasia instead of proper support or treatment.

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