On November 1, 2018, the federal government's Regulations for the Monitoring of Medical Assistance in Dying ("MAiD") came into force. The Ministry of Health published a Guidance Document to assist and inform physicians, nurse practitioners, and pharmacists ("medical professionals") about the updated reporting requirements. The Regulations require medical professionals who receive written requests for MAiD to submit reports to the Saskatchewan Health Authority when they encounter certain situations with patients. The reporting requirements are triggered with all written requests for MAiD, even for patients whose written requests do not ultimately result in the provision of MAiD.
What Constitutes a Written Request for MAiD?
A "written request" for MAiD can come in a variety of forms. The request does not necessarily have to be in the format required by the Criminal Code to trigger the reporting requirements set out in the Regulations. However, the request must be explicit, rather than a mere inquiry or a request for information. Oral requests for MAiD or written communications containing questions about MAiD do not trigger the reporting requirements.
When Are Medical Professionals Required to Report?
The Guidance Document states that the purpose of the Regulations is to support the collection of MAiD data, which is a critical feature of the MAiD legislation. Under the Regulations, physicians and nurse practitioners who have received a written request for MAiD and encounter any of the scenarios listed in the table below are required to report within the specified timeframe:
| Scenario | Timeframe to Report | ||
| 1. | Providing MAiD by administering a substance to a patient | Within 30 days after the date the patient dies | |
| 2. | Providing MAiD by
prescribing a substance for self-administration by a patient |
Within 90-120 days after
the day of prescribing or providing, regardless of whether the
patient uses the substance. If the physician or nurse practitioner becomes aware that the patient has died, he or she can report prior to 90 days, but in all other instances must wait until 90 days has passed. |
|
| 3. | Referring a patient to another practitioner or service for MAiD | Within 30 days after the date of the referral | |
| 4. | Finding a patient to be ineligible for MAiD | Within 30 days after ineligibility is determined | |
| 5. | Becoming aware that a patient withdrew his or her request for MAiD (in writing or verbally) | Within 30 days after the practitioner becomes aware of the withdrawal | |
| 6. | Becoming aware of the death of a patient from a cause other than MAiD. | Within 30 days after the day the practitioner becomes aware of the death |
Pharmacists who dispense substances in connection with the provision of MAiD are also required to report within 30 days after the day the substance was dispensed. Pharmacists who receive or prepare prescriptions for the purpose of providing MAiD, but do not actually dispense the medication, are not required to report.
Where to Report
Physicians and nurse practitioners who receive a written request for MAiD in one province but assist with the administration of MAiD in another province, must report in the province where the written request was received.
How to Report
The Guidance Document lists the prescribed forms medical professionals must use to complete their reports. Some of the forms include space to provide details of which he or she may be unaware. For example, medical professionals who receive a written request for MAiD from a patient are required to report if they become aware that the patient has died from a cause other than MAiD. The medical professional in this situation may be unaware of the time of death, the location of the death, or the specific cause of death. In this situation, it is sufficient for a medical professional to indicate on the form that he or she is unaware of these details. Medical professionals are not required to seek out information about patients for the purpose of complying with the reporting requirements.
Once the required forms are completed, they must be submitted to the Saskatchewan Health Authority (the "SHA"), which is responsible for submitting the information to the federal government. Medical professionals who file inaccurate or incomplete forms will receive follow-up communication from the SHA.
Consequences for Failure to Report
The Criminal Code requires medical professionals to file information required by the Regulations within the specified timeframes. Therefore, a medical professional who knowingly fails to comply with the reporting requirements mandated by the Regulations can be found guilty of a criminal offence and could face imprisonment for a maximum term of two years.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
