A bill that would protect Manitoba health professionals' rights to refuse assisted dying services and protect them from reprisals is being called redundant and one-sided.
Bill 34, which was introduced in May and hasn't yet reached a second reading in the House, would ensure health professionals cannot be compelled to go against their own religious or ethical beliefs when it comes to providing medical assistance in dying (MAID) services.
It would also ban any professional regulatory body from requiring members to participate in medically assisted deaths, which were made legal by the Supreme Court in 2015.
The bill is being called into questions after a Manitoba man waited months to receive an assessment by the province's MAID team, after initially inquiring about it in May.
The Misericordia Health Centre, the faith-based hospital where he lives, insists he was given information on how to access MAID, but any further interactions between the patient and the MAID team are not facilitated by the hospital, which does not offer MAID services on-site.
Dying With Dignity Canada says Bill 34 is one-sided because it only protects health professionals who conscientiously object, not those who may seek to facilitate MAID services within an institution that objects, and doesn't offer any protection for patients who have a right to access services.
"It doesn't protect the rights of clinicians who may feel a conscientious duty to help their patients … especially if those doctors and nurse practitioners that are working in institutions that are allowed not to provide medical assistance in dying," said Shanaaz Gokool, CEO of Dying With Dignity Canada.
Faith-based hospitals within Manitoba are allowed to make their own policies surrounding MAID, including not allowing the services or any part of the process to take place in their facilities.
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Gokool says the bill doesn't include any protections for patients because it doesn't place any obligations on health-care providers who object to providing referrals and access to MAID.
"What we should be doing is putting forward legislation that supports the rights of all Manitobans, not just a certain select group that object to something that everyone has a right to," Gokool said.
"What I really see here is a situation where rights are buttressing up against each other," she said.
Health Minister Kelvin Goertzen, who introduced the bill, says the rights to access assisted dying are already ensured through the creation of the MAID team, and says the bill is needed because federal legislation doesn't offer employment protections for conscientious objectors.
"The legislation, federally, says that health-care professionals aren't mandated from participating, but it doesn't give specific employment protection," Goertzen said.
The College of Physicians and Surgeons of Manitoba says its policies already protect objectors.
"The bill is actually redundant and it's unnecessary, and we will be making a submission to government that actually indicates that, based on the standard that we have in place, this bill doesn't add anything," said Dr. Anna Ziomek, registrar at the college.
'What we should be doing is putting forward legislation that supports the rights of all Manitobans, not just a certain select group that object to something that everyone has a right to.' - Shanaaz Gokool, CEO of Dying With Dignity Canada
Goerzten says putting those protections into legislation ensures that those rights will be protected, even if policies of professional regulatory bodies change.
"It's difficult to predict the future, and what future colleges might do," he said.
Goertzen says the protections, asked for by medical professionals, have been well received.
"My office has received about 7,000 letters in support of the legislation, and about eight against [it], so we feel we are moving in the right direction," he said.
The bill initially faced criticism from the opposition NDP for not including an obligation for referral by those who refuse, but last week the NDP agreed to support the bill. Party leader Wab Kinew says they agree with protecting a person's rights to object, but more needs to be done.
"The government's bill looks at half of the equation, and we support that half, but we think that there's another half of the equation around palliative care, mental health and access for those of sound mind. So we will be bringing forward some ideas on how to proceed with that as well," Kinew said.
Critics worry about bill's wording
Critics of the bill also say the wording, as it's presented in the bill, doesn't make clear distinctions about what an objector's obligations are if a patient requests information or access to MAID.
Gokool worries that simply providing a card with contact information to patients, especially in a case where the patient may be physically unable to make contact, falls short of a good standard of patient care.
She also says the right not to aid in the process could be open to different interpretations.
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"What exactly do you mean when you say that clinicians don't have to provide medical assistance in dying, or aid in medical assistance in dying?" Gokool asks.
"From our perspective that could be carte blanche 'we don't have to provide any help whatsoever', and that can't be what we mean or what we intend," she said.
Gokool would like to see further protections for patients' rights put in place to ensure access, and see that even those who object to MAID are still obligated to provide a referral.
Ziomek agrees, saying the college's policies still require a doctor to give the patient information on how to access MAID.
"At the college we believe that providing information is not the same [as participating in MAID], and cannot be swept with providing or aiding in MAID," Ziomek said.
The bill could have its second reading in the coming weeks. It would have to make it to the committee level before any further amendments are possible.