Canadian province considers prohibiting assisted suicide for patients unable to make their own medical decisions 

Saskatchewan’s government has proposed legislation to prohibit assisted suicide for people who cannot make their own medical decisions. The measure would also protect healthcare workers who refuse to participate in assisted suicide.

Health Minister Jeremy Cockrill introduced the bill this week, called the Medical Assistance in Dying Additional Safeguards Act. The legislation would prohibit assisted suicide for minors and people whose only medical condition is mental illness.

“When the outcome is irreversible, the threshold for certainty must be exceptionally high,” he told lawmakers this week.

Cockrill belongs to the center-right Saskatchewan Party, which holds a majority of seats in the province’s legislative assembly.

The bill would prohibit doctors and nurse practitioners from approving assisted suicide for patients who cannot understand its effects. It would also require patients to be able to communicate their decisions themselves.

Patients would generally have to retain those abilities until they receive assisted suicide, with limited exceptions.

Some patients can waive final consent under current Canadian law. However, they must qualify for assisted suicide while they can still make decisions themselves. Their natural deaths must also be reasonably foreseeable, and they must have a written agreement with their healthcare provider before losing that ability, Health Canada explains.

Saskatchewan proposal differs from federal plan

That differs from what the Liberal federal government is proposing.

Last month, the government introduced Bill C-41, which would allow adults with serious, incurable illnesses expected to eventually eliminate their ability to consent to request assisted suicide in advance. The proposal could apply to people with Alzheimer’s who anticipate losing their decision-making capacity as the disease progresses.

Provinces would have to pass their own laws before allowing such advance requests.

Meanwhile, Saskatchewan wants to give medical workers greater authority to refuse involvement in assisted suicide.

“No practitioner shall be forced to provide or assist in the provision of medical assistance in dying,” the bill says, using Canada’s term for assisted suicide. In the decade since it was legalized, it has become one of the country’s leading causes of death.

The measure would prohibit employers from punishing workers who refuse to participate. Healthcare regulators also could not require participation or pursue complaints based on a worker’s refusal.

If the bill becomes law, Cockrill said healthcare workers would still have to provide these patients with other forms of care and support.

Mental illness exemption and religious support

Canada already prohibits assisted suicide for minors and people whose only medical condition is mental illness. However, the mental illness exclusion is set to expire in March unless Parliament extends it.

Bill C-41 would make the exclusion permanent.

Earlier this year, Heartlander News reported on Ottawa’s plan to maintain the ban. Canada’s Catholic bishops also supported separate legislation to preserve the exclusion.

“Human life is a gift that must be protected and valued at every stage and in every circumstance,” the bishops’ permanent council wrote in February.

The Association for Reformed Political Action Canada supports Saskatchewan’s bill.

“Governments, businesses, and non-profits have really stepped up in recent years to promote mental health supports and suicide prevention for those who are struggling,” Levi Minderhoud, a policy analyst for ARPA Canada, said in a release. “This is the right, life-affirming, and caring approach that a compassionate society should take in the face of mental illness.”

The group also wants Saskatchewan to limit assisted death to patients with fewer than six months to live. Bill 73 does not include that restriction.