With no federal assisted-dying law, Sask. docs will rely on provincial regulations

A 2015 Supreme Court ruling is set to become the law of the land when it comes to doctor-assisted dying in Canada — but Saskatchewan physicians will still be bound by provincial regulations.

The high court previously ruled doctors shouldn’t face criminal charges for helping patients die in certain circumstances. In the decision, known as the Carter ruling, the justices gave the federal government about a year to draft and pass new legislation. That deadline passed on Monday.

Bryan Salte, associate registrar and legal counsel for the College of Physicians and Surgeons of Saskatchewan (CPSS), said the provincial body passed its own standards in November 2015.

“We recognized in 2015 that there was some possibility that there might not be legislation in place by the time the deadline occurred,” he said.

Salte said the CPSS guidance document is mirrors most of the restrictions put forward in the Carter ruling.

He explained that in Saskatchewan, the college requires two physicians to confirm a patient suffers intolerably from a grievous and incurable medical condition, and has freely given consent to end their life.

“We, of course, can’t expand on what the Supreme Court said.  We are simply trying to incorporate what the Supreme Court said with some additional precautions. For example, the requirement of two physicians. The Supreme Court decision doesn’t require two physicians to confirm it. Our document does,” he said.

While the guidance document doesn’t carry the weight of criminal law, Salte said doctors who don’t follow CPSS standards and regulations can be subject to an investigation for unprofessional conduct.

Salte said the regulations leave room for doctors who don’t want to take part in assisted dying. 

“Nobody would ever be required to actually provide medical assistance in dying to a patient. Nobody would ever be required to do an assessment to determine whether the patient meets the criteria for medical assistance in dying,” he said.

At the same time, Salte said doctors who don’t want to be involved with assisted dying still have responsibilities to their patients. The standards avoid using the term referral, as it can be interpreted differently by some physicians, but Salte said no patient should be left to fend for themselves if their physician won’t help them die. 

“The patient has to be made aware of resources or other individuals who can provide that information to them,” he said.

Salte said medical regulators in other provinces have passed similar standards – making it unlikely patients could hop between jurisdictions looking for the easiest approval.

“How it will actually be implemented is totally another question. Are there going to be more willing physicians in one province than another? And I simply don’t know that, and I don’t think we could decide that at the present time,” he said.