Health Minister Sarah Hoffman says her ministry is reviewing options that would allow Alberta Health Services to provide medical assistance in dying at faith-based health facilities while respecting religious objections, although she cautions the province is "not there yet."

In an interview, Hoffman said she has received public feedback urging her to reverse her 2016 exemption that allowed Catholic health provider Covenant Health, which is publicly funded, to opt out of providing access to the procedure.

"A lot of Albertans are writing in, even folks from across the country," she said. "I know this is an issue that matters to everyone, and we're continuing to gather that and review the advice that is being given."

She did not provide a timeline for when that review might be complete.

In October, CBC News began publishing a series of stories that revealed the traumatizing effect Covenant Health's position on assisted dying — and the NDP government's tolerance of it — had on several terminally ill patients and their families.

For more than two years, Covenant's default position was that patients were not even allowed to sign the form requesting an assisted death, or undergo eligibility assessments by Alberta Health Services (AHS) staff, on Covenant Health property.

The Catholic health provider sometimes made exceptions. But its decisions were arbitrary, guided by a policy that ethics and legal experts called both inhumane and an infringement on patients' rights.

Following the CBC News stories and ensuing public and political pressure, Covenant Health revised its policy to permit on-site form signings and AHS assessments for all assisted-dying patients.

It still will not allow AHS staff to perform the assisted-dying procedure on Covenant property. As a result, terminally ill patients, often frail and in pain, must transfer to another facility to exercise their legal right to the procedure.

Hoffman called Covenant's revised policy "a step in the direction that the majority of the public has been urging."

But she acknowledged her ministry has more work to do.

"I understand that there are many who desire to have the full procedure administered on site," Hoffman said. "We are not there yet."

Considering possible solutions

The minister said she will discuss the issue with the medical assistance in dying (MAID) regulatory review committee, along with AHS, Covenant Health, and other stakeholders.

Jocelyn Downie, a MAID expert and health-law academic at Dalhousie University, publicly suggested one possible solution: declare certain rooms in Covenant Health facilities to be under the authority of Alberta Health Services, then perform the assisted-dying procedures there.

"That is definitely one of the options that a number of people have suggested," Hoffman said. "We will continue to discuss this with those providers and with folks who are working to make sure that we have respectful policies and a seamless system, and that patients are at the focus of it."

While individual medical professionals cannot be forced to facilitate assisted dying, federal law is silent on whether faith-based providers like Covenant Health possess those same Charter-protected conscience rights.

As a result, the administration of assisted dying varies across Canada and depends on each province's regulatory framework.

As in previous interviews, Hoffman would not directly answer the question of why the current system, which she said strives to be patient centred, forces the transfer of terminally ill patients from publicly funded facilities. At the province's last count, 64 patients have been been transferred from faith-based facilities so they could receive an assisted death.

By contrast, in Newfoundland and Labrador, public faith-based health providers can opt out of providing MAID, but their facilities must provide a space for the procedure to be carried out if transferring the patient would cause undue suffering.

"I think that is one of the first jurisdictions to go quite that far," Hoffman said, adding the experience of that province and others, as well as feedback from Albertans, "will certainly help influence where this lands in the long term."

If you have information about this story, please contact us in confidence at cbcinvestigates@cbc.ca.



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