Thank you. It's a privilege to speak to the committee.
I'm Dr. Douglas Grant. I'm a registrar of the college of physicians in Nova Scotia. I'm a family doc and a lawyer, and I represented the Federation of Medical Regulatory Authorities of Canada at the Health Canada working group.
My approach to the question is that all readiness must be built on regulatory readiness. My respectful submission is bluntly this: Regulators are ready for this. We don't need any more time. We're not coming for more time.
We will be ready for many reasons.
The first is that most of the hard work has been done. The model practice standard developed by the Health Canada working group is the best synthesis of the law with the input of all necessary stakeholder voices. I know I speak on behalf of my fellow registrars that we see these as very useful documents. The document can be adopted in whole, which Nova Scotia will do—and I can tell you that we will be adopting it in whole in other Atlantic provinces as well—or used as a template to build a professional standard upon. The supporting documents provide à la carte language that could be plugged into existing college standards.
At the end of the day, what will happen in March 2024 is that all medical regulators will have guidance and professional standards in place that are built from or informed by the model practice standard developed by the Health Canada working group. With exceptions for style and format, there will be substantial consistency between provinces.
The second reason why the regulators will be ready in March is that we have a solemn and legal duty to be ready.
There may be some slight variations in provincial legislation, but all medical regulatory colleges have a mandate to regulate the medical profession in the public interest. That mandate means we're in service to patients. In this case, we're in service to the specific patients who are suffering, who are being denied a form of care to which they are entitled in law, and who, as a class, have been suffering and denied this care since 2015.
Finally, our duty extends to physicians themselves who look to provide this care, who are entitled to a clear articulation of regulatory direction and expectations. I'm here to say that the regulators will meet their duties.
The fact that we're here implies that you have heard voices from non-regulators implying that the regulators are not ready. I would like to unpack those concerns.
First of all, they are not supported by history. At each step of MAID's evolution, there has been a chorus of voices asking whether the regulators were ready. After the one-year implementation period was coming to an end following Carter, there were calls of unreadiness. At the time, I was the president of the Federation of Medical Regulatory Authorities of Canada, and I made submissions to a joint committee like this—I don't think it was in this room—indicating that the regulators were ready. We were ready.
We were ready when the law evolved to include eligibility for patients whose natural death was not reasonably foreseeable. Then we were ready again when Audrey's amendment, which enabled a waiver of final consent to eligible patients at risk of a loss of capacity, came into law.
I guess I would like to say that this is par for the course. Medicine constantly evolves. MAID will evolve and the medical regulators will respond, because we have a duty to be nimble.
I hope that the concerns of unreadiness are not in response to silence on the websites of colleges like my own. That would be a mistake. Professional standards serve many purposes. They declare the regulatory expectations, direct the caregivers, and also serve a public purpose. They advise the public of what it is entitled to expect. Rooms like this indicate that the situation is fluid. The regulators in the college in Nova Scotia, which I run, will wait until the path forward is settled and political debate has stopped. The medical regulators have no desire to mislead or confuse the public.
I would encourage this committee to be disciplined in its efforts to distinguish opposition to MAID from accusations of unreadiness. In my experience, the choir of voices making accusations of unreadiness has been entirely composed of voices that are opposed to MAID. With the courts having made their final decision, opposing voices cannot advance arguments to stop MAID.
I would ask the committee to ask whether the accusations of unreadiness are a genuine argument or simply an attempt to buy time for the sake of time, when no time is needed—at least not from the regulatory perspective.