Mr. Speaker, the Government of Canada believes that Canadians deserve to live in comfort and dignity, with access to care, including end-of-life care, that is appropriate to their needs and that respects their wishes. It also recognizes that medical assistance in dying, MAID, is a deeply personal choice and is committed to ensuring our laws reflect Canadians’ evolving needs, protect those who may be vulnerable and support autonomy and freedom of choice.
The federal legislation under the Criminal Code sets out a consistent set of eligibility criteria and safeguards for the legal provision of MAID across the country. Although the federal government plays a role in supporting health care by providing funding to the provinces and territories, the provincial and territorial governments have primary jurisdiction in the administration and delivery of health care services. This includes setting their own rules and requirements for the delivery of MAID, as well as making decisions on how and where the services are available.
The Canada Health Act, Canada’s federal health care insurance legislation, sets out the criteria and conditions that must be satisfied by the provincial and territorial health care insurance plans for them to qualify for their full share of the cash contribution available under the federal Canada health transfer.
The federal government does not provide any direct funding for the delivery of MAID services or for the provision of medications or substances for the purpose of MAID.
To support transparency and public trust, the Minister of Health must make regulations to collect information for the purpose of monitoring and reporting and must publish a report on MAID in Canada at least once a year. This reporting provides greater insight into who is requesting and receiving MAID in Canada and the circumstances surrounding their request. To bolster and address existing data gaps and strengthen the breadth and quality of information on MAID delivery in Canada, the federal government is also supporting policy-oriented research through contracts and contribution agreements.
With the passage of amended legislation on MAID in March 2021, federal budget 2021 provided funding of $13.2 million over five years, beginning in 2021-22, with $2.6 million per year ongoing, to Health Canada to ensure that Canada’s MAID framework is implemented consistently and with all appropriate safeguards. This funding has supported the development of training and guidance materials for practitioners to facilitate consistent and safe access to MAID. Funding will also support research to guide the evolution of MAID in Canada.
For example, the Canadian Association of MAID Assessors and Providers, CAMAP, will receive $4.97 million over five years to develop and deliver the first nationally accredited bilingual MAID education program. This program was recently launched in August 2023 and is available to licensed physicians and nurse practitioners across the country. This multi-year project, going from 2021-22 to 2025-26, will develop and implement a series of training modules to advise and support clinicians in assessing persons who request MAID, including those with mental illness and complex chronic conditions or who are impacted by structural vulnerability, as well as help with the practical application of the MAID legislative framework. It will be delivered through a combination of online and in-person learning sessions for interested health practitioners, regardless of their level of experience. Also, in 2023-24, CAMAP is creating additional clinician resources to assist assessments of complex MAID requests, such as clinical tool kits and templates. The announcement can be found here: https://www.canada.ca/en/health-canada/news/2022/07/government-of-canada-outlines-progress-towards-recommendations-made-by-the-expert-panel-on-maid-and-mental-illness-in-their-final-report.html.
As another example, the University of Alberta will receive $560,000 in funding over two years, from 2022-23 to 2023-24, to conduct the first comprehensive national review of how MAID is provided across the country and to expand understanding about individual and family experiences with MAID. This project, “MAID: Descriptions of and experiences with models across Canada”, will further enhance knowledge about approaches to MAID delivery across the country by gathering data and information to highlight strengths, challenges and considerations of MAID service delivery, and will identify best practices for all levels of government as well as health partners. The project will complement information collected and reported through the federal MAID monitoring system, providing a better understanding of the experiences of persons requesting MAID, including factors leading to their request. It will also help to shed light on issues such as access to MAID, quality of delivery and cultural appropriateness. The announcement can be found here: https://www.newswire.ca/news-releases/government-of-canada-supports-research-to-better-understand-the-delivery-of-medical-assistance-in-dying-in-canada-831267389.html#:~:text=This%20project%2C%20MAID%3A%20Descriptions%20of%20and%20experiences%20with,levels%20of%20government%20as%20well%20as%20health%20partners.
The Government of Canada will continue working with the provinces and territories and health partners to support MAID practice in Canada so that it operates in a consistent and safe manner across the country.
Federal spending related to federal MAID policy and program activities between the 2016-17 and 2023-24 fiscal years as of October 31, 2023, is broken down as follows:
Contracts total $145,021, and spending was for seeking clinical expertise and research support to develop or enhance clinical or regulatory guidance and to better understand views and perspectives of various groups related to MAID. Spending was as follows: 2016-17, $0; 2017-18, $1,650; 2018-19, $1,500; 2021-22, $796; 2022-23, $87,737; and 2023-24, $53,337.
Contribution agreements total $5,213,348, and spending was for expert reviews on various MAID topics, development of MAID training programs, clinical guidance and supporting engagement with various groups related to views and perspectives on MAID. Spending was as follows: 2016-17, $0; 2017-18, $1,297,217; 2018-19, $1,456,187; 2022-23, $1,516,073; and 2023-24, $943,871.
Interdepartmental settlements total $1,695,136, and spending was for supporting Health Canada’s mandate to develop and maintain a MAID monitoring system through the Canadian MAID data collection portal, which is hosted on Statistics Canada’s secure web-based platform, and for supporting indigenous engagement activities on MAID. Spending was as follows: 2016-17, $0; 2018-19, $214,000; 2019-20, $160,500; 2020-21, $120,200; 2021-22, $147,200; 2022-23, $778,236; and 2023-24, $275,000.