Submission to the Alberta Department of Justice

Re: 2026 Bill 18 (Alberta) Safeguards for Last Resort Termination of Life Act

Protection of Conscience Project

Abstract

The affirmation in Section 8 of the freedom of nurse and medical practitioners to refuse to provide EAS/MAiD and related opinions is satisfactory. However, the section should be amended to include affirmation of their freedom to refuse to actively assist in or facilitate the provision of EAS/MAiD, and to prohibit bullying or harassment of and discrimination against those who refuse to collaborate in the services. Further: these provisions should be applied to all regulated health professionals, since medical and nurse practitioners are not the only regulated health professionals likely to be called upon to collaborate in EAS/MAiD.

Affirmation of the freedom of health facility operators to refuse to permit EAS/MAiD on their premises is laudable and necessary from the perspective of freedom of conscience. However, the provision that affirms their freedom to refuse to permit the provision of opinions related to EAS/MAiD on their premises invites confusion and conflict. Refusing to permit opinions about the foreseeability of natural death or “eligibility” for EAS/MAiD is not the same as refusal to permit evaluations or assessments that would form the basis for such opinions. Assuming that Bill 18 is intended to affirm the freedom of the operators of health care facilities to refuse to allow EAS/MAiD assessments in their premises, that is what Section 8 should say.

Those refusing for reasons of conscience to preserve their moral/professional integrity should be able to step aside to avoid complicity in EAS/MAiD, and individuals refused should be able to to seek the services from willing practitioners and facilities. Bill 18 strikes this balance by requiring refusing practitioners or facilities to direct individuals to a resource that can reasonably be expected to provide accurate information about all available medical options, not to an EAS/MAiD practitioner or a resource dedicated to EAS/MAiD.

It does not appear that the establishment of exclusion zones contemplated in Bill 18 is essential to ensure the protection of freedom of conscience in the operation of a health care facility, though in some circumstances it may be desirable for the protection of patients, or from the perspective of the Alberta government or of a particular facility.

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Table of Contents

I.    Introduction

 II.    Relevant considerations

III.    Section 8

• III.1    Provisions
• III.2    Project comment
  • Refusal of practitioners to provide EAS/MAiD & related opinions
    • i) Need to prevent other forms of forced collaboration
    • ii. Need to protect other regulated health professionals
    • iii) Recommendations
  • Refusal of health care facilities to permit EAS/MAiD
  • Refusal of health care facilities to permit opinions
    • Recommendation
  • Duty of individuals and facilities refusing 

IV.    Section 9

•  IV.1 Provisions
•  IV.2 Project comment

V.    Section 10

•  V.1 Provisions
•  V.2 Project comment

VI.    Section 14

•  VI.1 Provisions
•  VI.2 Project comment

VII. Summary of Project recommendations

•  Section 8
•  Section 9
•  Section 14
• Recommendations applied (example)

Appendix “A”:     Rights and obligations in Carter v Canada (Attorney General) 2015 SCC 5

Appendix “B”:    Carter: cautionary note on physician freedom of conscience and religion

Appendix “C”:    Health care facilities can exercise freedom of conscience

Appendix “D”:    Religious health care facilities

Appendix “E”:    Objecting non-governmental health care facilities and practitioners

• Claim: Objecting NGHC facilities and practitioners are state actors
  • Eldridge v. British Columbia (Attorney General)
  • Chaoulli v. Quebec (Attorney General)
  • Carter v. Canada (Attorney General)
  • Alleged Charter violations
• Response: Objecting NGHC facilities and practitioners are not state actors
  • Eldridge revisited
  • The Eldridge Principle (reformulated)
  • Chaoulli revisited

Appendix “F”:    Primacy and priority of preservative freedom of conscience

• Canadian jurisprudence
•  Justice Wilson in R v Morgentaler
•  The principle against servitude
• “The basic theory underlying the Charter”
•  A framework for adjudication: perfective and perservative freedom of conscience
•  Limitations: the primacy and priority of preservative freedom of conscience
• The Oakes analysis
• Preservative freedom of conscience and institutions