B.C. found hundreds of MAID ‘compliance concerns’ in 2024. The province won’t say what happened

Hundreds of MAID cases in British Columbia in 2024 involved reporting errors and “compliance concerns” that resulted in practitioners receiving “education” on the criminal law and professional standards governing MAID, according to an internal B.C. government document.

The findings are bolstering calls for stronger, independent oversight of the country’s assisted death regime.

The data are contained in a confidential annual report prepared by B.C.’s MAID Oversight Unit obtained by Canadian Catholic News through a freedom of information request.

Housed within the province’s ministry of health, the unit reviews every case of MAID in B.C.

All required documentation submitted by doctors and nurse practitioners, and pharmacists who dispense drugs used in MAID, is reviewed for compliance with eligibility criteria, federal regulations, safeguards and regulatory college practice standards.

Staff follow up if there’s missing or incomplete information, or to clarify what’s provided. Doctors have reporting obligations if they receive a request for MAID and assess the person for eligibility, even if the request doesn’t result in MAID.

In an email to the National Post, the health ministry said that if a compliance issue has occurred, the oversight unit determines the appropriate response, from education to referral to police.

In 2024, 4,169 people sought MAID in B.C.

Half those cases — 51.9 per cent — required follow-up by the oversight unit, “with a total of 2,807 errors across those cases,” according to the report.

Most follow-up was due to clerical errors, like missing information, or missing pages from provincial forms, information classified as “non-critical” but reportable.

A sizeable proportion of those errors — 12.5 percent, or 353 cases — required “education to practitioners and pharmacists” over concerns about compliance with legal requirements and professional standards.

“In these cases, the unit will provide education to a medical practitioner, nurse practitioner or pharmacist in response to a deviation from a mandated MAID process that, on its own, has a limited impact on the integrity of the assessment, provision or reporting process,” the health ministry’s statement said.

“Such education is intended to support practice improvement.”

The most common examples include forms submitted late, missing forms and “not reviewing the relationship between the patient and witness on the patient’s written request for MAID,” the ministry said.

Serious deviations are rare, according to the province. “Only 0.2 per cent of reported MAID cases (since 2018) involve serious compliance concerns which may have a significant impact on the integrity of the MAID process, appropriateness of care, and/or public safety” requiring a formal notice to the practitioner from the health ministry’s director of MAID, referrals to regulatory colleges and/or referrals to law enforcement, the department said.

Since 2018, 17,304 people have died of MAID in B.C. The province accounts for the third-highest proportion of MAID deaths in Canada, behind Quebec and Ontario.

While the MAID oversight unit reviews the required paperwork, it doesn’t conduct investigations, and serious compliance concerns identified during case reviews “are not allegations of misconduct,” the ministry said.

Instead, any investigation would be conducted by the appropriate regulatory college or police.

The ministry said it couldn’t disclose how many cases have been referred to police or licensing colleges, citing provincial privacy laws. Any information about the outcomes of any referrals would need to be directed to the colleges and law enforcement, it added.

The data come amid calls for greater scrutiny — and more public transparency — over MAID deaths. Recent controversial cases include an Ontario man who was assessed for MAID outside a Tim Hortons coffee shop and, six months later, driven by the same doctor to a storage facility where bodies are prepared for funerals, where the MAID provision took place.

In another case, an Ontario man resumed breathing after being declared dead after the doctor failed to use the proper sequence of drugs.

Last December 26-year-old Kiano Vafaeian, who struggled with vision loss from diabetes and depression, died by MAID in a Vancouver funeral home after being denied MAID by doctors in his home province.

A special joint federal parliamentary committee that last month recommended Prime Minister Mark Carney’s Liberals legislate an indefinite pause on expanding MAID to those with mental illness alone heard conflicting views on MAID oversight. Some expressed concerns assessors are playing loose with eligibility criteria and liberally interpreting the law amid a lack of enforcement.

Dr. John Maher, who specializes in treating severe mental illness, told the committee people are getting MAID “for reasons that are frankly illegal.”

But Dr. Douglas Grant, registrar and CEO of the College of Physicians and Surgeons of Nova Scotia, testified that allegations of misconduct would be quickly investigated.

Since MAID became legal in 2016, the Nova Scotia college has investigated 4,000 complaints, only three of them involving MAID, and all three involved cases where family members were unable to get an assessment for MAID by a conscientiously objecting physician, Grant told the committee.

He said he had a “hard time envisaging a situation” where a regulator, a health authority and other professionals involved in a MAID death would be “blinded” to an illegal MAID provision.

“I don’t think we can speculate” about the serious compliance concerns flagged by the B.C. oversight unit, Dr. Ramona Coelho, a former member of the Ontario Coroner’s Office MAID death review committee, said in an email.

“However, they do raise important questions about safety and transparency in the reporting of a procedure that causes death,” she said.

A significant share of the missing or incomplete information is meant to protect patients and includes eligibility criteria, safeguards for patients whose deaths aren’t “reasonable foreseeable” and the right to rescind a request for MAID, Coelho said.

“The ministry should disclose how many cases resulted in referrals to regulatory colleges or law enforcement, the nature of those concerns and the outcomes of any investigations.”

More broadly, oversight “cannot simply consist of reviewing practitioner-submitted paperwork after a death has occurred,” Coelho said. There should be independent oversight bodies “with the authority and resources to investigate concerns and enforce safeguards.”

Of the 4,169 people who sought MAID in B.C. in 2024, 72 per cent — 3,000 people — ultimately died by MAID. Most (98 per cent) were “Track 1” cases whose natural deaths were reasonably foreseeable; two per cent were Track 2 (natural death is not reasonably foreseeable.)

In the remaining 28 per cent of MAID requests, the person died of a cause other than MAID, was found ineligible or withdrew the request.

National Post