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Newfoundland and Labrador and British Columbia are moving to reassure health-care workers that they will not be prosecuted if they participate in assisted deaths.Barabas Attila

Newfoundland and Labrador and British Columbia are moving to reassure health-care workers that they will not be prosecuted if they participate in assisted deaths, following the lead of Alberta, which issued a hands-off directive to police this week. And Nova Scotia is in discussions to do the same.

Ontario is refusing to issue a directive that clearly spells out a no-prosecution policy, as Alberta has done.

The moves are in response to the absence of a federal law on assisted dying. The Supreme Court said that, after June 6, severely ill Canadians would have a new constitutional right – the right to medical help in dying. It declared the right in a ruling in February, 2015, but said it would not take effect for a year to give governments time to draft a framework for it. It later extended that by four months and allowed patients to ask courts for permission during that period.

This comes as the Senate voted 41-30 Wednesday night to significantly alter federal legislation on assisted dying, broadening the scope of Bill C-14 by amending its definition of who is eligible for medically assisted death in Canada, including scrapping the requirement that a patient be close to death. A mix of Conservatives, independents and independent Liberals supported the change.

It is now unclear when or if a new law will pass.

Without a law in place, regulatory bodies for nurses and pharmacists have instructed their members not to participate in assisted deaths, citing the risk of criminal charges.

The Supreme Court ruling gave doctors explicit protection from prosecution. Ontario and Manitoba have told patients and physicians to seek court authorization for assisted deaths – a process legal experts say might not succeed. (Quebec is the only jurisdiction with its own law on assisted dying.)

Newfoundland and Labrador plans to issue a directive to police later this week along the lines of Alberta's, which said there will be no prosecutions in assisted deaths that fall within the parameters the Supreme Court set out in February, 2015: The right belongs to mentally competent adults suffering intolerably from grievous and irremediable conditions.

"The Public Prosecutions Office of Newfoundland and Labrador has drafted a directive to prosecutors and police which we expect to issue in the next day or so," a spokesman said.

British Columbia's Criminal Justice Branch, which oversees prosecutions in the province, issued guidelines late on Wednesday that said health-care professionals, including nurses and pharmacists, would not be charged if they adhere to the requirements set out in the Supreme Court of Canada decision.

"When charges are assessed on a case-by-case basis, the conditions of physician-assisted death set out in [the Supreme Court ruling] should be applied to physicians and to other health care professionals involved in carrying out, or providing information about, a physician-assisted death," the branch said in a news release.

Ontario is requiring that all medically assisted deaths be reported to the Office of the Chief Coroner. Unlike Alberta's directive, Ontario's policy does not spell out clearly that health-care workers will not be charged if they stay within the parameters of the Supreme Court ruling.

"A defined set of senior OCC personnel will manage all of these investigations. As with all deaths investigated by the OCC, if the coroner believes the death may be criminally suspicious, the police will be contacted to participate in the investigation," said Brent Ross, a spokesman for the Community Safety Ministry.

He said the Office of the Chief Coroner would have to determine how Ontario draws a line between legal assisted deaths and criminally suspicious ones.

Dirk Huyer, the Chief Coroner, said his office is not responsible for prosecutions; it investigates deaths, and if it determines criminality may be involved, contacts the police to investigate. In medically assisted deaths, the key, as in Alberta, will be whether they respect the Supreme Court ruling, and the guidelines of the College of Physicians and Surgeons of Ontario, he said.

In Nova Scotia, medical colleges representing doctors, pharmacists and nurses are pressing the Public Prosecution Service for a directive similar to Alberta's. "The issue requires careful thought and thorough consultation," Chris Hansen, prosecution service spokesman, said in an e-mail. "The Nova Scotia Public Prosecution Service is consulting with its justice partners and stakeholders on the matter."

In Manitoba, MLA Jon Gerrard tabled the Alberta directive in the Legislative Assembly, saying, "Manitoba should have similar clarity." The Minister of Justice did not respond.

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