Newfoundland and Labrador

Under the Advanced Health Care Directives Act, it is presumed that people 16 years of age or older are competent to make health care decisions, while minors younger than 16 years of age are not. This means that minors under the age of 16 may consent to medical treatment including abortion care if they understand the information that is relevant to making a health care decision and are able to appreciate the reasonably foreseeable consequences of that decision.¹

Despite this, a patient under the age of 19 must have parental consent to have a medical abortion at the Health Sciences Centre, unless they are independent of their family.²

The Access to Abortion Services Act was the second safe access zone law passed in Canada and is nearly identical to British Columbia’s law. Under the Act, facilities that provide abortion care must apply for a zone, which is then established by regulations. Homes and offices of doctors who provide abortion are automatically protected, and access zones for the residences of a class of service providers, or the residence of a specific service provider, may be established by regulation. Harassment of doctors and service providers outside of the safe access zone is also prohibited under the Act.

The dimensions of the zones are calculated from the edge of the lot on which the home or facility is located and are set at: 

• 160 metres for a doctor's or service provider's home 
• 10 metres for a doctor's office (which can be extended up to a maximum of 20 metres) 
• up to a maximum of 50 metres for a facility 

The Athena Health Centre had moved in 2015 and became besieged by protesters. The clinic began to collect evidence and do research, and met with government ministers to get support. The Justice Minister advocated the law in public, and in the meantime, the clinic was given an injunction to protect patients. The injunction banned anti-abortion activists within a 40 metre radius of Athena Health Clinic, where 90% of abortions in Newfoundland and Labrador are performed, as well as a 40 metre radius within the homes of clinic staff.

Soon after, the Access to Abortion Services Act and the Access to Abortion Services Regulations increased the access zone to a 50 metre radius and 160 metre radius from residences of clinic staff. The government adapted British Columbia’s bubble zone legislation because their law had already withstood constitutional scrutiny by the courts.

Physicians

The College of Physicians and Surgeons in Newfoundland and Labrador adopts the Canadian Medical Association’s Code of Ethics and Professionalism, which does not require physicians to provide or refer for a medical service they object to providing based on personal beliefs. This means that a physician may deny a patient abortion care, and is not obligated to provide them a referral to another provider or clinic.

Nurse practitioners

The College of Registered Nurses of Newfoundland and Labrador adopts the Canadian Nurses Association’s Code of Ethics for Registered Nurses, which states that in cases of conscientious objection, nurses are obligated to notify their employers or the patient receiving care in advance so that alternative arrangements can be made.

In some instances, patients may have to travel outside of the country to receive abortion care currently not available in Canada. 

Newfoundland and Labrador’s Medical Care Plan includes out-of-province coverage for patients referred for medically necessary physician services not available in Canada. 

A Newfoundland and Labrador physician must submit a request form on behalf of the patient and receive prior approval from the Medical Care Plan in order for the patient to be eligible for coverage.

Travel support

Newfoundland and Labrador has two travel support programs for patients covered by the province’s Medical Care Plan (MCP):

Medical Transportation Assistance Program (MTAP)

MTAP is available for patients who need to access “specialized insured medical services” that are not available in their community and/or within the province. It includes airfare (and related eligible taxi fares); private vehicle usage; purchased registered and private accommodations (and related meal allowance); busing and use of ferries based on program criteria. Limitations and deductibles may apply.

Medical Transportation Benefits for Income Support Clients (ISMT)

ISMT is a needs based program that provides non-urgent medical transportation benefits to eligible Income Support clients and home support, long-term care, private paying personal care home and low-income residents seeking access to insured medical services. Eligible patients and their escorts receive 100% of eligible travel, accommodations, and meal expenses, within set limits. Patients may be required to pay a contribution towards the cost of the trip based on a financial eligibility assessment.