Federal bill to relax criteria
for physician-assisted dying
OTTAWA - Physician-assisted dying will be more readily available to those whose deaths are "reasonably foreseeable", but will no longer be prohibited for others who are suffering and claiming it.
The Trudeau government tabled a bill on Monday afternoon to facilitate access to physician-assisted dying, as ordered by a court.
Ottawa is taking the opportunity to ban this aid in dying when mental illness is the only medical condition.
The federal government is also eliminating the requirement that someone whose application has been approved must wait 10 days before
getting the procedure. Ottawa is also removing the rule that a person must be able to give consent a second time immediately
before receiving medical assistance in dying.
But these two changes do not apply to everyone.
"Some have chosen to die sooner than necessary (...) to be sure of having access to medical assistance in dying," said Justice Minister David Lametti, explaining why he wants to withdraw the obligation to second consent for persons whose death is “reasonably foreseeable”.
The Trudeau government tabled a bill on Monday afternoon to facilitate access to physician-assisted dying, as ordered by a court.
Ottawa is taking the opportunity to ban this aid in dying when mental illness is the only medical condition.
The federal government is also eliminating the requirement that someone whose application has been approved must wait 10 days before
getting the procedure. Ottawa is also removing the rule that a person must be able to give consent a second time immediately
before receiving medical assistance in dying.
But these two changes do not apply to everyone.
"Some have chosen to die sooner than necessary (...) to be sure of having access to medical assistance in dying," said Justice Minister David Lametti, explaining why he wants to withdraw the obligation to second consent for persons whose death is “reasonably foreseeable”.
Because the Minister of Justice has chosen not to completely dismiss this concept of “reasonably foreseeable death”.
A person who is not as close to his end will have to wait 90 days before obtaining medical aid in dying, while one whose death is
“reasonably foreseeable” can proceed as quickly as he wishes.
“Safeguard measures” will therefore be different in the two cases.
People who are not on the verge of death, for example, will need to have discussed with doctors ways in which their suffering can be relieved.
They will also have to confirm their consent before receiving help that will end their lives.
Minister Lametti believes that this difference does not violate the rights guaranteed by the Charter.
“What the Superior Court asked us to do is to broaden the scope of the law and that is what we have done (...) We have opened the door to cases that are not not at the end of life and we did it in a balanced, sensitive way. I am confident it will be deemed constitutional,
”said the minister during a press conference Monday afternoon in Ottawa.
As for the vagueness of the concept of “reasonably foreseeable death”, the Federal Minister of Health says that we are no longer there.
"A lot of work has been done by the medical community to define what it means," said Minister Patty Hajdu.
A person who is not as close to his end will have to wait 90 days before obtaining medical aid in dying, while one whose death is
“reasonably foreseeable” can proceed as quickly as he wishes.
“Safeguard measures” will therefore be different in the two cases.
People who are not on the verge of death, for example, will need to have discussed with doctors ways in which their suffering can be relieved.
They will also have to confirm their consent before receiving help that will end their lives.
Minister Lametti believes that this difference does not violate the rights guaranteed by the Charter.
“What the Superior Court asked us to do is to broaden the scope of the law and that is what we have done (...) We have opened the door to cases that are not not at the end of life and we did it in a balanced, sensitive way. I am confident it will be deemed constitutional,
”said the minister during a press conference Monday afternoon in Ottawa.
As for the vagueness of the concept of “reasonably foreseeable death”, the Federal Minister of Health says that we are no longer there.
"A lot of work has been done by the medical community to define what it means," said Minister Patty Hajdu.
Mental illness
The text of Bill C-7 amends the Criminal Code by specifying “that medical assistance in dying is not permitted when
mental illness is the only medical condition invoked”.
“Experts, doctors, nurses told us that there was no consensus on this, that it was complex. We heard across Canada
what our counterparts heard in Quebec, ”revealed Minister Lametti.
In January, the prospect that medical aid in dying would become available for people suffering from mental illness caused quite a controversy
in Quebec. Quebec Health Minister Danielle McCann therefore decided to hold a consultation before getting there.
Minister Lametti assures that his bill which closes this door does not announce in advance the result of the review that will be started this spring.
This review should look at advance requests for medical assistance in dying, access by minors and, also, cases of people suffering from mental illness.
"This is still an open question," said the minister.
The text of Bill C-7 amends the Criminal Code by specifying “that medical assistance in dying is not permitted when
mental illness is the only medical condition invoked”.
“Experts, doctors, nurses told us that there was no consensus on this, that it was complex. We heard across Canada
what our counterparts heard in Quebec, ”revealed Minister Lametti.
In January, the prospect that medical aid in dying would become available for people suffering from mental illness caused quite a controversy
in Quebec. Quebec Health Minister Danielle McCann therefore decided to hold a consultation before getting there.
Minister Lametti assures that his bill which closes this door does not announce in advance the result of the review that will be started this spring.
This review should look at advance requests for medical assistance in dying, access by minors and, also, cases of people suffering from mental illness.
"This is still an open question," said the minister.
First reaction of the Bloc Québécois
"I am pleasantly surprised," said Luc Thériault, a member of the Bloc, when he spoke after Ministers Lametti and Hajdu.
He welcomed, among other things, the removal of final consent for people at the end of life.
"We do not give all the sedation necessary to relieve the patient's suffering so that he can have his whole head at the time of the second consent,
" said Mr. Thériault who referred to his very personal experience at his father's bedside, passed away two weeks ago.
"We relieved him but it was not completely," he said.
According to him, the promised changes would “dramatically improve people's end of life”.
The Bloc Québécois will continue, however, to campaign for the right to advance requests for people suffering from certain diseases,
such as Alzheimer's disease.
The Canadian Medical Association (CMA) considers the proposed changes to be a “prudent step” in response to the Truchon-Gladu decision.
“We welcome the government's gradual approach to carefully consider more complex issues. We are ready to work with Parliament on upcoming legislative work and the legislative review scheduled for later this year, ”said the CMA in a statement.
"I am pleasantly surprised," said Luc Thériault, a member of the Bloc, when he spoke after Ministers Lametti and Hajdu.
He welcomed, among other things, the removal of final consent for people at the end of life.
"We do not give all the sedation necessary to relieve the patient's suffering so that he can have his whole head at the time of the second consent,
" said Mr. Thériault who referred to his very personal experience at his father's bedside, passed away two weeks ago.
"We relieved him but it was not completely," he said.
According to him, the promised changes would “dramatically improve people's end of life”.
The Bloc Québécois will continue, however, to campaign for the right to advance requests for people suffering from certain diseases,
such as Alzheimer's disease.
The Canadian Medical Association (CMA) considers the proposed changes to be a “prudent step” in response to the Truchon-Gladu decision.
“We welcome the government's gradual approach to carefully consider more complex issues. We are ready to work with Parliament on upcoming legislative work and the legislative review scheduled for later this year, ”said the CMA in a statement.
Request for delay
It is a judgment of the Superior Court of Quebec, in the Truchon and Gladu case, which ordered to change the federal and provincial laws before
March 11. The concept of “death become reasonably foreseeable”, used in federal law, was found to be too restrictive.
Minister Lametti asked for a four-month delay in applying the judgment, fearing that the changes he tabled on Monday would not be adopted in time. Tuesday, the court will hear, in Montreal, the arguments of Ottawa for its request for delay.
Judge Christine Baudouin had also struck down the provision in the Quebec law on assisted dying which limited eligibility to those who are “at the end
of their life”. The Quebec government announced on January 21 that a person will now be able to claim medical assistance in dying even if they are not dying - the “end of life” criterion. From a legal point of view, this “end of life” criterion will therefore become ineffective as of March 12.
If Ottawa did not obtain the requested delay, the judgment would only apply in Quebec. The rest of Canada would wait for the adoption
of C-7 before seeing new rules for accessing medical assistance in dying.
It is a judgment of the Superior Court of Quebec, in the Truchon and Gladu case, which ordered to change the federal and provincial laws before
March 11. The concept of “death become reasonably foreseeable”, used in federal law, was found to be too restrictive.
Minister Lametti asked for a four-month delay in applying the judgment, fearing that the changes he tabled on Monday would not be adopted in time. Tuesday, the court will hear, in Montreal, the arguments of Ottawa for its request for delay.
Judge Christine Baudouin had also struck down the provision in the Quebec law on assisted dying which limited eligibility to those who are “at the end
of their life”. The Quebec government announced on January 21 that a person will now be able to claim medical assistance in dying even if they are not dying - the “end of life” criterion. From a legal point of view, this “end of life” criterion will therefore become ineffective as of March 12.
If Ottawa did not obtain the requested delay, the judgment would only apply in Quebec. The rest of Canada would wait for the adoption
of C-7 before seeing new rules for accessing medical assistance in dying.