Last September, a Quebec court ruled that Canada’s medical assistance in dying (MAID) legislation was too restrictive because it limited eligibility to people whose deaths were reasonably foreseeable. The decision gave the federal government until March 11, 2020, to change that provision in the law. If it does not do so, the reasonably foreseeable clause will be removed from the legislation in Quebec.
The federal election was underway at the time, and politicians, including the Prime Minister, rushed to comment on the decision. Trudeau said:
David Lametti, Minister of Justice and Attorney General of Canada, announced Monday that the government is undertaking a consultation with Canadians and experts as it prepares to consider amendments to the current MAID legislation. Passed in June 2016, the law was scheduled for a regular review in Summer 2020, but the government hopes to address the issue raised by the Quebec case before the March 11th deadline. Lametti says:
“Medical assistance in dying is a profoundly complex and personal issue. . . . It touches people and families facing some of the most difficult and painful times in their lives. . . . The consultations we are launching today will allow us to hear directly from Canadians and guide the path forward.”
The government may want to hear from us, but we are not being given much time. Anyone wishing to participate in the online survey must complete and submit it by January 27th.
What is the government asking?
The survey poses questions about two aspects of MAID: its appropriateness in situations where death is not imminent and whether advance directives should be permitted.
With respect to non-imminent death – that is, situations where someone may have a permanent health condition that causes intolerable levels of pain and suffering with no relief but where their death from that condition is not imminent or reasonably foreseeable –the questions focus on whether current safeguards are sufficient or whether additional protections should be added. Eight possible new protections are offered for comment, including a longer reflection period, whether the medical professional must agree with the patient that there are no other reasonable options and whether there should be a mandatory psychological or psychiatric assessment of the patient.
Advance directives would allow a medically assisted death for people who had provided instructions and consent when competent even if they had lost capacity by the time of the MAID. The current legislation requires the person to have the capacity to understand and consent to their medically assisted death at the time it is to occur. This means that people who develop dementia or lose capacity because of another medical condition, but who wanted a MAID while they were competent, cannot have an assisted death.
The survey asks two questions about advance directives. Should they be permitted if the person has made a request for a medically assisted death and been found eligible but then loses capacity to consent before the death can occur? Should someone who has received a diagnosis of a medical condition such as Alzheimer’s but who is still competent be able to request and be approved for a medically assisted death and receive that assistance in dying later, after they lose capacity?
In addition to the online survey, the government is holding in-person consultations with “experts,” who will also be discussing whether MAID should be available to mature minors (people under 18 years of age) and to people who wish to die because of mental illness alone.
Only the first issue – MAID in cases whether death is not reasonably foreseeable – has to be dealt with by March 11.
The survey is straightforward and contains background information for anyone not familiar with the current legislation. The Dying with Dignity website also provides a wealth of information about MAID, as well as powerful personal stories from people who have sought and received (or not) medical assistance in dying.
Since the legislation was passed in mid-2016, more than 6,700 Canadians have been able to choose when they were ready to die. It is important for the government to hear from those of us who would like to see the legislation expanded to make it possible for those whose deaths are not reasonably foreseeable, who may lose capacity after requesting a medically assisted death, who are mature minors or whose mental illness makes their lives intolerable the same access to a dignified and chosen death.
Please take the time to complete the survey by January 27th. It will only take you a few minutes, but it could change the life and death of someone you care about (or you).