A political fight is brewing after a parliamentary committee recommended the federal government make doctor-assisted dying immediately available to all adults with "grievous and irremediable" medical conditions -- including mental illnesses -- and eventually allow “mature minors” to also end their lives.
The special parliamentary committee released 21 recommendations Thursday, which will guide the government as it drafts medically-assisted dying legislation that’s required in response to a Supreme Court of Canada ruling.
The committee wants the new rules to be implemented in two stages. The first would apply immediately to those over 18 experiencing “intolerable” physical or mental suffering. The second stage -- “no later than three years after the first” would extend it to “competent mature minors.”
The committee said each patient must be fully assessed by two doctors, independent of each other, to ensure he or she has the capacity to provide informed consent.
MP Michael Cooper was among the four Conservatives on the committee who dissented from the majority report. He said he was troubled by the recommendation to include minors, and concerned that people with arguably treatable conditions like anxiety and depression could choose assisted-death.
Cooper told reporters in Ottawa that he also sees a “serious problem” with the fact that the proposal doesn’t recommend requiring either of the doctors signing off on an assisted-death to be a psychiatrist.
Harold Albrecht, who also dissented, said the model proposed could create a “tragic permanent solution to what was a temporary problem,” adding “there are many people living today who have gone through severe depression.”
Sen. James Cowan, a Liberal, told CTV Power Play that he believes mentally ill people would still opt to consult a psychiatrist or other specialist, “just as you would, if your complaint was bone cancer, consult with an oncologist.”
Cowan said the committee didn’t go as far as some would have liked. Although they did approve of allowing people with “progressive” conditions like ALS or dementia to request assisted-dying before they lose their capacity to consent to it, Cowan points out they wouldn’t allow people to request assisted dying for diseases they might one day get.
The report also recommended that provisions be made for doctors and other health professionals who object to assisted dying. Governments should work with medical regulatory bodies to establish ways to respect these professionals’ freedom of conscience while at the same time respecting the needs of patients, the report said.
Cowan said his view is that while “no one should be forced to participate in this if it is against (his or her) conscience” health care providers shouldn’t be allowed to “simply abandon” patients requesting assisted-death.
He suggested doctors who disagree with patients seeking assisted-dying assessments be forced to refer their patients to other doctors who will do the assessments.
The committee called for an oversight mechanism to regularly monitor assisted death and also suggested the legislation be reviewed every four years “to identify any potential areas that require refinement.”
Minister of Justice Jody Wilson-Raybould thanked the committee for its report, saying her department would consider all its recommendations as it drafted a new legislative framework for physician-assisted dying.
Wilson-Raybould said in a statement that the assisted dying issue is complex and that her department is “committed to developing an approach that is based on empathy and strikes the best balance among a range of interests.”
“It is important that we protect people’s choices and freedoms in a way that makes sure our society protects the most vulnerable,” she added.
Wilson-Raybould told reporters on Parliament Hill that her department intends to “move quickly” but that it is “too early to say what will be in the legislation and what won’t be.”
The Supreme Court has given the federal government until June 6 to produce the legislation, after striking down the ban on assisted death as unconstitutional last year.
The committee heard more than 20 hours of testimony in addition to written briefs before compiling its recommendations. Committee co-chair Rob Oliphant said in a statement they looked to the “wealth of information” from jurisdictions such as Quebec that already have laws in place on assisted dying.
Dying With Dignity Canada, a national organization that works to expand end-of-life choices for Canadians, applauded the recommendations and urged the federal government to heed them when drafting new rules.
CEO Shanaaz Gokool said the group was particularly pleased with the recommendation to allow patients facing the loss of mental competency to make advance requests for assisted dying.
“Patients deserve real choice,” she said.
“Without the option to consent in advance to assisted dying, Canadians with dementia who want to die in peace with the help of a physician face a dire choice: access assisted dying prematurely, while they are still competent; or risk losing competence before their wishes can be carried out, only to be condemned to the exact fate they sought to avoid.”
She also thanked the committee for recommending that all publicly-funded hospitals, hospices and long-term care facilities be required to allow assisted dying on their premises.
