The Special Joint Committee on Physician-Assisted Dying released its report late last week, outlining recommendations for the government to consider as it develops legislation in response to the Supreme Court of Canada’s decision in Carter v. Canada. CCLA is pleased that the report recognizes the importance of ensuring equitable access to medical assistance in dying for all Canadians and that it directly addresses some very difficult issues, including the rights of minors and the use of advance directives. Overall, we agree with many of the Committee’s recommendations, including: that a terminal condition is not a prerequisite to accessing medical assistance in dying; that questions of the capacity of an individual to make decisions related to medical assistance in dying can be assessed using existing medical practices; and that advance requests for medical assistance in dying should be permitted in some circumstances. While CCLA has argued that mature minors should be able to benefit from medical assistance in dying, the Committee’s recommendation to study this issue further and implement the law relating to mature minors in a “second phase” is not an unreasonable approach.
We are also in agreement with the Committee’s recommendation that the freedom of conscience of medical practitioners must be addressed by any legislative scheme, but that objecting practitioners should, at a minimum, be required to provide an effective referral.
Unfortunately, some of the Committee’s recommendations — particularly some of those characterized as procedural safeguards — may impose unreasonable or onerous barriers on individuals. For example, the requirements that two physicians agree that a patient meets eligibility criteria and that two witnesses with “no conflict of interest” witness the request for assistance in dying, may be difficult to implement in some parts of the country. These do not have a clear medical benefit and may have a detrimental affect on patients and their rights to autonomy.
CCLA intervened in the Carter case before the Supreme Court of Canada and engaged in consultations with the Federal External Panel that studied physician-assisted dying and the Provincial-Territorial Expert Advisory Group. We made written submissions to the Special Joint Committee and are looking forward to continuing to engage with policy makers on this important issue.