Justice minister confident feds will meet tight deadline to change assisted dying regime

OTTAWA — The federal government is confident Parliament will have enough time to fully consider a series of proposed changes to Canada’s medically assisted dying regime, despite having just over two months to debate, study, and possibly amend the legislation.

On Monday Justice Minister David Lametti reintroduced the federal government’s proposed changes to the medically assisted dying legislation, in the face of a pressing court deadline to see the bill—on what remains a controversial, complex, and deeply personal topic— pass through the House of Commons and Senate.

After the last version died on the order paper when Prime Minister Justin Trudeau prorogued Parliament this summer, Lametti said the revived bill will pick up on conversations already underway as the text has not changed.

“We’re going to build on our consultations… we felt at that time and we still feel it is the case now that that this bill is the product very much of a consensus that Canadians are ready for, and therefore that should be reflected across both sides of the aisle,” Lametti said. “We’re pretty confident. We’ll do everything we can, in terms of trying to build consensus with our parliamentary partners in both houses, to make sure that the bill gets heard, and discussed ,and debated properly. But we are confident that this can move expeditiously.”

Bill C-7—coincidentally also the name of the same bill during the last session—seeks to allow those eligible to pursue a medically assisted death whether or not their death is reasonably foreseeable, and makes other proposed amendments to the regime to comply with a Quebec Superior Court ruling.

Last fall, that court ruled that sections of the federal and Quebec laws on medically-assisted dying were invalid, finding that they were unconstitutional because they were too restrictive.

The court specifically took issue with the Criminal Code requirement that a natural death be “reasonably foreseeable” in order for a person to be eligible for assisted death. This gave the federal and provincial governments six months to review the ruling and revise their laws, with the court’s ruling set to come into effect on March 11, 2020, unless an extension was granted.

The Liberals were granted that as well as a second extension, citing the delays caused by the COVID-19 pandemic, including to the regular parliamentary schedule.

Now, the federal government has until Dec. 18 to pass the bill.

Medically assisted dying under certain parameters has been legal in Canada since June 2016, and according to federal officials since then there have been over 13,000 reported medically-assisted deaths in Canada.

The federal law as it stands states that Canadians 18 years of age or older who are considered mentally competent can access an assisted death, under a series of eligibility criteria. It also puts in place protections for medical professionals who would play a role in administering the assisted death. Not included in the law—but called for by some at the time— was the ability for patients to give advance directives, or for mature minors to have the ability to seek an assisted death.

CHANGES PROPOSED

The new federal legislation aims to make it easier for patients who are near death and have requested an assisted death, but are worried about losing their ability to consent as their illness progresses, to still qualify by removing the requirement for them to consent immediately before the procedure.

Given the intent to repeal the reasonable foreseeability of natural death criteria, the legislation would now specifically state that in order to be eligible, mental illness is not considered a “serious and incurable illness, disease or disability.”

The 15-page bill also proposes to ease certain safeguards while creating other protections for Canadians whose natural death is not imminent, and expands the monitoring system for medical practitioners and pharmacists to reflect updates to assessment requirements.

To provide for assisted deaths in cases where a natural death is not considered to be reasonably foreseeable, the federal government is proposing to require two independent practitioners to confirm that all eligibility criteria are met, and one of the two must have expertise in the condition that is causing the patient’s suffering.

In these situations the person has to be informed of, and offered consultations on all counselling, mental health, and disability supports, as well as the community services and palliative care available to them. As well, the two practitioners have to agree that the person requesting an assisted death has “appropriately considered” the options they have for alleviating their suffering.

In addition to responding to the ruling, the federal government is proposing to make some other slight adjustments to the law to address issues that “received considerable attention during our consultations with Canadian practitioners, experts, and stakeholders,” as Lametti put it.

The legislative process to pass this bill in the last Parliament was at times tense and emotional, with the government taking the approach of a joint House and Senate committee to study the bill given the time crunch legislators were also under at the time.

Since the Liberals passed the initial regime, they have faced questions about changing the law. Even before it passed, the legislation generated considerable parliamentary debate, with a handful of Liberal MPs voting against it, saying that as it was drafted it would be unconstitutional. Among them was now-minister Lametti.

On Monday he said this bill should be seen as a “first step” based on the social consensus about changes needed to the now four-year-old regime, but that he hoped a further conversation could be had in the months ahead, reviewing more deeply the law as it stands.

The Quebec government has already announced it would comply with the court decision, dropping the sections the court took issue with, but would be not making any additional amendments to the provincial law.


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