The law is being reworked after a court struck down the requirement that people requesting a medically assisted death have a 'reasonable foreseeability of natural death'
OTTAWA — When parliament resumes later this month after its winter break, one of the first items of business will be reforms to the medically assisted death law, which was passed in 2016 and is now up for review.
On Monday, the federal government opened a public consultation prompted by an approaching court-ordered deadline, after the Quebec superior court recently struck down a clause that requires people requesting a medically assisted death to have “reasonable foreseeability of natural death.” The government has decided not to appeal that ruling.
The government is also preparing for a parliamentary review on some of the most sensitive and controversial aspects of the law, including how it handles advance requests, mature minors, and those suffering from mental illness.
“We always knew that there would be continual changes that would be made to the law as Canadian society evolved,” Justice Minister David Lametti said in an interview.
“Canadian society has evolved quite rapidly since the legislation passed,” he said, adding that the experience of other countries has also helped move public opinion. “People are generally comfortable now with the concept and so my guess is we will be able to move on those other larger issues.”
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The government says more than 6,700 Canadians have chosen medically assisted death since the legislation was passed.
The online public consultation will run until Jan. 27, the same day the House of Commons returns from its winter break. Lametti, along with fellow cabinet ministers Patty Hajdu and Carla Qualtrough, will also be holding consultations around the country with front-line experts, academics and associations representing people who may request a medically assisted death.
The government will have to move quickly to introduce legislation responding to the Quebec court decision, which has a deadline of March 11, 2020 (although the government can request an extension). The court ruling makes it unconstitutional to restrict access to a medically assisted death to people who are already near death. The law currently requires death to be “reasonably foreseeable.”
Meeting the deadline will be difficult, given the minority parliament situation. “The goal is still to try to make that deadline,” Lametti said. “I would like to have a bill introduced as soon as possible so that we have some idea of where the process is and how long it could take.”
If the consultations show there is consensus on other reforms, those may also make it into the bill this spring. But a parliamentary committee will start a study of the law later this spring, a review mandated by the original legislation. That study will tackle some of the thorniest issues that still remain, and three issues in particular will be at the top of the agenda.
First, the committee will look at advance requests, where a person knows their mental faculties will deteriorate and wants to authorize a medically assisted death ahead of time. Currently the law requires a person to give fully informed consent immediately before the death happens, meaning those who have lost mental capacity become ineligible.
Secondly, there’s the issue of whether mature minors — people younger than 18 who demonstrate the ability to make informed decisions about their health — should have access to a medically assisted death. The law currently forbids it to anyone younger than 18.
Finally, the committee will look at whether a medically assisted death should be available to someone whose sole underlying medical condition is mental illness. Currently such people are not technically forbidden, but the law’s criteria makes it very difficult for them to get access.
The federal government already commissioned a report on all three issues from the Council of Canadian Academies, which was released in December 2018. The report did not make specific recommendations, but instead tried to capture the state of knowledge from experts and lay out the pros and cons of changes.
Lametti couldn’t specify a timeline for when further reforms may happen — it depends in part on how quickly the committee study concludes, and how long the minority government lasts until there’s another election. But he said the government will have to proceed very carefully.
“The human element of all this means we have to always be sensitive,” he said. “I’m a lawyer and and it’s easy for me to say the rule ought to be this or that, but you always have to take people into account and the impact that you’re having on people at a very vulnerable point in their lives.”