Government tables framework for medically assisted suicide

The Federal Government has tabled legislation regarding medical assisted suicide in Canada following a recent Supreme Court of Canada (SCC) ruling.

In 2015 the SCC ruled that sections of the Criminal Code that make it illegal for anyone, including a doctor, to cause the death of another person who consents to die are unconstitutional. In the landmark ruling, the SCC unanimously struck down the law against physician-assisted suicide in the country. The ruling was suspended for 12 months, allowing the Federal government, provincial governments and medical regulatory bodies to draft new laws and policies around physician-assisted suicide.

On Thursday, the federal government has proposed framework to provide access to medical assistance to those who are eligible. The approach contains specifically worded legislation which includes:

• recognize individual choice of a medically assisted death for adults who are suffering intolerably and for whom death is reasonably foreseeable;
• affirm the inherent and equal value of every person's life;
• avoid encouraging negative perceptions of the quality of life of persons who are elderly, ill or disabled;
• protect vulnerable people from being encouraged to die in moments of weakness;
• re-affirm society's goals with regard to preventing suicide; and
• encourage a consistent approach to medical assistance in dying across Canada.

In order for someone to have access to medical assistance in dying in Canada, the Criminal Code will be changed to reflect the following:

• Physicians, nurse practitioners - and those who help them - can provide assistance to die to eligible patients without the risk of being charged with assisted suicide or homicide.
• There will be safeguards to make sure those who receive medical assistance in dying are eligible, can give informed consent, and voluntarily request it.
• The foundation is laid for the Minister of Health to make regulations to establish a process for monitoring and reporting on the use of medical assistance in dying.

Medically assisted suicide would be eligible to people who are 18 years of age or older who are mentally competent, individuals who make a voluntary request to give informed consent to receive assistance, have a serious and incurable illness, disease, or disability, and be in an advanced state of irreversible decline in capacity. The individual would also have to experience enduring and intolerable suffering as a result of their medical condition and be on the course toward the end of life.

The following safeguards would ensure that patients are eligible and have given informed consent:

• Patients would have to make a written request for medical assistance in dying (a designated person can do so if the patient cannot write), and have it signed by two independent witnesses;
• Two independent physicians or authorized nurse practitioners would be required to evaluate the request;
• There would be a mandatory period of at least 15 days of reflection, unless death or loss of capacity to consent is imminent;
• Patients would be able to withdraw a request at any time.

The government adds that health care in the country is shared between federal-provincial-territorial jurisdiction, but provinces and territories hold primary responsibility for delivering health services in Canada. They may choose to adopt additional laws and regulations around medical assistance in dying, or set out more requirements for health professionals. The government is proposing to work with provinces and territories on the development of mechanisms to coordinate end-of-life care for patients who want access to medical assistance in dying.

The current Criminal Code prohibition on medical assistance in dying will remain in place until June 6, 2016 or until the legislation is passed in Parliament and comes into effect.