Canadians given until Jan. 27 to contemplate assisted suicide rules: government survey underway (UPDATED article)

Psychotherapists may be the next medical professionals expected to refer patients for medically-assisted suicide or euthanasia, as eligibility rules come into question.

Article UPDATED Jan. 21, 2020

By Brian Dryden, Canadian Catholic News

OTTAWA – Opponents and supporters of legally sanctioned medically-assisted death in Canada are being urged to make their views known before the government proposes changes to the rules surrounding who qualifies for a government-approved suicide.

About 200,000 Canadians have already taken part in a federal government survey that continues until 11:59 p.m. on Monday, Jan. 27 to provide public input into how the federal government changes regulations surrounding assisted-suicide / euthanasia to fall in line with a Quebec court ruling that the “reasonably foreseeable” and imminent death requirement to qualify for an assisted death is unconstitutional.

Tell the government what you think about expanding assisted suicide and euthanasia in Canada and protecting the vulnerable: LINK to Online Survey

PDF version of the survey for those who prefer to print and submit by mail or e-mail: Survey document

Euthanasia Prevention Coalition guide to filling out the survey for those who oppose assisted suicide: LINK

The latest public consultations, which are primarily being conducted through an online public survey, were launched on Monday, Jan. 13 by the federal government, and Canadians can give their views on what the rules should be surrounding state-sanctioned suicide by the end of the day Jan. 27, 2020. The survey can be accessed at:  Justice Ministry web page.

The rush to make changes to Canada’s assisted-death laws is a direct response to a Quebec court decision in September 2019 that ruled that the “reasonable foreseeability of natural death” criteria in the federal law and the “end-of-life” criteria in Quebec’s provincial law on medically-assisted suicide / euthanasia as being unconstitutional because those rules are too restrictive.

When the federal government first brought in regulations surrounding assisted-dying in 2016, which in itself came after previous court decisions, the government promised there would be a larger review of the system after five years, primarily focusing on three complex issues: requests for medically assisted suicide/euthanasia by mature minors, for reasons of mental illness only, and for advance requests.

“As we prepare to launch the full review of the MAID law this summer, the Government of Canada is moving quickly in the shorter term to help inform our response to the recent Quebec court ruling. Updating Canada’s MAID law will expand eligibility for MAID beyond people who are nearing the end of life, and could possibly result in other changes once the review is complete,” a statement on the Justice ministry’s website said. MAID or “Medical Assistance In Dying” is the term used by the government for medically-assisted suicide/ euthanasia.

Federal Justice Minister David Lametti – who voted against his own government’s original assisted suicide/ euthanasia regulations when they were first adopted because he felt those regulations were too restrictive – said in a statement that he understands that the issues surrounding assisted-death are “complex.”

“Medical assistance in dying is a profoundly complex and personal issue for many Canadians,” Lametti said in a statement on Jan 13, 2020 when the new public consultations were unveiled.

“The consultations we are launching today will allow us to hear directly from Canadians and guide the path forward,” Lametti said.

Opponents of allowing legally-sanctioned medically-assisted death say that any move to further expand who would be eligible is the slippery slope that they warned about when the practice was first legalized in Canada.

“What are we going to allow?” asked Alex Schadenberg, the executive director of the Euthanasia Prevention Coalition, adding that his organization is worried that minors and people with mental disabilities will eventually be made eligible to ask for an assisted death, as has happened in other jurisdictions in the world where legally-sanctioned suicide / euthanasia has been allowed.

While Canada struggles to come up with an assisted suicide/ euthanasia system that meets court mandated requirements, opponents continue to argue that much more support is needed for palliative care and hospice options in Canada that would help people who are nearing death without having to resort to suicide as a way to speed up their natural death.

The Euthanasia Prevention Coalition’s Schadenberg points out that Canadian hospices are concerned that the issue of end of life care for Canadians that hospices provide is being tangled up in the assisted suicide/ euthanasia debate.

News item: B.C. Hospice faces deadline to offer assisted suicide

Schadenberg recently reported on the Euthanasia Prevention Coalition’s website how in November 2019 the Canadian Hospice Palliative Care Association (CHPCA) and the Canadian Association of Palliative Care Physicians (CAPCP) issued a joint statement “stating categorically that ‘national and international hospice palliative care organizations are unified in the position’ that MAID is not part of the practice of hospice palliative care. Medical aid in dying, they argued, is not an ‘extension of palliative care’ but a violation of hospice and palliative medical goals of care.”

Court rulings driving legalization and expansion

The Quebec court decision in September 2019 known as the Truchon decision – which either the federal and Quebec governments could have appealed but have decided not to – means that the federal government must make changes to Canada’s assisted-dying regulations by March 11 of this year.

The whole issue of legalization of medically-assisted suicide in Canada has been driven by court rulings, following a Canadian Supreme Court decision in 2015 that led to the existing federal law in 2016.

The 2016 law came with a number of restrictions including that a person seeking assisted suicide / euthanasia must be an adult, not suffering from a mental illness, and that people suffering from progressive mentally-disabling illnesses such dementia were not permitted to give advance permission for medically-assisted /suicide to take effect after their condition deteriorates to the point in which they are mentally impaired from making a final decision.

Federal Justice Minister David Lametti told reporters at a press scrum before a Liberal cabinet retreat in Winnipeg shortly after the federal government launched its online survey on Jan. 13 that more than more 150,000 people had already responded to the survey and he expects to have a new bill before the House of Commons by the middle of February.

Opponents urged to use comment section of survey

While the Euthanasia Prevention Coalition (EPC) is urging its members to take part in the online survey, Alex Schadenberg, the executive director of the coalition, says the wording of the survey’s questions make it clear that the federal government is leaning towards a much more permissive regime for who would qualify for an assisted-death.

“The language of the consultation questionnaire is not great, nonetheless, the questionnaire does allow you to leave further comments,” Schadenberg said.

And he urges opponents of a legal medically-assisted death to use that opportunity for further comments to express opposition to assisted suicide in all its forms.

Along with philosophical opposition to the very idea of government-sanctioned suicide, Schadenberg is concerned that the existing narrow pathway to seeking an assisted suicide will be expanded and that the mentally ill, youth and other vulnerable Canadians will be allowed to seek the option of an assisted death.

Schadenberg has prepared a guide on the EPC website for how those who oppose legal euthanasia in Canada should answer the government survey questions, a guide he said is needed because the survey questions are written in a manner that leans towards expansion of who qualifies for an assisted death. He said he wrote the guide to answering the consultation questionnaire because some of the questions are biased, and imply support for assisted suicide / euthanasia

One issue that the EPC has continually raised is what it considers a lack of direct oversight of the system to make sure that the checks and balances that are supposed to make sure assisted suicide/ euthanasia is permitted in a manner that is consistent with existing regulations being adhered to.

Schadenberg is calling for a retrospective review of our cases by a committee to verify that the eligibility criteria and safeguards were satisfied and in place.

Canadian Physicians for Life, an organization of pro-life medical practioners in Canada, has reached out to its membership to make sure they are aware of the ongoing government survey so they may also respond to the government questionnaire if they wish.

“We have reached out to all our members,” Canadian Physicians for Life executive director Nicole Scheidl said. “What we don’t do is tell them how to fill the survey out, that is up to each individual.”
One issue that is of significant concern to Canadian Physicians for Life is the feedback it has received from some family members of people who claim they are being pushed by some doctors to consider euthanasia for their family member, even if they don’t want to.

“What concerns us is the amount of pressure that family members can face to consider (medically-assisted suicide euthanasia) as an option,” Scheidl said.

While groups and organizations, including the Canadian Conference of Catholic Bishops, that have always opposed any form of legally-sanctioned suicide have been vocal in their opposition to assisted suicide/euthanasia and any expansion of who can qualify, supporters of assisted-death being an option in Canada are also urging Canadians to also speak out on the issue as well. And they are calling on the government to make the assisted-death system as permissive as possible.

Alexandra Da Dalt of Dying with Dignity Canada, which calls itself the “the leading national charity defending end-of-life rights” in Canada, said the federal government must “pursue a rights-based approach as it considers changes to the 2016 assisted dying law.” Dying with Dignity Canada is calling on the federal government to allow advance requests for euthanasia in any changes to the law.

“The current ban on advance requests unfairly prohibits many people with capacity-eroding conditions such as dementia from accessing their right to a medically assisted death,” according to Dying with Dignity Canada.

Former Nova Scotia Liberal Senator James Cowan, who is on the board of directors of Dying with Dignity Canada, said removing the reasonably-foreseeable criteria from the assisted death rules does not mean that other safeguards to restrict access to assisted suicide/ euthanasia need to be put in place. “We caution the government against adding unnecessary roadblocks in the law that, instead of protecting vulnerable people, unfairly restrict access to medical assistance in dying,” Cowan said.