Government report recommends euthanasia for children and euthanasia by advanced directive.

By James Schadenberg

A report by the Special Joint Committee on Medical Assistance in Dying (AMAD) was tabled in the House of Commons on February 15 calling for a drastic expansion of euthanasia  (MAiD) in Canada. The report recommends that children "mature minors" and patients with mental illnesses should be eligible for euthanasia and that patients with illnesses such as dementia should be permitted to make advanced requests by advanced directives for euthanasia. The report, Medical Assistance in Dying in Canada: Choices for Canadians, can be viewed here: (Link).

Sign our petition: No to child euthanasia in Canada (Link)

The report was supported by Liberal, NDP and Bloc-Quebecois members of the committee. The report gave 23 recommendations for actions by the government regarding euthanasia. 

• The majority of Canadians oppose euthanasia for mental health (Link).

Recommendation 13 involved euthanasia for mental illness alone. The report suggests that prior to the legalization of MAiD for mental illness, AMAD should re-convene to ensure its "safe and adequate application":

Recommendation 13 

That, five months prior to the coming into force of eligibility for MAID where a mental disorder is the sole underlying medical condition, a Special Joint Committee on Medical Assistance in Dying be re-established by the House of Commons and the Senate in order to verify the degree of preparedness attained for a safe and adequate application of MAID (in MD-SUMC situations). Following this assessment, the Special Joint Committee will make its final recommendation to the House of Commons and the Senate.

Recommendations 14 - 20 all involve the exapansion of euthanasia in Canada to children (or as referred to in the report as "mature minors"):

Recommendation 14

That the Government of Canada undertake consultations with minors on the topic of MAID, including minors with terminal illnesses, minors with disabilities, minors in the child welfare system and Indigenous minors, within five years of the tabling of this report.

Recommendation 15

That the Government of Canada provide funding through Health Canada and other relevant departments for research into the views and experiences of minors with respect to MAID, including minors with terminal illnesses, minors with disabilities, minors in the child welfare system and Indigenous minors, to be completed within five years of the tabling of this report.

Recommendation 16

That the Government of Canada amend the eligibility criteria for MAID set out in the Criminal Code to include minors deemed to have the requisite decision-making capacity upon assessment.

Recommendation 17

That the Government of Canada restrict MAID for mature minors to those whose natural death is reasonably foreseeable.

Recommendation 18

That the Government of Canada work with provinces, territories and First Nations, Inuit and Métis communities and organizations to establish standards for assessing the capacity of mature minors seeking MAID.

Recommendation 19

That the Government of Canada establish a requirement that, where appropriate, the parents or guardians of a mature minor be consulted in the course of the assessment process for MAID, but that the will of a minor who is found to have the requisite decision-making capacity ultimately take priority.

Recommendation 20

That the Government of Canada appoint an independent expert panel to evaluate the Criminal Code provisions relating to MAID for mature minors within five years of the day on which those provisions receive Royal Assent, and that the panel report their findings to Parliament.

• Why euthanasia for children "mature minors" is wrong (Link).

Recommendations 21 - 23 all call for permitting advance requests for euthanasia for those with dementia and other incurable illnesses. This would mean that patients can be killed through euthanasia after they've lost the capacity to consent to it:

Recommendation 21

That the Government of Canada amend the Criminal Code to allow for advance requests following a diagnosis of a serious and incurable medical condition disease, or disorder leading to incapacity.

Recommendation 22

That the Government of Canada work with provinces and territories, regulatory authorities, provincial and territorial law societies and stakeholders to adopt the necessary safeguards for advance requests.

Recommendation 23

That the Government of Canada work with the provinces and territories and regulatory authorities to develop a framework for interprovincial recognition of advance requests.

The report also included a dissenting opinion by members of the committee from the Conservative Party. In it, the Conservative members of the committee express their disapproval for the hasty and reckless way that the government has moved to expand Canada's MAiD regime, though they are divided on whether to allow advanced requests. They claim the government refused to put "evidence ahead of ideology" when they moved to expand MAiD for situations where mental illness is the sole underlying medical condition without first determining whether it could be implemented safely. 

The Conservative members dissenting report did not approve child euthanasia, claiming "it would be irresponsible for the Liberal government to move ahead with any expansion of MAID for mature minors" and that "Conservatives do not support MAID for mature minors at this time".

The dissenting report concluded with the following statement:

The Liberals’ rushed and reckless approach to Canada’s MAID regime has put the lives of vulnerable Canadians at risk. We caution the Liberal government against repeating the mistakes they made concerning MAID MD-SUMC. MAID policy must be grounded in evidence, consultation with impacted groups, and with serious consideration given to protecting the vulnerable.

The recommendations being put forth by AMAD would give Canada the most permissive euthanasia law in the world. Given the current state of Canada, where vulnerable people continue to be pressured to euthanasia on a frequent basis, it is inappropriate for the government to consider these radical expansions to the euthanasia law. There should instead be a greater focus on how governments in Canada can help people who may be feeling that their life is not worth living.

The Euthanasia Prevention Coalition submitted a brief to AMAD in early 2022, which expressed the dangers of Canada's current MAiD regime, and the dangers of expanding it to allow for advance directives and child euthanasia. This brief can be viewed here: (Link).

Further reading:

• Euthanasia by Advanced Directive - A recipe for abuse (Link).
• Responding to the Special Joint Committee on Medical Assistance in Dying (Link).