By: Amy Hasbrouck
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Amy Hasbrouck
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Amy is a long-time disability rights activist, a leader with Not Dead Yet and a past president of the Euthanasia Prevention Coalition.
That was then. This is now. (Link to the substack).
From September, 2013 to June, 2020, Toujours Vivant-Not Dead Yet hosted a weekly webcast on issues related to assisted suicide, euthanasia and other life-ending practices that disproportionately affect disabled people. During that time, we (predicted and) chronicled the legal, legislative, and regulatory milestones that have led to the broad and expanding euthanasia program that Canada calls medical assistance in dying (MAiD).
The series “That was then, this is now” revisits podcast texts marking important milestones on the road to legalization and expansion of euthanasia in Canada, and reflects on the outcomes of those social and policy choices.
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THAT WAS THEN:
Duelling expert panels
On July 17, 2015, the Harper government named an External Panel on Options for a Legislative Response to Carter v. Canada.
The panel included experts in palliative care, disability and law:
Harvey Chochinov, Distinguished professor of psychiatry and palliative care at the University of Manitoba;
Catherine Frazee, professor emeritus in Disability Studies at Ryerson University; and
Benoit Pelletier, professor of law at the University of Ottawa.
The
panel was charged with conducting a consultation with medical experts
and interveners in the Carter case to gather opinions and perspectives
on the issues raised by the decision to help the government develop a
legislative response to the Court’s decision. Topics included:
Different forms of physician-assisted dying (assisted suicide and/or euthanasia);
Eligibility criteria and definition of key concepts;
Risks to individuals and society associated with physician-assisted dying; and
Safeguards
to address risks and procedures for assessing requests for assistance
in dying and the protection of physicians’ freedom of conscience.
However,
with the announcement in August of the federal election for October 19,
2015, the panel suspended its activity as of August 4.
The
federal panel’s final report was released in December of 2015 and can
be found at
https://www.justice.gc.ca/eng/rp-pr/other-autre/pad-amm/pad.pdf
The Province of Ontario launched a similar group in August of 2015 the Provincial-Territorial Expert Advisory Group on Physician-Assisted Dying representing all provinces and territories except Québec, with the same mandate as the federal panel.
Several members of the provincial panel are activists for assisted suicide, including:
Jennifer Gibson (Co-Chair) – Director of the University of Toronto Joint Centre for Bioethics
Maureen Taylor (Co-Chair) – Physician Assistant in Infectious Diseases and Medical Journalist
Jocelyn Downie – Professor in the Faculties of Law and Medicine at Dalhousie University
Arthur Schafer – Director of the Centre for Professional and Applied Ethics at the University of Manitoba.
The panel did not include anyone with expertise in palliative care or disability rights.
The
only panel member who had said she opposes assisted suicide was Dr.
Nuala Kenny. Her status as a Catholic nun probably reduced her
credibility on a committee and in a society that prefers non-religious
values.
The Provincial-territorial panel was surely
created to try to supplant the federal panel. It continued its
consultation until the election and submitted a report to
parliament before the Carter ruling came into effect on February 6,
2016.
If parliament hadn’t received any input when it
came back after the October election, it’s possible that the Supreme
Court may have granted an extension to draft legislation. But since the
Provincial panel had provided recommendations, the Supreme Court was less
likely to push back the deadline.
Though the federal
panel is not holding meetings, people could still submit testimony and
comments via their web site.
Ontario’s information about MAiD is at https://www.ontario.ca/page/doctor-assisted-dying-and-end-life-decisions-consultation
The panel’s final report can be found at https://novascotia.ca/dhw/publications/Provincial-Territorial-Expert-Advisory-Group-on-Physician-Assisted-Dying.pdf.
Proposed regulations to implement Québec’s euthanasia law
The Act Respecting End-of-life Care was adopted in Québec on June 5, 2014, and came into effect in December of 2015.
The Government of Québec published its regulations to implement the euthanasia program on July 15, 2015.
If you think of a legislative Act as stating what must be done, the regulations explain how to do it.
The law allowed people to choose medical aid in dying – euthanasia – among the options for “care” at the end of life.
These
regulations relate to the information doctors have to provide to the
Commission on End-of-life Care (which oversees the euthanasia
program), and the activities of the commission itself.
The proposed regulations don’t give enough detail, they cause confusion, and they don’t fill in the gaps in the law.
The
regulations require doctors to provide information about screening and
evaluations for eligibility, but there’s no explanation of how these
evaluations will be done nor how eligibility will be determined.
The
regulations don’t explain how a doctor would make a referral if s/he
doesn’t want to kill a person, nor what to do if the person isn’t
eligible for euthanasia.
There is no explanation of how euthanasia is to be carried out.
The “safeguard” of oversight by the Commission is retroactive. That doesn’t help the person who is already dead.
The
doctor must report “the reasons why the suffering cannot be relieved in
a manner the person deems tolerable” but doesn’t have to say what
services or treatments (if any) were provided to alleviate suffering.
The
overall impression of the law and regulations is a program that is
badly designed, with problems and legal loopholes that won’t protect
vulnerable people.
The Commission has no responsibility
to verify that medical killing and euthanasia are not happening aside
from those counted in the doctors’ reports.
THIS IS NOW: September, 2025
Duelling consultation panels
When
this webcast was written, Stephen Harper had been Canada’s Prime
Minister for nearly a decade. Despite having ratified the Convention on
the Rights of Persons with Disabilities (CRPD), the Harper government
had done nothing to implement the Convention, nor to address the
inequality faced by disabled people, as well as barriers to employment,
housing, and a liveable income.
The Conservatives’ choice of panelists for the federal body tasked with identifying options for a legislative response to Carter were
well received, while the over-representation of assisted dying
proponents on the Provincial-Territorial panel was worrisome. So while
on a policy level, the election of the Liberals on October 19 might
initially have seemed like good news, Trudeau soon showed he favoured
the Provincial-Territorial panel’s perspective and approach; thus the
tradition of disregarding the needs and views of disabled people
continued apace.
The Federal panel opened its
consultations to all Canadians, while the Provincial-Territorial group
provided policy advice based on submissions from invited stakeholders,
which did not include groups opposed to assisted dying (such as the
Euthanasia Prevention Coalition or Not Dead Yet) while the group Dying
with Dignity was invited to provide both written and in-person
submissions.
Québec proposed regulations
Despite
vigorous advocacy by disabled people, Québec lags behind other
provinces in funding self-directed personal assistance services;
preferring institutional long-term care for elders and younger disabled
people who need help with personal care and activities of daily living.
Thus, euthanasia has become the go-to option for people facing loss of
autonomy in Québec. Nor has access to palliative care improved to meet the needs of people at the end of life seeking relief from unremitting suffering.
The problems noted in the draft regulations have not been addressed.
