By: Amy Hasbrouck
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| Amy Hasbrouck |
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.
What is the procedure and standard for deciding if a person is capable of giving “free and informed” consent?
What factors are counted in deciding if the request is the result of external pressure?
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.
Access has become:
Easier – Prompted by high rates of non-compliance, Québec’s health minister eliminated the requirement that the second doctor must be independent as of February of 2017. Since then, numerous other safeguards have been eliminated.
faster – Same-day euthanasia was documented as early as 2017.
Broader – Euthanasia is available to more people, under a wider variety of circumstances.
See also “In Contrast to Carter” describing the expansion of euthanasia on a national scale.
The problems noted in the draft regulations have not been addressed.
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