Humanists in British Columbia are reacting with skepticism to some of the provisions contained within a new bill purported to expand access to medical assistance in dying (MAID).
Canada's Justice Minister David Lametti tabled Bill C-7 today, which amends the Criminal Code restrictions on who can access MAID. The bill permits those whose deaths aren't reasonably foreseeable to access MAID and allows those whose deaths are reasonably foreseeable to make an advance request for MAID. It also restricts those with mental illnesses from being eligible.
The BC Humanist Association (BCHA) supports MAID "for all who choose it."
While the bill repeals the requirement that a person's "natural death" be "reasonably foreseeable", it divides safeguards for those whose deaths are and aren't foreseeable. The BCHA and others argued that this language was vague when it was proposed in Bill C-14 and today's bill still doesn't clarify the terminology.
For those whose deaths are foreseeable, patients will no longer be subject to a 10-day waiting period. These patients will also be able to sign an advance request for MAID should their condition render them unable to consent.
For those whose deaths are not foreseeable, patients must be informed "of the means available to relieve their suffering" (such as counselling services and palliative care options) and they must have an additional consultation with an expert in the patient's condition. When these requirements were proposed in a consultation questionnaire prepared by the government, the BCHA called them "paternalistic". Most incredibly though, these patients will also face a nearly three month ("90 clear days") waiting period after their initial assessment before accessing MAID.
In either case, patients will only require one independent witness (rather than two).
The bill also explicitly excludes "mental illness" as a illness, disease or disability that qualifies for MAID.
Finally, the bill expands the government's data monitoring regime.
Ian Bushfield, Executive Director, BC Humanist Association:
While we are glad to see the unconstitutional restrictions around the "reasonable foreseeableness" of one's death be repealed, it's bizarre that the government has chosen to preserve this unclear language in dividing up how Canadians can access their rights. Why the government wouldn't simply use the language given to it by the Supreme Court in Carter continues to befuddle us.
Similarly, continuing to preclude those with mental illness from MAID cannot be reconciled with Carter, which doesn't differentiate between physical and mental suffering.
However, it's the details that should alarm all who support compassionate MAID. Sentencing a patient who's suffering but not likely to die immediately to nearly three months of pain is both needless and cruel.
Requirements that healthcare providers paternalistically explain to a suffering patient what their options are borders on compelled speech. Every health profession's ethical guidelines already cover these grounds, there is no need to invoke the threat of the Criminal Code.
The Supreme Court of Canada struck down Canada's previous restrictions on assisted dying in its 2015 Carter v Canada decision. The ruling found the ban on assisted dying violated the rights of individuals with "a grievous and irremediable medical condition that causes enduring and intolerable suffering."
The bill will face heightened scrutiny in the minority Parliament and a largely independent Senate. The federal government has already sought a four month extension to a Quebec court ruling that found parts of the law to be unconstitutional.
The BCHA will continue to scrutinize this Bill as it moves through Parliament and encourages all supporters of the right to die with dignity to speak to their Member of Parliament.
Banner image via Twitter/@JusticeCanadaEN