Looking forward: The future of MAID in Canada

On September 30, 2020, James Cowan, Helen Long, and Puneet Luthra from Dying With Dignity Canada presented a webinar on the topic of medical assistance in dying (MAID). Their discussion included an overview of the major changes proposed in Bill C-7, the current status of legislation in parliament, the long-awaited parliamentary review of MAID, and what comes next. This blog post summarizes some of the key takeaways from that presentation. 

Brief overview of MAID legislation in Canada

The right to access MAID in Canada dates back to February 2015. In Carter v Canada (Attorney General), the Supreme Court of Canada made a unanimous decision that prohibiting physician-assisted dying was unconstitutional, and that it violated the Canadian Charter of Rights and Freedoms. As a result, Bill C-14 was passed. The federal legislation on medical assistance in dying was enacted on June 17, 2016.

Following this decision, Jean Truchon and Nicole Gladu, two Canadians suffering from incurable degenerative diseases in Quebec, presented a constitutional challenge to the reasonably foreseeable death requirement – arguing that the laws violated their Charter rights. Quebec Superior Court Justice Christine Baudouin ruled in September 2019 that it is unconstitutional to limit medically assisted death to those whose natural death is “reasonably foreseeable,” and gave the federal government six months to respond.

Amendments to Canada’s MAID legislation (also known as Bill C-7), were introduced by the federal government on February 24, 2020. Bill C-7 proposed broadening the 2016 law on medically assisted death to include those whose death was not reasonably foreseeable, among other changes.

In March 2020, and again in June 2020, the federal government asked for and was granted an extension to comply with the ruling by the Quebec Superior Court. Then on August 18, parliament prorogued – delaying the amendments to MAID legislation even further.

On October 5, 2020, Justice Minister David Lametti reintroduced Bill C-7, giving the federal government two months to comply with the Quebec ruling.

Bill C-7

Bill C-7 proposes the following changes to MAID eligibility criteria:  

1. Removing the requirement that a person’s death has become reasonably foreseeable
2. Allowing a waiver of final consent for a person who has been assessed and approved for MAID, set a date for their provision, but has lost capacity to consent before the date arrives (also known as Audrey’s Amendment)
3. Reducing the number of Independent Witnesses required for a written request from two to one
4. Permitting a personal care or health care worker to act as an Independent Witness for MAID
5. Removing the 10-day reflection period for those whose death is reasonably foreseeable

Additional safeguards proposed for when death is not reasonably foreseeable:

1. Requiring two independent health care professionals to evaluate an individual’s eligibility, and adding that one of the two professionals must have expertise in the condition causing suffering
2. Extending the minimum reflection period to 90 days between the first assessment and the provision

Parliamentary Review of MAID

Dying With Dignity Canada is strongly urging the federal government to initiate the parliamentary review called for in Bill C-14 – specifically, to address the following three issues:

1. Mental illness as the sole underlying condition
2. Advanced requests for MAID
3. Mature minors

For more information and background on these three issues, please see The Council of Canadian Academies’ reports here.