‘Ottawa’ ‘Clarity’ Urged as Liberal’s Likely to Miss June 6 Deadline for Assisted Dying Bill
OTTAWA — With the Liberal government almost certain to miss the Supreme Court’s deadline for passing a new assisted-dying law, the focus turns to what will happen on June 6. Will there be a stampede of Canadians rushing to ask their physicians to help them die? Will their doctors oblige?
Medical and legal experts agree that some Canadians who wouldn’t otherwise qualify will ask their doctors for help in ending their lives before Bill C-14 comes into effect. That includes people with mental illnesses or other non-terminal conditions.
But there’s sharp disagreement over how many physicians will actually approve such requests.
Until June 6, only superior court judges can decide whether someone is eligible for an assisted death. If a new law is not in place at that time, however, it will be up to individual doctors to make such a determination.
Physicians will not make such decisions in a vacuum. The Supreme Court laid out four criteria for determining who qualifies for an assisted death. The person must be a competent adult, provide clear consent, have a “grievous or irremediable medical condition,” and be enduring “intolerable” suffering.
This is an entirely new paradigm.
Physician colleges and other regulatory bodies in most provinces and territories have since issued guidelines to doctors on how to apply that criteria when determining if someone is eligible for an assisted death.
“This won’t be the Wild West,” Dr. Gus Grant, president of the Federation of Medical Regulatory Authorities of Canada, told a Senate committee on May 10.
“There is sufficient guidance in the (Supreme Court) decision and the regulators who are legislated to have the responsibility of regulating the delivery of the practice of medicine will regulate.”
But Grant and Dr. Rocco Gerace, registrar at the Ontario College of Physicians and Surgeons, who was also testifying, acknowledged there will be “deficiencies in the system” if a new law isn’t in place on June 6. That includes protections for non-physicians who assist such procedures, and no national registry of deaths.
Canadian Medical Association vice-president Jeff Blackmer, whose organization supports C-14, said that is why federal legislation is essential: to ensure all doctors across Canada understand the expectations and procedures when someone comes to them and asks for help in dying.
“This is an entirely new paradigm,” he said. “Our focus is on getting clarity and protection for members and physicians.”
University of Ottawa constitutional law expert Errol Mendes agreed legal concerns will be top of mind for many doctors. “If they don’t come within the parameters that the court set down, there could be a potential prosecution for murder,” he said. “That’s big. So how many doctors would be willing to go through that?”
But the head of Dying with Dignity, an advocacy group that feels C-14 is too restrictive, says most doctors will be hesitant regardless no matter what. “Whether we having the legislation or not having the legislation,” said Shanaaz Gokool, “access is still going to be a problem probably for many months ahead.”
Trudo Lemmens, Scholl chair of health law and policy at the University of Toronto, agreed that most physicians will remain “reluctant and prudent” when deciding whether to end a patient’s life. His concern is that there will be some who feel “all too comfortable, too driven” to approve such irreversible procedures.
“Evidence from Belgium and the Netherlands shows that a handful of overly zealous or even sloppy individual physicians can provide all-too-easy access to (physician-assisted death), leading to the premature deaths of vulnerable people who need our protection and care, not life-ending measures,” he said.