ACCESSIBLE AND SIMPLIFIED VERSION: Government of Canada proposes changes to medical assistance in dying legislation

From: Department of Justice Canada

News release

February 24, 2020 - Ottawa - Department of Justice Canada

Note: The information below presents a simplified, accessible version of the news release issued on February 24, 2020 and should not be considered a legal document.

Medical assistance in dying is when doctors or nurse practitioners help people, who are very sick and have extreme suffering, to die. Canada’s medical assistance in dying law is called MAID. It is a very complicated and personal issue. 

Today, a new bill about MAID was introduced. The Honourable David Lametti, Minister of Justice and Attorney General of Canada, the Honourable Patty Hajdu, Minister of Health, and the Honourable Carla Qualtrough, Minister of Employment, Workforce Development and Disability Inclusion announced the bill.

The Bill recommends changes to Canada’s Criminal Code rules about MAID. These changes would mean the following things:

  1. people who have extreme suffering, but are not dying, would be able to receive MAID
  2. people would be protected in two ways:
    •  current safeguards would be kept or made a little easier for persons who are suffering and are expected to die
    • new and stronger safeguards would apply for persons who are suffering but are not expected to die
  3. people with mental illness as their only medical condition would not be able to receive MAID
  4. in some situations, people would not have to give final consent immediately before receiving MAID. This could happen when a person is dying and has been approved for MAID, but might lose their ability to consent before MAID can be provided  
  5. the federal government would collect more information about MAID. This would give a better picture of MAID use in Canada

The introduction of this Bill is a response to a court case. The Superior Court of Québec made a ruling in September 2019. The ruling is called the Truchon decision. In this decision, the Court found the “reasonable foreseeability of natural death” requirement in the Criminal Code to be unlawful because it went against the Constitution (and so the law cannot continue to work).

The Bill proposes new protections to help people who request MAID, but are not expected to die. Professionals would have to take additional steps to protect those people. They would make sure that people have the information they need about services and treatments that can help them feel better. They would make sure that people have thought about all these options carefully, before they decide that they want to have MAID.

Canada has had four years of experience with MAID. This Bill was informed by that experience, and the views and concerns of many people. Ministers consulted with Canadians, experts, medical professionals, stakeholders, Indigenous groups, and provinces and territories. These consultations were held in January and February 2020.

If the Bill is passed by Parliament, the Government of Canada would support partners to carry out the changes. These partners include the provinces and territories. They also include partners in the health system and organizations that make rules for doctors and nurse practitioners to follow. This will include ways to monitor and report on MAID. It will also include best practices and guidance for the MAID system. The federal government will also work with provincial and territorial partners to improve disability supports.

Other important questions related to MAID in Canada could be considered during an upcoming review of the MAID law by Parliament. This could include advance requests for people who have a diagnosis that could affect their decision-making ability in the future. This could include people who request MAID only for their mental illness diagnosis. This could also include the ability of mature minors to access MAID. Mature minors are people who are under 18 years old who can fully understand the treatment they are asking for. This review would begin by June 2020. 

Quotes

“Medical assistance in dying is a deeply personal issue that touches real people and real families. Canadians have shown us during the consultations just how important this issue is to them. We are proud to announce proposed changes that have been informed by their views as well as by Canada’s experiences to date in implementing the 2016 medical assistance in dying regime. The proposed amendments aim to reduce suffering, while also supporting individual autonomy and freedom of choice.”

The Honourable David Lametti, P.C., Q.C., M.P.
Minister of Justice and Attorney General of Canada

“I want to sincerely thank all Canadians who participated in the consultations. We heard many personal stories from individuals, experts, advocacy groups, health professionals and other key stakeholders. Their feedback helped us shape the changes we are proposing today. Protecting vulnerable people, while respecting the autonomy of Canadians, remains our central objective. We will continue to work with provincial and territorial governments and stakeholders at all levels as we move forward on the implementation of the proposed changes.”

The Honourable Patty Hajdu, P.C., M.P.
Minister of Health

“The Government of Canada fully respects the equality rights of persons with disabilities. We also recognize that disability inclusion requires more than legislation and are working with the disability community and other stakeholders to address stigma and bias. It is important to bring about a culture change to ensure that the important contributions made to Canada by persons with disabilities are recognized and valued on the same basis as those of other Canadians.”

The Honourable Carla Qualtrough, P.C., M.P.
Minister of Employment, Workforce Development and Disability Inclusion

Quick facts

  • The MAID law came into effect in Canada in June 2016. The current law has requirements for people who want to apply for MAID. There are also safeguards in the law. These need to be followed by medical professionals.

  • There have been more than 13,000 medically assisted deaths reported in Canada since June 2016. This number is based on the information reported by the provinces and territories. This information was also collected through a new monitoring system that began in November 2018.

  • There has been a slow and steady increase in MAID deaths over the last three years. This was expected. People have become more aware of assisted dying as a legal option. And the MAID law is becoming more accepted by Canadians.

  • There are three medical conditions that most often lead to MAID. The first is cancer, the second is brain conditions, and the third is heart and lung conditions.

  • The amount of MAID deaths in Canada is similar to other countries that have assisted dying laws.

  • In January and February 2020, the Government of Canada looked for feedback on expanding MAID. They spoke with provinces and territories, Canadians, and Indigenous groups. They also spoke to key stakeholders, experts, and medical professionals.

    • Over 300,000 Canadians took part in online public consultations. These took place between January 13 and 27, 2020.
    • Ministers Lametti, Hajdu and Qualtrough and their Parliamentary Secretaries met with stakeholders, experts, medical professionals, and Indigenous groups to talk directly with them about possible changes to the MAID law.
    • The federal government continues to work with the provinces and territories. This happens through discussions among ministers at the federal, provincial and territorial levels. It also happens through a working group on medical assistance in dying. The working group involves people from all provincial and territorial governments and the federal government.

  • The recommended changes to MAID would go through a legislative process. They would become law after they receive Royal Assent.

  • The Council of Canadian Academies has completed three independent reviews that looked at three areas where MAID requests were not allowed under the 2016 law. One area was requests by mature minors. One area was advance requests. And one area was requests where mental illness was the only medical condition.

  • Canada’s current MAID law needs review by Parliament. There will include a review of the state of palliative care in Canada. This will be done by one or more committees. The review will start by June 2020. This review would allow for more public consultation on MAID. It would also allow for more parliamentary study on all aspects of MAID in Canada.

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Contacts

For more information, media may contact:

Rachel Rappaport
Press Secretary
Office of the Minister of Justice and Attorney General of Canada
613-992-6568

Media Relations
Department of Justice Canada
613-957-4207
media@justice.gc.ca

Cole Davidson
Press Secretary
Office of the Minister of Health
613-957-0200

Media Relations
Health Canada
613-957-2983
hc.media.sc@canada.ca

Marielle Hossack
Press Secretary
Office of the Honourable Carla Qualtrough
819-654-5552
marielle.hossack@hrsdc-rhdcc.gc.ca

Media Relations Office
Employment and Social Development Canada
819-994-5559
media@hrsdc-rhdcc.gc.ca

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2020-02-24