Introduction

Webcast archive: Bill C-7 removes safeguards, offers little in return

Today, we take a look at new euthanasia bills here in Canada, and in Portugal.

Webcast archive: Bill C-7 removes safeguards, offers little in return

In this episode of Euthanasia & Disability, Amy Hasbrouck, Taylor Hyatt and Christian Debray discuss:

  • The MAiD amendment bill C-7 removes safeguards and offers little in return
  • Portuguese parliament approves euthanasia and assisted suicide

Please note that this text is only a script and that our webcast contains additional commentary.

MAID AMENDMENT BILL C-7 REMOVES SAFEGUARDS AND OFFERS LITTLE IN RETURN

  • On February 24, the ministers of Justice, Health and Disability Inclusion presented Bill C-7 that would amend the medical assistance in dying (MAiD) law.  To comply with the Truchon decision, the bill removes the requirement that the person’s death has become “reasonably foreseeable,” thus expanding eligibility for assisted suicide and euthanasia (AS/E) far beyond people with a terminal illness.  However the bill offers little to protect people whose life choices are limited by discrimination and barriers.
  • The preamble acknowledges Canada’s obligations under the U.N. Convention on the Rights of Persons with disabilities “including in respect of the right to life.”
  • The proposed legislation maintains the focus on ending people’s lives rather than improving the quality of their lives. As safeguards, quality-of-life measures act as barriers to the bill’s stated goal of enabling the person to die.  Requiring an applicant to have quality of life supports in place as a condition of MAiD eligibility might serve as an incentive to the person to seek out such services, and to governments to provide them. And, of course, improved quality of life might eliminate the need for MAiD altogether.
  • The good news is that the bill does not expand eligibility to mature minors, and it specifically excludes people whose only medical condition is a “mental illness.”  But that exclusion doesn’t provide as much protection as it might appear. The bill doesn’t address:
    • people with multiple conditions, including mental illness;
    • People for whom abuse, barriers and discrimination have caused isolation, stress, and low self-esteem that, though they don’t rise to the level of a mental illness, affect their judgment about wanting to die.
    • People with related conditions, like autism or brain injuries.
  • Bill C-7 reduces the number of witness signatures on the application form from two to one, and would allow personal care providers to witness the form. This would make it easier for an abusive caregiver to pressure a person into filling out a MAiD application, then sign off as the only witness to the document.
  • The new bill creates two separate systems of safeguards, depending on whether or not the person is near the end of life.  However it does not clarify when natural death is “reasonably foreseeable.“
    • For people whose death is “reasonably foreseeable” the bill:
      • Removes the ten-day waiting period;
      • Allows for a waiver of the requirement that the person be capable to consent when euthanasia is administered if:
        • before losing capacity, they arrange for euthanasia to be provided on “a specified day,” and
        • the person “does not demonstrate, by words, sounds or gestures, refusal … or resistance to its administration.”
      • This section is a little confusing and we’re still looking into the precise meaning.
      • So, while the bill’s authors don’t say it in so many words, this section allows advance requests (or as the bill calls it, “advance consent”) for people whose death is reasonably foreseeable. And given the broad interpretation of “reasonably foreseeable” that has been adopted since 2016, that includes a lot of people.
    • For people whose death is not reasonably foreseeable
      • The time between initial assessment and euthanasia is increased to 90 days; unless the medical practitioner  shortens the period if they think the person might lose capacity.
      • One of the two medical practitioners must “have expertise in the condition that is causing the person’s suffering.” We note that it is the medical practitioner who decides if they have the required expertise. As well, the bill says nothing about people with multiple medical conditions, or about what happens when the cause of the suffering isn’t the condition that puts the person’s life or health at risk.
      • The bill expands the informed consent section by requiring that the person be informed of mental health and disability supports, in addition to palliative care, and that they be referred for consultations with “relevant professionals.”  The medical practitioner must also discuss options to relieve suffering with the person. As we’ve seen, this does not guarantee that the services will be provided or will meet the person’s needs.
  • In a new section called “advance consent – self-administration” the bill would allow a person to be euthanized if they’ve lost the capacity to consent after attempting assisted suicide.
  • The bill adds a reporting obligation on medical practitioners who do initial assessments before a written request for MAiD is completed.  It also obliges pharmacy technicians who dispense MAiD drugs to report these activities. These amendments to the monitoring system don’t do anything to verify that medical practitioners are filing the required reports, or to deal with errors or incomplete information.
  • Finally, from the “Oh, and by the way” department, along with the Bill C-7 announcement, the government mentioned in passing that 13,000 people have been euthanized since 2016, accounting for nearly 2% of deaths in Canada.
  • Disability rights activists must ask themselves if Bill C-7 creates what the Supreme Court called for in the Carter case; “a carefully-designed system” that “imposes stringent limits” that are “scrupulously monitored and enforced.”

PORTUGUESE PARLIAMENT APPROVES EUTHANASIA AND ASSISTED SUICIDE

  • On February 20, the parliament of Portugal approved five bills allowing euthanasia and assisted suicide for people with terminal illnesses. Only Portuguese citizens or legal residents would be eligible to end their lives under these statutes.
  • Portuguese President Marcelo Rebelo de Sousa could still veto the law, but his veto could be overruled by a second Parliamentary vote. The president could also ask the country’s Constitutional Court to review the legislation. It may conflict with Portugal’s Constitution, which states that human life is “sacrosanct.”
  • If the bills pass, two doctors and a psychiatrist would need to approve the person’s euthanasia request. The application would then be examined by a Verification and Evaluation Committee, which could approve or reject it.  The process could also “be postponed if it is legally challenged, or if the [person] loses consciousness.”
  • Oversight will be provided by the General Inspectorate for Health, whose mission is “to audit, to inspect, to supervise and to conduct disciplinary actions within the health sector, for ensuring compliance with the law.” Medical practitioners have the right to refuse to participate for “moral” reasons.