{"id":1749,"date":"2016-04-29T21:30:52","date_gmt":"2016-04-29T21:30:52","guid":{"rendered":"http:\/\/tvndy.ca\/?p=1749\/"},"modified":"2018-11-06T15:06:27","modified_gmt":"2018-11-06T15:06:27","slug":"webcast-archive-bill-c-14-amendments","status":"publish","type":"post","link":"https:\/\/tvndy.ca\/en\/2016\/04\/webcast-archive-bill-c-14-amendments\/","title":{"rendered":"Webcast archive: Bill C-14 amendments"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"1180\" height=\"664\" src=\"https:\/\/www.youtube.com\/embed\/tsyHC0zIQ9M?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe><\/p>\n<p>In this episode of <em>Euthanasia &amp; Disability<\/em>, Amy Hasbrouck and Christian Debray discuss:<\/p>\n<ul>\n<li>Bill C-14 amendments<\/li>\n<\/ul>\n<p>Please note that this text is only a script and that our webcast contains additional commentary.<\/p>\n<p><strong>PROPOSED AMENDMENTS TO BILL C-14<\/strong><\/p>\n<ul>\n<li>Bill C-14 is headed to the Justice committee for hearings, which begin next week.<\/li>\n<li>Toujours Vivant-Not Dead Yet has prepared a set of amendments to try to address some of the problems with Bill C-14 that we described last week.\u00a0 We will be looking for Members of parliament and senators to introduce these amendments in hopes that the final bill will include as many of them as possible.<\/li>\n<li>Reasonable but mistaken belief:\u00a0 The law provides exemptions for errors made by health care providers and ordinary citizens relative to assisted suicide and euthanasia that could result in negligent or culpable homicides but for this blanket exemption.\u00a0\u00a0<em>Amendment:<\/em>\u00a0 Remove\u00a0\u00a7\u00a7\u00a0227 (3) and 241 (6) Exemption for \u201creasonable but mistaken belief.\u201d<\/li>\n<li>The law allows an exemption for any person \u201cif they do anything for the purpose of aiding a medical practitioner\u201d to provide assisted suicide or euthanasia.\u00a0 These provisions are unnecessary and dangerous, and should be removed.\u00a0\u00a0<em>Amendment:\u00a0\u00a0<\/em>Remove \u00a7\u00a7\u00a0227 (2) and 241(3).<\/li>\n<li>The exemption for person aiding patient allows a layperson to \u201cdo anything\u201d to help the patient self-administer the lethal dose.\u00a0 This provision is also unnecessary and dangerous, and should be removed.\u00a0\u00a0<em>Amendment:<\/em>\u00a0 Remove \u00a7 241(5).<\/li>\n<li>\u00a7 241.2(1)(d) refers to voluntary requests for assisted suicide.\u00a0 By excluding only \u201cexternal pressure,\u201d this section is too narrow.\u00a0 It should be amended to include the Supreme Court\u2019s standard of \u201cvulnerable to inducement to commit suicide in a time of weakness.\u201d\u00a0\u00a0<em>Amendment:\u00a0\u00a0<\/em>In section 241.2(1)(d) after the word \u201cpressure,\u201d add the phrase \u201cnor is the result of circumstances that render him vulnerable to inducement to commit suicide;\u201d<\/li>\n<li>Additional safeguards are necessary to ensure effective communication for people with communication disabilities, and that persons who are potentially vulnerable to inducement to commit suicide in a time of weakness are not wrongly directed to medical aid in dying.<\/li>\n<li>Access to communications:\u00a0 Access to effective communication in life-and-death matters is essential to people with communication and sensory disabilities, and is a right as well.\u00a0\u00a0<em>Amendment:<\/em>\u00a0 In \u00a7 241.2(3), insert new section (a) \u201cProvide access to (written and oral) communications in all interactions between medical practitioners or nurse practitioners and the person making the request who has a sensory or communication disability.\u00a0 Access shall be provided by impartial, professional interpreters, speech-language pathologists, scribes and\/or assistive technology to achieve effective communication.\u201d<\/li>\n<li>Person meets eligibility criteria:\u00a0 Subsections (a), (c) and (f) of \u00a7 241.2 create subjective standards where objective standards would be preferable.\u00a0\u00a0<em>Amendment:<\/em>\u00a0 \u00a7 241.2(3)(a) should be changed by replacing the phrase \u201cbe of the opinion\u201d with the word \u201censure\u201d.\u00a0 Similarly, the phrase \u201cbe satisfied\u201d in subsections (c) and (f) should be replaced with the word \u201censure\u201d.<\/li>\n<li>Informed consent:\u00a0 The information provided in \u00a7 241.2(3)(b)(ii) is insufficient to ensure \u201cinformed consent.\u201d\u00a0\u00a0<em>Amendment:<\/em>\u00a0 In \u00a7241.2 (3)(b)(ii) after the word \u201ccircumstances\u201d add \u201c.\u00a0 The medical practitioner or nurse practitioner must ensure that the person is informed of and understands the methods and potential complications of medical aid in dying, the availability of palliative care and other alternative treatments and supports.\u201d<\/li>\n<li>Written opinion confirming: The language of \u00a7 241.2(3)(e) does not stipulate that the second medical practitioner or nurse practitioner must examine the person making the request for medical assistance in dying.\u00a0\u00a0<em>Amendment:<\/em>\u00a0 In \u00a7 241.2(3)(e) after the word \u201chas\u201d add the phrase \u201cphysically examined the person making the request and\u201d.<\/li>\n<li>Prior vulnerability assessment and prior palliative care assessment:\u00a0 In order to determine that a person is or is not vulnerable to inducement to commit suicide in a time of weakness, an assessment of that person\u2019s vulnerability must be conducted, and any vulnerabilities must be addressed before the person can be eligible for medical assistance in dying.\u00a0\u00a0<em>Amendment:\u00a0\u00a0<\/em>\u00a7 241.2(3) insert the following after (f):\u00a0 \u201c(g) Ensure that the person has a psychosocial assessment to determine any vulnerability to inducement to commit suicide in a time of weakness.\u00a0 Address any such vulnerabilities that are identified to ensure that the request is completely voluntary.<\/li>\n<li>(h) \u00a0Ensure that the person has consulted with a palliative care professional and received all appropriate palliative care services.\u201d<\/li>\n<li>Prior judicial review:\u00a0 This is an indispensable safeguard to ensure compliance with legislated requirements and to identify and address vulnerability before the life-ending act has taken place.\u00a0\u00a0<em>Amendment:\u00a0\u00a0<\/em>Insert a new section following \u00a7241.2(3) which states.<\/li>\n<\/ul>\n<p>\u201cEach request must be submitted to the superior court in the jurisdiction in question for an expedited review to verify the determination that:<\/p>\n<ol>\n<li>the person meets the eligibility criteria for medical assistance in dying;<\/li>\n<li>The person has a grievous and irremediable medical condition;<\/li>\n<li>The person has been informed of his diagnosis, prognosis, (including that his natural death is reasonably foreseeable) and of the availability of alternative treatments and supports;<\/li>\n<li>The person has had access to communication assistance and professional, impartial interpreter services for effective communication, as necessary;<\/li>\n<li>The person has made a voluntary request and is not subject to external pressure or other circumstances that render the person vulnerable to inducement to commit suicide;<\/li>\n<li>The person is capable of making medical decisions free of depression, drug effects, demoralization, cognitive limitations or other conditions that affect mood, insight or judgment;<\/li>\n<li>The person has been given access to palliative care and other services to alleviate his suffering;<\/li>\n<li>The person has a settled, unambivalent wish to avail himself of medical assistance in dying.\u201d<\/li>\n<\/ol>\n<ul>\n<li>Unable to sign:\u00a0 There is currently no restriction on who may write and sign the application on behalf of a person who cannot fill out the form himself.\u00a0 Thus an heir or employee of a nursing home could fill out the application for a person who has a communication disability, and their interpretation of the person\u2019s wishes would probably go unchallenged.\u00a0\u00a0<em>Amendment<\/em>:\u00a0 In \u00a7 241.2(4) following \u201cbehalf\u201d, replace the \u201c.\u201d With a \u201c,\u201d and add: \u201cexcept if they:<\/li>\n<\/ul>\n<ol>\n<li>know or believe that they are a beneficiary under the will of the person making the request or a recipient, in any other way, of a financial or other material benefit resulting from the person\u2019s death;<\/li>\n<li>are an owner or operator of any health care facility at which the person making the request is being treated or any facility in which the person resides;<\/li>\n<li>are directly involved in providing health care services to the person making the request; or<\/li>\n<li>Directly provide personal care to the person making the request.\u201d<\/li>\n<\/ol>\n<ul>\n<li>Conscience protection:\u00a0 While the preamble of bill C-14 mentions \u201crespect [for] the personal convictions of health care providers\u201d there is nothing in the statute to protect conscience rights of doctors, nurses, pharmacists or others.\u00a0\u00a0<em>Amendment:<\/em>\u00a0 Insert the following after \u00a7 241.2(7)<\/li>\n<\/ul>\n<p>\u201c(8) Freedom of conscience<br \/>\n(a)\u00a0No medical practitioner, nurse practitioner, pharmacist or other health care provider who objects to medical assistance in dying due to personal conviction shall be compelled to participate in any aspect of the medical assistance dying program.<br \/>\n(b) Hospices which operate on the principles of palliative care to neither delay nor accelerate natural death may elect not to participate in the medical assistance in dying program.<br \/>\n(c) Religious institutions are exempt from participation in the medical assistance in dying program.\u201d<\/p>\n<ul>\n<li>Regulations:\u00a0 Require reporting on each case with obligations for the provinces to gather and report on reasons for the request, options considered, the decision, and ultimate disposition.\u00a0 The federal government should require each province to complete these reports as a pre-requisite for transfer of funds through the health act.\u00a0 The Federal government must table an annual report in parliament.\u00a0 This is left too uncertain in bill C-14, and should be specified.\u00a0\u00a0<em>Amendment:<\/em>\u00a0 \u00a7 241.31(3) replace the word \u201cmay\u201d in the first sentence with the word \u201cshall.\u201d<\/li>\n<li>It would be unrealistic to expect that all, or even many, of these amendments will be adopted.\u00a0 But any improvement to the law could save lives.<\/li>\n<\/ul>\n   ","protected":false},"excerpt":{"rendered":"<div class=\"entry-summary\">\n<div class=\"entry-summary\">\nThis week, we discuss amendments we hope MPs make to Bill C-14.\n<\/div>\n<div class=\"link-more\"><a href=\"https:\/\/tvndy.ca\/en\/2016\/04\/webcast-archive-bill-c-14-amendments\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &ldquo;Webcast archive: Bill C-14 amendments&rdquo;<\/span>&hellip;<\/a><\/div>\n<\/div>\n<div class=\"link-more\"><a href=\"https:\/\/tvndy.ca\/en\/2016\/04\/webcast-archive-bill-c-14-amendments\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &ldquo;Webcast archive: Bill C-14 amendments&rdquo;<\/span>&hellip;<\/a><\/div>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[92],"tags":[338,245,339,121,96,118],"class_list":["post-1749","post","type-post","status-publish","format-standard","hentry","category-webcast-archive","tag-amendments","tag-bill","tag-communication","tag-euthanasia-disability","tag-safeguards","tag-webcast","entry"],"_links":{"self":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/1749","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/comments?post=1749"}],"version-history":[{"count":4,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/1749\/revisions"}],"predecessor-version":[{"id":3700,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/1749\/revisions\/3700"}],"wp:attachment":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/media?parent=1749"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/categories?post=1749"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/tags?post=1749"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}