{"id":2504,"date":"2018-01-12T19:40:17","date_gmt":"2018-01-12T19:40:17","guid":{"rendered":"http:\/\/tvndy.ca\/?p=2504\/"},"modified":"2018-10-24T19:36:42","modified_gmt":"2018-10-24T19:36:42","slug":"webcast-archive-draft-regulations-for-canadas-euthanasia-and-assisted-suicide-law","status":"publish","type":"post","link":"https:\/\/tvndy.ca\/en\/2018\/01\/webcast-archive-draft-regulations-for-canadas-euthanasia-and-assisted-suicide-law\/","title":{"rendered":"Webcast archive: Draft regulations for Canada\u2019s euthanasia and assisted suicide law"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"1180\" height=\"664\" src=\"https:\/\/www.youtube.com\/embed\/oUnV1dqcv_s?feature=oembed\" frameborder=\"0\" allow=\"autoplay; encrypted-media\" allowfullscreen><\/iframe><\/p>\n<p>In this episode of\u00a0<em>Euthanasia &amp; Disability<\/em>, Amy Hasbrouck\u00a0and Christian Debray\u00a0discuss:<\/p>\n<ul>\n<li>Draft regulations for Canada\u2019s euthanasia and assisted suicide law<\/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>DRAFT REGULATIONS FOR CANADA\u2019S EUTHANASIA AND ASSISTED SUICIDE LAW<\/strong><\/p>\n<ul>\n<li>Happy New Year, everybody!\u00a0 The day after our last webcast, on December 16, Health Canada issued draft regulations for monitoring the assisted suicide and euthanasia program.\u00a0 We\u2019re using that term instead of the program\u2019s official name, Medical Assistance in Dying, (or MAiD), because of our policy to avoid softening the language around medical killing.<\/li>\n<li>We\u2019ve looked at the proposed regulations carefully and have a lot of comments to make, so let\u2019s get started.<\/li>\n<li>Canada Health said the primary purpose of the monitoring program was to \u201cprovide transparency and foster public trust.\u201d\u00a0 Among the program\u2019s objectives were \u201csupport the protection of vulnerable individuals\u201d and \u201chelp determine whether the legislation is meeting its objectives.\u00a0 For several reasons, we don\u2019t believe the proposed regulations will meet these goals:\n<ul>\n<li>The regulations were prepared following a secret \u201cpre-regulatory\u201d process where unnamed individuals and organizations were consulted in developing the first draft of the regulations.\u00a0 We are not aware that any consumer or disability rights groups were invited to participate, and this lack of input shows in the proposed regulations. \u00a0Health Canada did not provide minutes of these meetings or a list of who participated.\u00a0 So much for transparency and trust.<\/li>\n<li>The proposed regulations do not collect enough information to tell us:\n<ul>\n<li>What are the \u201ccharacteristics of individuals who request AS\/E, the circumstances in which requests arise, and whether individuals are seeking assisted dying due to certain socio-demographic conditions, as opposed to suffering emanating from their medical condition and the dying process.\u201d<\/li>\n<li>Whether the safeguards are effective in preventing ineligible people from being euthanized, and protecting vulnerable people from being induced to commit suicide in a time of weakness.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>The regulations don\u2019t include any way to verify that doctors are actually filing reports.\u00a0 As we\u2019ve seen in Qu\u00e9bec and European countries, non-reporting of medical killing by doctors is a major problem that leads to a distorted picture of how many people are dying by euthanasia and assisted suicide.<\/li>\n<li>The regulations put the responsibility for enforcing the law back on local law enforcement agencies, but without a clear system for informing them of violations.\u00a0 Nor do the regulations guarantee that local authorities will have the means and incentive to prosecute violations.<\/li>\n<li>As is the case in Oregon and Washington, the regulations don\u2019t track what happens to \u201cassisted suicide\u201d prescriptions for lethal drugs once they are written.\u00a0 There is nothing to prevent a third party from stepping in to administer the lethal dose to the person against their will.\u00a0 Not tracking the drugs means they could be left around the house, subject to theft and resale, or being accidentally taken by children.\u00a0 Nor is any information about complications of self-administered drugs (choking, vomiting, waking from coma) collected.<\/li>\n<li>The regulations say that doctors can file reports either with a provincial authority or via a federal online questionnaire, which is still to be developed.\u00a0 But the regulations don\u2019t explain what happens if the report provided by the doctor or the provincial authority is incomplete. \u00a0What is the process for getting more information or clarifying answers that are unclear?\u00a0 What happens when (as is sometimes the case in Qu\u00e9bec) a request for more information still doesn\u2019t answer the questions, or doctors simply refused to provide the information asked for?<\/li>\n<li>The regulations will not be effective in monitoring the program should eligibility be expanded to include minors, people whose suffering is purely psychological, or those using advance directives in case of dementia.\u00a0 Obviously, the regulations would have to be updated, but this should be stated clearly.<\/li>\n<li>There is still no effective safeguard in the law or regulations to prevent a third party from making a request on behalf of a person who has a communication disability or who is under the influence of the third party.\u00a0 This is a loophole in the law itself, which could have been closed by the regulations.\n<ul>\n<li>By requiring practitioners to meet one-on-one with the person making the request (without any family or others in attendance) to verify that there is no coercion;<\/li>\n<li>By making the requirement for communication accommodations more specific and applying it earlier in the eligibility determination process, to ensure effective and unbiased communication;<\/li>\n<li>oBy adding a \u201cprotective services\u201d evaluation to the capacity stage of the eligibility determination process to detect potential abuse.<\/li>\n<\/ul>\n<\/li>\n<li>The regulations do not attempt to track the participation of assisted suicide advocates in the request and eligibility determination process.\u00a0 This is important in order to:\n<ul>\n<li>Avoid the potential for the advocacy group to persuade the person that AS\/E is the best choice, even if the person is ambivalent.<\/li>\n<li>Track how much money the advocacy group may be making for their services through &#8220;donations&#8221; or &#8220;legacies&#8221; made by the person.<\/li>\n<li>Prevent advocacy organizations\u2019 participation having an effect on the process.\u00a0 Advocates may be asked to act as witnesses to the signing of the application, and practitioners may begin to off-load certain tasks (of informing or documentation) onto them.<\/li>\n<\/ul>\n<\/li>\n<li>Demographic information collected is insufficient to determine the role of economic factors in a decision to request AS\/E.\u00a0 Household composition and income, home-ownership (or lack thereof), date of onset of disability, and illness- and disability-related expenses are all factors that affect the person\u2019s economic situation.<\/li>\n<li>It appears that, during the closed pre-regulatory process, Health Canada bowed to pressure to push back deadlines for doctors\u2019 reports.\u00a0 Also, they have also broadcast their intention not to enforce the timelines; by stating that \u201cevents [don\u2019t] occur within particular time frames.\u201d\u00a0 In other words, the regulations\u00a0<em>seem to<\/em>\u00a0allow that, if the request does not result in euthanasia, the obligation to report it will disappear after 90 days.<\/li>\n<li>The proposal to allow for multiple systems for collecting data (federal or provincial \u201crecipients\u201d) could create confusion and a lack of uniformity.\u00a0 Also, if provinces are submitting reports with data that\u2019s already clumped together, will it be possible to find enough information about individual cases to tell if there is a violation?<\/li>\n<li>There is no requirement to document the process of death by euthanasia; e.g. time between injections, onset of coma, time between administration and death, documenting complications, and what measures are taken to resolve them.<\/li>\n<li>The proposed regulations don\u2019t say how long the data will be kept.<\/li>\n<li>Where the person making the request is determined ineligible, demographic data is not collected.\u00a0 Information about the application of safeguards is also not required.\u00a0 Some of these steps should be verified\u00a0<em>before<\/em>\u00a0the eligibility determination proceeds, including:\n<ul>\n<li>Ensure the request was made in writing and duly signed, dated and witnessed;<\/li>\n<li>Ensure the person was informed they had a grievous and irremediable medical condition;<\/li>\n<li>Inform the person they may withdraw the request at any time;<\/li>\n<li>Take all necessary measures to ensure effective communication.<\/li>\n<\/ul>\n<\/li>\n<li>All safeguards should be verified where the person becomes ineligible during the assessment process.<\/li>\n<li>The proposed demographic information to be collected includes place of residence (but does not offer the option of \u201chomeless\u201d or \u201clong-term hospitalization\u201d), postal code, marital status and occupation during working life.\u00a0 Additional demographic information that should be collected:\n<ul>\n<li>Race<\/li>\n<li>Religion<\/li>\n<li>Ethnic background<\/li>\n<li>Household composition<\/li>\n<li>Income range<\/li>\n<li>Is the person a home-owner?\u00a0 Homeless?<\/li>\n<li>Language spoken (whether person is receiving services in their first language)<\/li>\n<li>Whether medical condition is:\n<ul>\n<li>Lifelong \/ onset in childhood<\/li>\n<li>Adult onset<\/li>\n<li>Recent (within one year) onset<\/li>\n<\/ul>\n<\/li>\n<li>Who is the primary health care provider?<\/li>\n<li>How many hours of personal care are required per day?<\/li>\n<li>Are the person\u2019s personal assistance needs being met, and by whom?<\/li>\n<li>Does the person report problems in their living situation?<\/li>\n<li>Is there supplemental health insurance?<\/li>\n<li>Expenses related to illness \/ disability<\/li>\n<\/ul>\n<\/li>\n<li>To read the draft regulations, visit the website (<a href=\"http:\/\/www.gazette.gc.ca\/rp-pr\/p1\/2017\/2017-12-16\/html\/reg6-eng.html)\">http:\/\/www.gazette.gc.ca\/rp-pr\/p1\/2017\/2017-12-16\/html\/reg6-eng.html)<\/a>\u00a0or find it by doing a google search on \u201cHealth Canada regulations MAiD\u201d and following the links. \u00a0Comments are due on February 13, 2018.\u00a0 We encourage you to submit your own comments.<\/li>\n<li>We will post our draft comments on our website as soon as we finish the French translation.<\/li>\n<\/ul>\n   ","protected":false},"excerpt":{"rendered":"<div class=\"entry-summary\">\n<div class=\"entry-summary\">\nThis week, we&#8217;re looking at Health Canada&#8217;s long-awaited regulations for monitoring assisted suicide.\n<\/div>\n<div class=\"link-more\"><a href=\"https:\/\/tvndy.ca\/en\/2018\/01\/webcast-archive-draft-regulations-for-canadas-euthanasia-and-assisted-suicide-law\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &ldquo;Webcast archive: Draft regulations for Canada\u2019s euthanasia and assisted suicide law&rdquo;<\/span>&hellip;<\/a><\/div>\n<\/div>\n<div class=\"link-more\"><a href=\"https:\/\/tvndy.ca\/en\/2018\/01\/webcast-archive-draft-regulations-for-canadas-euthanasia-and-assisted-suicide-law\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &ldquo;Webcast archive: Draft regulations for Canada\u2019s euthanasia and assisted suicide law&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":[121,127,188,118],"class_list":["post-2504","post","type-post","status-publish","format-standard","hentry","category-webcast-archive","tag-euthanasia-disability","tag-health-canada","tag-monitoring","tag-webcast","entry"],"_links":{"self":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/2504","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=2504"}],"version-history":[{"count":4,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/2504\/revisions"}],"predecessor-version":[{"id":3486,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/2504\/revisions\/3486"}],"wp:attachment":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/media?parent=2504"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/categories?post=2504"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/tags?post=2504"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}