{"id":5000,"date":"2020-10-27T10:57:16","date_gmt":"2020-10-27T14:57:16","guid":{"rendered":"https:\/\/tvndy.ca\/?p=5000"},"modified":"2020-11-16T11:27:08","modified_gmt":"2020-11-16T16:27:08","slug":"bill-c-7-is-a-band-aid-for-a-fractured-system","status":"publish","type":"post","link":"https:\/\/tvndy.ca\/en\/2020\/10\/bill-c-7-is-a-band-aid-for-a-fractured-system\/","title":{"rendered":"Bill C-7 is a band-aid for a fractured system"},"content":{"rendered":"

The Trudeau government re-launched <\/span>Bill C-7<\/span><\/a> to bring Canada\u2019s medical assistance in dying (MAiD) law into line with a 2019 Qu\u00e9bec superior court ruling which struck down the requirement that a person\u2019s natural death must be reasonably foreseeable.\u00a0 The court in the <\/span>Truchon<\/span><\/i> case delayed the effect of the decision to allow parliament to amend the MAiD law, and has granted two extensions since then.\u00a0 If parliament fails to adopt Bill C-7 by December 18, the reasonably foreseeable natural death (RFND) eligibility criterion will disappear from the MAiD law, with no other changes. Bill C-7 is touted as providing additional safeguards to replace the end of life criterion, but does it really? And what would happen if Bill C-7 were not adopted?<\/span><\/p>\n

For all people asking to die, Bill C-7 would reduce the number of witnesses required to sign the request from two to one, and would allow a personal support worker to witness the request.\u00a0 This could create a situation where an abusive care provider coerces a person to ask for MAiD then acts as the only witness to the written request.\u00a0\u00a0<\/span><\/p>\n

Among the \u201csafeguards\u201d in Bill C-7 is an exclusion to the effect that \u201ca mental illness is not considered to be an illness, disease or disability\u201d for purposes of the MAiD law. This is supposed to prevent the deaths of people whose only medical condition is a mental illness. But it is unlikely to be effective for several reasons. Mental illness is universally recognized as a disability in laws, treaties, regulations and court decisions. For parliament to try to create an exception for this one law would be going against legal precedent and public policy. As well, the exclusion doesn\u2019t address autism, brain injury or organic brain syndrome, which are not mental illnesses, but which may, especially in combination with discrimination, barriers and stigma, include symptoms that cause a wish to die. As long as the MAiD law allows eligibility based on psychological suffering, there will be an inevitable slide toward allowing euthanasia for psychiatric survivors.\u00a0<\/span><\/p>\n

Bill C-7 would create a two-track approval process, one for people whose natural death is reasonably foreseeable, the other for people, like the plaintiffs in the <\/span>Truchon<\/span><\/i><\/a> and <\/span>Lamb<\/span><\/i><\/a> cases, with long-term disabilities who are not dying.\u00a0\u00a0<\/span><\/p>\n

For people whose deaths are considered reasonably foreseeable, Bill C-7 would remove the ten-day waiting period. Thus, a person could be approved and euthanized the same day, as has already happened in <\/span>Qu\u00e9bec<\/span><\/a>. Like the <\/span>current MAiD law<\/span><\/a>, Bill C-7 does not define what \u201c<\/span>reasonably foreseeable<\/span><\/a>\u201d means as applied to a person\u2019s natural death but it\u2019s likely that a large majority of people will fall into this category. As of December 31, 2019, nearly 14,000 people had met that eligibility criterion, which has expanded through <\/span>court decisions<\/span><\/a> and <\/span>practice guidelines<\/span><\/a>. Also, doctor shopping and referrals from euthanasia advocacy groups virtually guarantee that a person can easily find two medical professionals to approve euthanasia.\u00a0<\/span><\/p>\n

The bill would also remove the requirement that the person be competent to confirm their wish to die when death is administered; creating, in effect, an advance directive for euthanasia or assisted suicide. As long as the person had capacity and provided informed consent when they made the written request, and they do not \u201cdemonstrate, by words, sounds or gestures, refusal to have the substance administered or resistance to its administration,\u201d the lethal injection can go ahead.\u00a0<\/span><\/p>\n

The bill \u201cclarifies\u201d that \u201cinvoluntary words, sounds or gestures made in response to contact do not constitute a demonstration of refusal or resistance.\u201d\u00a0 Which raises the question; do \u201cInvoluntary words\u201d include \u201cno\u201d or \u201cstop\u201d? This section is probably added in response to the case of a 74-year-old woman with dementia in the <\/span>Netherlands<\/span><\/a> who was euthanized under an advance directive, despite giving mixed signals about her wish to die as the date for euthanasia drew near.\u00a0 The physician in the case, who was <\/span>cleared of wrongdoing<\/span><\/a>, allegedly put a sedative in the woman\u2019s coffee and asked her family to hold her down to receive the lethal injection.<\/span><\/p>\n

For people who are not at the end of life, Bill C-7 proposes an approval process with a three-month waiting period, which can be waived if both medical providers believe the person will lose capacity to consent. This waiting period will probably be challenged as a violation of charter rights.\u00a0 The bill also requires that one of the medical professionals have (presumably self-defined) expertise in the condition that causes the person\u2019s suffering. That could mean a doctor who took a two-week course in pain management might decide they have expertise in managing the pain caused by multiple sclerosis, fibromyalgia or lupus.<\/span><\/p>\n

The current MAiD law (Bill C-14) calls for the person to \u201cgive informed consent to receive medical assistance in dying after having been informed of the means that are available to relieve their suffering, including palliative care.\u201d Bill C-7, takes informed consent a step further for people who are not near death, saying that the medical practitioner must \u201censure that the person has been informed of the means available to relieve their suffering, including, where appropriate, counselling services, mental health and disability support services, community services and palliative care and has been offered consultations with relevant professionals who provide those services or that care.\u201d A few things to note about these additions:\u00a0<\/span><\/p>\n