Ottawa unveils ‘emotional’ assisted-dying legislation

News Apr 14, 2016 by Tonda MacCharles OurWindsor.Ca

OTTAWA — The federal Liberal government has set out a new legislative scheme to limit access to medically-assisted suicide to “competent adults” whose death is “reasonably foreseeable” and are suffering “intolerably.”

Bill C-14, tabled Thursday in the House of Commons, is a more narrow regime than the Supreme Court of Canada or a parliamentary committee would have permitted.

It proposes mandatory criteria that must be met in order for a person to lawfully end their life with the aid of a doctor or nurse practitioner.

The patient must be 18 years or older, and “competent”, make a voluntary request and provide “informed consent” to a medical assistance to end their life, and be covered under provincial health insurance plans — a move to prevent a medical death tourism industry from cropping up.

The bill says five specific eligibility criteria must be met:

1. The patient must be 18 years or older, and “competent”,

2. The patient must have a “grievous and irremediable medical condition” defined as having all the following elements.

• A “serious and incurable illness, disease or disability” and -be in an advanced state of “irreversible decline in capabilities;”

• Enduring physical or psychological suffering, caused by the medical condition, that is intolerable to the person, and cannot be relieved.

• Natural death must be “reasonable foreseeable” however it doesn’t have to be imminent, said justice officials who provided a background briefing on the bill.

3. Make a voluntary request

Text of the bill on assisted dying

Assisted Dying Bill unveiled by Ottawa by torontostar

4. Provide “informed consent” to a medical assistance to end their life,

5. Be covered under provincial health insurance plans – a move to prevent a medical death tourism industry from cropping up.

Nobody would be compelled to accept treatment to relieve suffering they find intolerable.

The bill does not bar mentally ill people from being eligible for a doctor-assisted death, but mental illness alone is not enough.

It must be accompanied by intolerable physiological or psychological suffering.

The bill, which must now be debated in Parliament and passed before a Supreme Court of Canada-imposed deadline of June 7 — punts the question of whether “mature minors” should be allowed access to doctor assisted suicide, saying the government will study that issue and work with provinces to ensure better end-of-life care overall, including more access to palliative care and medically assisted death.

Officials say that conditions like dementia or depression alone would not necessarily exclude someone as long as a patient maintains the ability to consent and make health care decisions for themselves.

The bill sets out certain safeguards to protect what the government calls vulnerable persons.

It says only medical practitioners — defined as physicians or registered nurse practitioners — and pharmacists may aid a suicide or dispense drugs. However it would also protect social workers or other people who are asked to help a person — say, fill out a form or lift a glass to a patient’s mouth to aid swallowing.

But it does not set out whether or how a medical professional can refuse a request, leaving such regulations up to provinces and the self-regulating bodies that govern doctors and nurses.

The bill also requires two medical opinions, independent of each other, that a patient meets all the criteria, a request by the patient in writing before two independent witnesses that the patient seeks a medically-assisted suicide.

Patients would have the right to withdraw consent at any time. And it sets out a 15-day waiting period between the date of the written request and the medical action. “It’s intended to ensure a person doesn’t make a rash decision . . . a day after they receive a diagnosis, for instance,” said a justice official. But the period could be shortened if both medical professionals are convinced death or the patient’s loss of capacity to consent has become imminent.

Justice Minister Jody Wilson-Raybould said the drafting of the bill was “an incredibly” emotional exercise, noting her grandfather died of Alzheimers’ and that as well as the experience of her grandmother’s death informed her views, but said the bill had to try to reflect all views of Canadians.

Health Minister Jane Philpott, a physician, said “it is a profound experience to sit by the side of people who slip away from life.”

“I’ve had the experience of feeling a heartbeat stop,” said Philpott. “I’ve seen people die well and I’ve seen people die in misery.”

She said “if we have the opportunity to make sure people have access to a good death . . . we owe it to Canadians.” Philpott has written publicly about the loss of her daughter, but on Thursday she spoke of a young niece who has a Neurodegenerative condition and is non-verbal. She said there are “many others like her” and “we have to protect the vulnerable.”

Liberal House leader Dominic Leblanc said the government will allow MPs to vote freely, but cabinet members will be required to support the bill. If the bill doesn’t pass, he noted, there will be a “complete vacuum” governing the exercise of a charter right.

Prime Minister Justin Trudeau said Canadians are seized with this “deeply personal” issue.

“This government is focused very much on respecting Canadians’ rights, defending their choices and allowing them choices, while at the same time protecting the most vulnerable,” Trudeau told reporters at an announcement in London, Ont. Thursday.

“The plan that we put forward is one that respects Canadians’ choices while putting in place the kinds of safeguards needed. But as we highlighted as part of the plan, the extraordinary work that the special joint committee did looking at various aspects of the difficult choices that Canadians are facing, means that we have more work to do in the coming years to look at different aspects that weren’t in this particular piece of legislation … This is a response to the Supreme Court decision that will have a positive and significant impact on the lives of Canadians, and how we move forward in a thoughtful, respectful way, will engage not just parliamentarians, but all Canadians, provinces, municipalities, we know we have a lot of work to do around palliative care, quality end of life care, and not just ending life issues.

“And these things are issues that I am, quite frankly, extremely proud to be part of parliament that has approached this in as thoughtful and responsible way as Canadians expect us to.”

– Includes files from Alex Boutilier

Toronto Star

Ottawa unveils ‘emotional’ assisted-dying legislation

To get help in dying, people must be mentally competent, have a serious and incurable disease, illness or disability and be in an irreversible decline

News Apr 14, 2016 by Tonda MacCharles OurWindsor.Ca

OTTAWA — The federal Liberal government has set out a new legislative scheme to limit access to medically-assisted suicide to “competent adults” whose death is “reasonably foreseeable” and are suffering “intolerably.”

Bill C-14, tabled Thursday in the House of Commons, is a more narrow regime than the Supreme Court of Canada or a parliamentary committee would have permitted.

It proposes mandatory criteria that must be met in order for a person to lawfully end their life with the aid of a doctor or nurse practitioner.

The patient must be 18 years or older, and “competent”, make a voluntary request and provide “informed consent” to a medical assistance to end their life, and be covered under provincial health insurance plans — a move to prevent a medical death tourism industry from cropping up.

The bill says five specific eligibility criteria must be met:

1. The patient must be 18 years or older, and “competent”,

2. The patient must have a “grievous and irremediable medical condition” defined as having all the following elements.

• A “serious and incurable illness, disease or disability” and -be in an advanced state of “irreversible decline in capabilities;”

• Enduring physical or psychological suffering, caused by the medical condition, that is intolerable to the person, and cannot be relieved.

• Natural death must be “reasonable foreseeable” however it doesn’t have to be imminent, said justice officials who provided a background briefing on the bill.

3. Make a voluntary request

Text of the bill on assisted dying

Assisted Dying Bill unveiled by Ottawa by torontostar

4. Provide “informed consent” to a medical assistance to end their life,

5. Be covered under provincial health insurance plans – a move to prevent a medical death tourism industry from cropping up.

Nobody would be compelled to accept treatment to relieve suffering they find intolerable.

The bill does not bar mentally ill people from being eligible for a doctor-assisted death, but mental illness alone is not enough.

It must be accompanied by intolerable physiological or psychological suffering.

The bill, which must now be debated in Parliament and passed before a Supreme Court of Canada-imposed deadline of June 7 — punts the question of whether “mature minors” should be allowed access to doctor assisted suicide, saying the government will study that issue and work with provinces to ensure better end-of-life care overall, including more access to palliative care and medically assisted death.

Officials say that conditions like dementia or depression alone would not necessarily exclude someone as long as a patient maintains the ability to consent and make health care decisions for themselves.

The bill sets out certain safeguards to protect what the government calls vulnerable persons.

It says only medical practitioners — defined as physicians or registered nurse practitioners — and pharmacists may aid a suicide or dispense drugs. However it would also protect social workers or other people who are asked to help a person — say, fill out a form or lift a glass to a patient’s mouth to aid swallowing.

But it does not set out whether or how a medical professional can refuse a request, leaving such regulations up to provinces and the self-regulating bodies that govern doctors and nurses.

The bill also requires two medical opinions, independent of each other, that a patient meets all the criteria, a request by the patient in writing before two independent witnesses that the patient seeks a medically-assisted suicide.

Patients would have the right to withdraw consent at any time. And it sets out a 15-day waiting period between the date of the written request and the medical action. “It’s intended to ensure a person doesn’t make a rash decision . . . a day after they receive a diagnosis, for instance,” said a justice official. But the period could be shortened if both medical professionals are convinced death or the patient’s loss of capacity to consent has become imminent.

Justice Minister Jody Wilson-Raybould said the drafting of the bill was “an incredibly” emotional exercise, noting her grandfather died of Alzheimers’ and that as well as the experience of her grandmother’s death informed her views, but said the bill had to try to reflect all views of Canadians.

Health Minister Jane Philpott, a physician, said “it is a profound experience to sit by the side of people who slip away from life.”

“I’ve had the experience of feeling a heartbeat stop,” said Philpott. “I’ve seen people die well and I’ve seen people die in misery.”

She said “if we have the opportunity to make sure people have access to a good death . . . we owe it to Canadians.” Philpott has written publicly about the loss of her daughter, but on Thursday she spoke of a young niece who has a Neurodegenerative condition and is non-verbal. She said there are “many others like her” and “we have to protect the vulnerable.”

Liberal House leader Dominic Leblanc said the government will allow MPs to vote freely, but cabinet members will be required to support the bill. If the bill doesn’t pass, he noted, there will be a “complete vacuum” governing the exercise of a charter right.

Prime Minister Justin Trudeau said Canadians are seized with this “deeply personal” issue.

“This government is focused very much on respecting Canadians’ rights, defending their choices and allowing them choices, while at the same time protecting the most vulnerable,” Trudeau told reporters at an announcement in London, Ont. Thursday.

“The plan that we put forward is one that respects Canadians’ choices while putting in place the kinds of safeguards needed. But as we highlighted as part of the plan, the extraordinary work that the special joint committee did looking at various aspects of the difficult choices that Canadians are facing, means that we have more work to do in the coming years to look at different aspects that weren’t in this particular piece of legislation … This is a response to the Supreme Court decision that will have a positive and significant impact on the lives of Canadians, and how we move forward in a thoughtful, respectful way, will engage not just parliamentarians, but all Canadians, provinces, municipalities, we know we have a lot of work to do around palliative care, quality end of life care, and not just ending life issues.

“And these things are issues that I am, quite frankly, extremely proud to be part of parliament that has approached this in as thoughtful and responsible way as Canadians expect us to.”

– Includes files from Alex Boutilier

Toronto Star

Ottawa unveils ‘emotional’ assisted-dying legislation

To get help in dying, people must be mentally competent, have a serious and incurable disease, illness or disability and be in an irreversible decline

News Apr 14, 2016 by Tonda MacCharles OurWindsor.Ca

OTTAWA — The federal Liberal government has set out a new legislative scheme to limit access to medically-assisted suicide to “competent adults” whose death is “reasonably foreseeable” and are suffering “intolerably.”

Bill C-14, tabled Thursday in the House of Commons, is a more narrow regime than the Supreme Court of Canada or a parliamentary committee would have permitted.

It proposes mandatory criteria that must be met in order for a person to lawfully end their life with the aid of a doctor or nurse practitioner.

The patient must be 18 years or older, and “competent”, make a voluntary request and provide “informed consent” to a medical assistance to end their life, and be covered under provincial health insurance plans — a move to prevent a medical death tourism industry from cropping up.

The bill says five specific eligibility criteria must be met:

1. The patient must be 18 years or older, and “competent”,

2. The patient must have a “grievous and irremediable medical condition” defined as having all the following elements.

• A “serious and incurable illness, disease or disability” and -be in an advanced state of “irreversible decline in capabilities;”

• Enduring physical or psychological suffering, caused by the medical condition, that is intolerable to the person, and cannot be relieved.

• Natural death must be “reasonable foreseeable” however it doesn’t have to be imminent, said justice officials who provided a background briefing on the bill.

3. Make a voluntary request

Text of the bill on assisted dying

Assisted Dying Bill unveiled by Ottawa by torontostar

4. Provide “informed consent” to a medical assistance to end their life,

5. Be covered under provincial health insurance plans – a move to prevent a medical death tourism industry from cropping up.

Nobody would be compelled to accept treatment to relieve suffering they find intolerable.

The bill does not bar mentally ill people from being eligible for a doctor-assisted death, but mental illness alone is not enough.

It must be accompanied by intolerable physiological or psychological suffering.

The bill, which must now be debated in Parliament and passed before a Supreme Court of Canada-imposed deadline of June 7 — punts the question of whether “mature minors” should be allowed access to doctor assisted suicide, saying the government will study that issue and work with provinces to ensure better end-of-life care overall, including more access to palliative care and medically assisted death.

Officials say that conditions like dementia or depression alone would not necessarily exclude someone as long as a patient maintains the ability to consent and make health care decisions for themselves.

The bill sets out certain safeguards to protect what the government calls vulnerable persons.

It says only medical practitioners — defined as physicians or registered nurse practitioners — and pharmacists may aid a suicide or dispense drugs. However it would also protect social workers or other people who are asked to help a person — say, fill out a form or lift a glass to a patient’s mouth to aid swallowing.

But it does not set out whether or how a medical professional can refuse a request, leaving such regulations up to provinces and the self-regulating bodies that govern doctors and nurses.

The bill also requires two medical opinions, independent of each other, that a patient meets all the criteria, a request by the patient in writing before two independent witnesses that the patient seeks a medically-assisted suicide.

Patients would have the right to withdraw consent at any time. And it sets out a 15-day waiting period between the date of the written request and the medical action. “It’s intended to ensure a person doesn’t make a rash decision . . . a day after they receive a diagnosis, for instance,” said a justice official. But the period could be shortened if both medical professionals are convinced death or the patient’s loss of capacity to consent has become imminent.

Justice Minister Jody Wilson-Raybould said the drafting of the bill was “an incredibly” emotional exercise, noting her grandfather died of Alzheimers’ and that as well as the experience of her grandmother’s death informed her views, but said the bill had to try to reflect all views of Canadians.

Health Minister Jane Philpott, a physician, said “it is a profound experience to sit by the side of people who slip away from life.”

“I’ve had the experience of feeling a heartbeat stop,” said Philpott. “I’ve seen people die well and I’ve seen people die in misery.”

She said “if we have the opportunity to make sure people have access to a good death . . . we owe it to Canadians.” Philpott has written publicly about the loss of her daughter, but on Thursday she spoke of a young niece who has a Neurodegenerative condition and is non-verbal. She said there are “many others like her” and “we have to protect the vulnerable.”

Liberal House leader Dominic Leblanc said the government will allow MPs to vote freely, but cabinet members will be required to support the bill. If the bill doesn’t pass, he noted, there will be a “complete vacuum” governing the exercise of a charter right.

Prime Minister Justin Trudeau said Canadians are seized with this “deeply personal” issue.

“This government is focused very much on respecting Canadians’ rights, defending their choices and allowing them choices, while at the same time protecting the most vulnerable,” Trudeau told reporters at an announcement in London, Ont. Thursday.

“The plan that we put forward is one that respects Canadians’ choices while putting in place the kinds of safeguards needed. But as we highlighted as part of the plan, the extraordinary work that the special joint committee did looking at various aspects of the difficult choices that Canadians are facing, means that we have more work to do in the coming years to look at different aspects that weren’t in this particular piece of legislation … This is a response to the Supreme Court decision that will have a positive and significant impact on the lives of Canadians, and how we move forward in a thoughtful, respectful way, will engage not just parliamentarians, but all Canadians, provinces, municipalities, we know we have a lot of work to do around palliative care, quality end of life care, and not just ending life issues.

“And these things are issues that I am, quite frankly, extremely proud to be part of parliament that has approached this in as thoughtful and responsible way as Canadians expect us to.”

– Includes files from Alex Boutilier

Toronto Star