The federal government has introduced legislation to bar people with mental illness from seeking medical assistance in dying.
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government → introduce → dying
Justice Minister Sean Fraser announced plans earlier this month to make the change, along with an amendment to the Criminal Code that allows people who are at risk of losing their capacity to consent to assisted dying to make an advance request.
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who → announce → request
Advocates have long pushed for that change, arguing that people diagnosed with conditions like dementia and Alzheimer’s disease are forced to choose to end their lives early for fear that they will lose the capacity to consent to lethal injection.
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they → push → injection
The bill introduced on Tuesday will allow advance requests to be made in provinces that have a legislative regime of their own.
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that → introduce → own
Fraser told reporters in early October that the federal government will not force provinces to allow advance requests.
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government → tell → requests
In order to be considered eligible for MAID by advance written request, the bill states that two separate medical practitioners must confirm the person meets the criteria that include being in a state of irreversible decline and having prepared the request with the help of a doctor or nurse practitioner.
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that → consider → doctor
The requests themselves need to set out the individual criteria under which a person would want their life to be ended, in “observable clinical manifestations.”
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life → need → manifestations
Fraser’s bill includes safeguards to ensure that people who make advance requests cannot be forced to end their lives if they have changed their minds, something that critics have warned could happen.
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critics → include → minds
The law would prohibit MAID in cases where the person “demonstrates, by words, sounds or gestures, refusal or resistance” or if a medical practitioner or nurse practitioner doubts whether the person is trying to refuse.
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person → prohibit → refusal
That does not include involuntary sounds or gestures that are a response to contact.
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that → include → contact
If that happens, another attempt cannot be made for at least 30 days.
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attempt → happen → days
The proposed safeguards demonstrate just how sensitive and difficult it is to legislate advance requests, said Heather Campbell Pope, founder of Dementia Justice Canada.
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Pope → propose → Canada
“The safeguards don’t go far enough,” Campbell Pope said.
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Pope → go → ?
“Our question is, when the doctors, the nurses, the social worker and the family members are around the table discussing whether to carry out MAID, who is in the seat representing the patient?”
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who → discuss → patient
The group is calling for an independent, publicly-funded statutory lawyer advocating for the patient’s rights before death is administered.
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death → call → rights
That doesn’t necessarily mean stopping MAID, she said, but it potentially avoids undue influence from family members, including “deep concerns about the financial conflicts of interest” of adult children anticipating an inheritance, Campbell Pope said.
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Pope → mean → inheritance
Campbell Pope also had concerns about the safeguards around future resistance to MAID by a person with an advance request.
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Pope → have → request
The legislation would require the person to actively communicate “no” when they may not understand what is happening to them, Pope said.
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Pope → require → them
And, in the event of any doubt or uncertainty of resistance, practitioners must wait 30 days before trying again.
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practitioners → wait → days
“That sits very unwell with me,” said Campbell Pope.
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Pope → sit → me
“What, we’re going to try to kill them again in 30 days?
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we → go → days
It’s so arbitrary and it speaks to why this is such a problematic thing to be allowing.
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this → ’ → ?
Doctors and nurse practitioners who knowingly fail to comply with the requirements in the law and are found guilty of an offence could be subject to up to five years in prison.
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who → fail → prison
So far, only Quebec has laws that permit advance requests.
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that → have → requests
Alberta’s government has passed legislation that would prohibit advance requests.
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that → pass → requests
The bill will need to be passed and come into effect before March 17, the date on which the current law will allow people with mental illness as a sole underlying condition to become eligible for MAID.
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people → need → MAID
That was first proposed in changes made to the laws in 2021, but it’s been extremely controversial.
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it → propose → 2021
In June, a parliamentary committee recommended against allowing people with mental illness to become eligible for MAID after hearing that there is no consensus within the medical community about what makes a mental illness irremediable.
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illness → recommend → community
The Aporia
