The Plague-Ground – A Bill to Kill You

If you’ve never heard of Bill C-7 or recall only vaguely that it’s something Parliament is debating, it’s time you learned more, because C-7 can determine how and when you die.

Some background: medically-assisted death (MAiD) was legalized in Canada in 2016. The rules weren’t perfect, and anything involving legally killing people is bound to break people into opposing camps, especially doctors who take an oath to “do no harm” and yet who are there at your bedside, your angel of death.

When the subject itself is life-and-death, every issue is a life-and-death one: How sick do you have to be? How unrelenting is your pain? When are you expected to die? Is there a minimum age? Can you qualify just by being “very old”? What if your religion views suicide as a mortal sin? Does mental anguish count as much as physical anguish? And what if you’ve been diagnosed with Alzheimer’s and know that in five years you’ll have no memory, and if that’s so, think there’s no reason to live, can you get approved in advance? (No, not under the current law because you’re not suffering now and you can’t get approved when your Alzheimer’s accelerates because you’re no longer of sound mind).

Then in September of last year, the Superior Court of Quebec declared both “the reasonable foreseeability of natural death” and the “end of life” criteria for MAiD to be unconstitutional. In other words, you could be living with a serious chronic condition like ALS or Parkinsons, which won’t necessarily kill you, and get approved for MAiD.

For a bunch of legal and constitutional reasons I won’t get into here, the Federal Government decided to follow Quebec’s lead and, at the same time, to institute other changes to the laws around who qualifies for MAiD. Since then, the legislation was meant to be voted on three different times by our MPs, and three different times it was delayed, from March 11 to July 11 to December 18. Then last  Friday, with the Bill approved by the House but not yet even discussed in the Senate, the Minister of Justice asked for a fourth extension to February 26th.

Why so many delays? Well, COVID of course, which slows down everything; plus a minority government which doesn’t want to touch an issue so guaranteed to send voters to the ramparts; but mainly because of the rising controversy from Canadians who are only now coming to realize just how far-reaching the proposed changes will be.

The arguments for those who believe the changes will create death-on-demand were summed up cogently by Andrew Coyne in Friday’s Globe and Mail, while the arguments for those who believe the current rules for MAiD still constitute cruel and unusual punishment is argued by the lobby group Dying With Dignity.

In a nutshell, the new changes will:

  1. Remove your natural death being ‘reasonably forseeable’ in order to be eligible for MAiD.
  2. Deny MAiD to you if you’re suffering solely from a mental illness.
  3. Allow just one doctor to determine your eligibility for MAiD instead of the current two.
  4. Remove the obligation for doctors to present MAiD as an option for patients and let patients initiate the conversation about it themselves. (The Canadian Medical Association have said doctors must present MAiD as an option).
  5. Remove the mandatory 10-day waiting period between your request for assisted suicide and its execution, to allow for a change of heart.
  6. Neither will two witnesses be required to witness your request. Henceforth, one will do.

It’s important to understand that not all doctors, let alone all among Canada’s 300+ MAiD doctors and nurse practitioners, agree with the legislation. Last week, one of them, Liberal Member of Parliament Dr. Marcus Powlowswki, said he would vote with his conscience and against his party when the Bill was voted on in the House. As he told the CBC, “My biggest concern, as someone who has spent my whole life trying to avoid accidentally killing people, is that we don’t end up using MAID for people who don’t really want to die.”

He’s not the only one.

My wife Jean also happens to be a MAiD doctor. She was one of the founding members of CAMAP, the Canadian Association of MAiD Assessors and Providers, and serves on the medical advisory committee of Dying with Dignity.

Even she is saying “Hold on. This is all too rushed.”

But while she understands that these new laws can have a profound effect on who is eligible for MAiD, she laments what those changes will create for MAiD doctors.

Friday’s edition of The Plague-Ground will offer her perspective on the changes Bill C-7 will bring from a MAiD doctor’s standpoint. Friday is also the day the House of Commons rises for its Christmas break, when all of this was meant to be signed, sealed and delivered.

Perhaps this is one time when government delays are better than haste.

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10 thoughts on “The Plague-Ground – A Bill to Kill You”

  1. Is tatted to read this note, Bob – and as usual was speeding through it first time out and thought one of the questions was “Is there a minimum wage?”.

  2. Thanks for raising these issues with the legislation Bob. Removing the wait time and going from two to one doc and witness removes vital safeguards. I wonder about the woman with dementia who decided when capable she wants to do this but as her cognition declines settles into a kind of childlike joy. How could anyone follow her earlier wishes in good conscience ?
    Death in an uncomfortable subject. I have known elderly people who one day express a wish to die and the next day discover the preciousness of life powerful enough to change their minds.
    Another important issue that our society. Needs to think about is how we feel about aging and the value and respect afforded our elderly. I sense movement in this area but that may be because the very large baby boom cohort is now approaching their final decades or years.

  3. I look forward to reading Jean’s article. She is an angel for doing the work she does.
    As a side note, I read Coyne’s article. His insistence on using the term assisted suicide vs. medically assisted dying was inflammatory.

  4. This article neglected to mention that the original Supreme Court decision made no mention of death being reasonably foreseeable. Our MP Rob Oliphant chaired the original committee on the topic but ultimately voted against the bill because of the “reasonably foreseeable” clause being added. He told us at a Liberal party re-nomination meeting that Judy Wilson-Raybould and Jane Philpott had ganged up on him and made that change without any discussion. So I am happy that in that respect, the original intent of the Supreme Court will belatedly be adhered to. However, I do believe strongly in safeguards in the process. Some of those safeguards appear to have been weakened (your points 3 through 6) so I’d like to know why before passing comment.

    Mental illness is a difficult issue. I had thought it was going to be studied further before definitive conclusions were reached. I’d like to hear about the experience in other countries in that respect.

    You also don’t mention that the major reason the bill was held up was because the Conservatives mounted a filibuster in the House of Commons and as a result, the Senate had very little time to debate the bill under the original timetable.

    Like others, I look forward to Jean’s views but I will also say that I believe a person has the right to make their own decisions regarding their future and even though others may think their decision is wrong, that doesn’t give them the right to step in. People are entitled to make their own mistakes even if it involves taking their own life – subject to the appropriate safeguards. It is their life not anybody else’s.

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