Euthanasia in Canada: Difference between revisions

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=== Bill C-7 ===
The federal government passed Bill C-7 on 17 March 2021.<ref>{{Cite web |title=Government Bill (House of Commons) C-7 (43-2) - Royal Assent - An Act to amend the Criminal Code (medical assistance in dying) - Parliament of Canada |url=https://parl.ca/DocumentViewer/en/43-2/bill/C-7/royal-assent |access-date=15 July 2022 |website=parl.ca |language=en-ca}}</ref> The new legislation relaxed or eliminated some of the safeguards for patients whose deaths were ''reasonably foreseeable'', notably removing the 10-day waiting period, requiring only a single independent witness, and removing the requirement to offer palliative care. The legislation also introduced a new avenue for those whose death was not ''reasonably foreseeable'' to access euthanasia, conditional on the approval of medical practitioner who specialized in the underlying condition, a 90-day assessment period, and discussion on all other available treatment methods. The legislation also included a sunset clause that would allow people with severe refractory mental illnesses that have exhausted all treatment options to be eligible for euthanasia two years after the legislation passed. This clause has been particularly controversial due to the perceived difficulty of receiving informed consent from individuals suffering from a mental illness, particularly when the mental illness is already associated with a suicidal[[suicide ideation]].<ref>{{Cite web |title=Oh, Canada! Your New Law Will Provide, Not Prevent, Suicide for Some Psychiatric Patients |url=https://www.psychiatrictimes.com/view/canada-law-provide-not-prevent-suicide |access-date=15 July 2022 |website=Psychiatric Times |date=June 2021 |language=en}}</ref> However, multiple studies show that the majority of people with mental illnesses do not lack the mental competence or the capacity to make treatment-related decisions.<ref>{{cite journal |pmid=17906238 | year=2007 |last1=Okai | first1=D. |last2=Owen |first2=G. |last3=McGuire |first3=H. |last4=Singh |first4=S. |last5=Churchill |first5=R. |last6=Hotopf |first6=M. |title=Mental capacity in psychiatric patients: Systematic review |journal=The British Journal of Psychiatry: The Journal of Mental Science |volume=191 |pages=291–297 |doi=10.1192/bjp.bp.106.035162 |s2cid=7819093 |doi-access=free}}</ref><ref>{{cite journal |url=https://pubmed.ncbi.nlm.nih.gov/28624976/ |pmid=28624976 |year=2018 |last1=Rooney |first1=W. |last2=Schuklenk |first2=U. |last3=Van De Vathorst |first3=S. |title=Are Concerns About Irremediableness, Vulnerability, or Competence Sufficient to Justify Excluding All Psychiatric Patients from Medical Aid in Dying? |journal=Health Care Analysis |volume=26 |issue=4 |pages=326–343 |doi=10.1007/s10728-017-0344-8 |s2cid=4054272}}</ref><ref>{{cite journal |pmc=6099778 |year=2018 |last1=Dembo |first1=J. |last2=Schuklenk |first2=U. |last3=Reggler |first3=J. |title="For Their Own Good": A Response to Popular Arguments Against Permitting Medical Assistance in Dying (MAID) where Mental Illness is the Sole Underlying Condition |journal=Canadian Journal of Psychiatry |volume=63 |issue=7 |pages=451–456 |doi=10.1177/0706743718766055 |pmid=29635929}}</ref><ref>{{cite journal |url=https://jme.bmj.com/content/48/11/929.abstract |pmid=33849958 |year=2022 |last1=Bahji |first1=A. |last2=Delva |first2=N. |title=Making a case for the inclusion of refractory and severe mental illness as a sole criterion for Canadians requesting medical assistance in dying (MAiD): A review |journal=Journal of Medical Ethics |volume=48 |issue=11 |pages=929–934 |doi=10.1136/medethics-2020-107133 |s2cid=233233285}}</ref> This expansion in access to medical assistance in dying was originally planned for March 2023 before being postponed by one year to 17 March 2024.<ref>{{cite web |last1=Lavery |first1=Irelyne |title=Feds looking to delay expansion of assisted dying: 'Need to get this right' |url=https://globalnews.ca/news/9352016/medically-assisted-death-maid-expansion-lametti-announcement/ |website=Global News |access-date=4 May 2023}}</ref> It was further postponed to 2027.<ref>{{cite web |last1=Baxter |first1=David |title=Medically assisted death for mental illness delayed until 2027: minister |url=https://www.globalnews.ca/news/10265616/maid-expansion-delayed-2027/ |website=Global News |access-date=16 May 2024}}</ref>
 
A panel was established by the government to study potential issues and safeguards with implementing medical assistance in dying for people whose sole medical condition was a mental illness.<ref>{{cite web |title=Canada's medical assistance in dying (MAID) law |url=https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html#e |website=Government of Canada |date=17 March 2021 |access-date=29 April 2023}}</ref> A report of this process was given to parliament on 6 May 2022. The panel had nineteen recommendations that could be implemented without amending the Criminal Code. Some arguments addressed to the panel suggested that there was no evidence that safeguards and protocols could be adequate and thus the panel's mandate could not be fulfilled. The panel concluded that despite these uncertainties, people could still voluntarily wish to request medical assistance in dying and thus its mandate could be fulfilled.<ref name="SUMCreport">{{cite web |title=Final Report of the Expert Panel on MAiD and Mental Illness |url=https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/expert-panel-maid-mental-illness/final-report-expert-panel-maid-mental-illness.html |website=Government of Canada |date=13 May 2022 |access-date=29 April 2023}}</ref> One member of the panel, Ellen Cohen, resigned for ethical reasons. Cohen believes that the issues faced by those in poverty or seeking housing was not adequately considered by the rest of the panel.<ref>{{cite web |last1=Cohen |first1=Ellen |title=Why I resigned from the federal expert panel on medical assistance in dying |url=https://www.theglobeandmail.com/opinion/article-expert-panel-maid-mental-illness/ |website=Globe and Mail |access-date=7 May 2024}}</ref> A person can simultaneously seek medical assistance in dying while waiting for other treatments.<ref>{{cite web |title=9 things to know about medical assistance in dying for mental illness |url=https://www.ctvnews.ca/w5/9-things-to-know-about-medical-assistance-in-dying-for-mental-illness-1.6242690 |website=CTV News|date=23 January 2023}}</ref>