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Canada to miss deadline to enact assisted dying law, government says Canada to miss deadline to enact assisted dying law, government says
(about 1 hour later)
The Canadian government has acknowledged it will miss a deadline to bring in a law allowing medically assisted death and predicted many sick patients would have trouble finding doctors willing to help end their lives. Doctor-assisted dying is about to become legal in Canada without clear legislation on how it would work.
The country’s supreme court overturned a ban on physician-assisted suicide last year and gave Ottawa until 6 June to introduce a law to allow the practice. Canada’s supreme court last year struck down laws that bar doctors from helping someone critically ill die, but put the ruling on hold until midnight on Monday to give the government time to come up with a new law. The House of Commons passed a law last week but it requires Senate approval and that could take days or weeks.
The topic is highly sensitive and prompted a political debate that dragged out for so long that the final version of the draft legislation is not ready. It could be months before a law is adopted and even then, legal challenges are likely. Provincial regulators issued guidelines based on the eligibility outlined by the supreme court but health minister Jane Philpott said Monday the guidelines do not provide enough clarity and protection to doctors. She hopes the federal legislation will pass soon.
“Unfortunately, despite tremendous effort, this bill is not yet in place,” Jane Philpott, the health minister, said on Monday. “Doctors may have inadequate protection and I expect in these early days, many physicians will be extremely reluctant to provide assistance to patients wanting medical assistance in dying,” Philpott told healthcare professionals in a speech in Ottawa. Philpott noted the guidelines vary from province to province and doctors lack standard criteria for who is eligible.
Doctors will be able to help patients die starting 7 June, but in the absence of a federal law it is now up to Canada’s 10 provinces to individually set their own guidelines. Philpott said this would produce a patchwork of differing rules. “Some of the regulatory recommendations talk about an age of 18 or over and some don’t. There are differences in how many witnesses are required. In some cases it is one, others two,” she said.
“Doctors may have inadequate legal protection, and I expect that in these early days, many physicians will be extremely reluctant to provide assistance to patients wanting medical assistance in dying,” she told a health conference. Philpott offered no advice to fellow doctors on whether to proceed with physician-assisted dying without legislation in place. She said they should contact their professional associations for advice.
Ontario, Canada’s most populous province, on Monday said it would set up a referral service for doctors seeking advice. Assisted suicide is legal in Switzerland, Germany, Albania, Colombia, Japan and the US states of Washington, Oregon, Vermont, New Mexico and Montana. California lawmakers also passed legislation, expected to take effect in June, where proof of state residency will be required.
“We encourage patients and health care providers to seek further clarity about how the Supreme Court’s decision applies to their particular circumstances,” Ontario health minister Eric Hoskins said in a statement. Canada’s supreme court ruling means a doctor can’t be prosecuted for assisting death for those with a “grievous and irremediable” illness. The government’s proposed law applies to “adults who are suffering intolerably and for whom death is reasonably foreseeable”. It says the person must be mentally competent, 18 or older, have a serious and incurable disease, illness or disability and be in an advanced state of irreversible decline of capability.
The supreme court last year said willing adults facing intolerable physical or psychological suffering from a severe and incurable medical condition had the right to a medically assisted death. The proposed Canadian law applies only to citizens and residents, meaning Americans won’t be able to travel to Canada to die. To get a doctor’s help under Canada’s proposed law, written request is required either from the patient or a designated person if the patient is incapable. The request would need to be signed by two independent witnesses.
The Liberal government, though, chose to draft a narrow law and rejected proposals covering minors, the mentally ill and those who do not have a terminal disease. Two independent physicians or authorized nurse practitioners would have to evaluate it, and there would be a mandatory 15-day waiting period unless death or loss of capacity to consent was imminent.
The bill is now before the senate upper chamber, where several members plan to introduce amendments broadening the scope of the legislation. Once the senate has finished, the draft will go back to the house of commons lower chamber. Some groups have said the law doesn’t go far enough and have noted law excludes people who have received a diagnosis of dementia or Parkinson’s from making a request in advance for assisted suicide.
The Liberals will then have to decide whether to approve amendments they had previously rejected, and given that the house breaks for the summer this month, debate could be pushed back until later in the year. Before the supreme court decision last year, it had been illegal in Canada to counsel, aid or abet a suicide, an offense carrying a maximum prison sentence of 14 years. But the top court said doctors are capable of assessing the competence of patients to consent, and found there is no evidence that the elderly or people with disabilities are vulnerable to being talked into ending their lives.
Whatever the final law looks like, constitutional experts predict legal challenges from people who feel it contravenes the spirit of the supreme court’s decision.