Medical Assistance in Dying
Legislative changes to medical assistance in dying (MAID) and passage of Bill C-7
Bill C-7, an Act to amend the Criminal Code (medical assistance in dying) received Royal Assent, amending the medical assistance in dying law in Canada on March 17, 2021. As a result:
- MAID is permitted in circumstances where “natural death is not reasonably foreseeable,” for example, for individuals who have serious and incurable illness, disease or disability, provided certain eligibility criteria and safeguards are met. MAID continues to be allowed in circumstances where “natural death is reasonably foreseeable”
- Individuals whose only medical condition is a mental illness will not be eligible for MAID until March 17, 2023, enabling the federal government more time to study this issue. The government will convene an expert panel to consider the matter
- A waiver of final consent is permitted immediately prior to receiving MAID, where natural death is reasonably foreseeable, providing that certain criteria are met
- A parliamentary committee will be struck to review other outstanding issues relating to MAID (for example, MAID in mature minors and advance requests for MAID)
This new law also enhances the federal government’s MAID monitoring abilities by extending data collection and reporting so the government may understand how MAID is implemented in Canada, including under the new provisions. This includes any requests that have not been put in writing or any preliminary assessments that may be undertaken by health professionals. The federal government will be consulting with key stakeholders to inform how to best collect and report this data.
Professional obligations and human rights
The OMA provided feedback in May 2021 to the College of Physicians and Surgeons of Ontario regarding its current Professional Obligations and Human Rights policy. The feedback provided was based on input from our members and recommends:
- Additional clarity and information regarding the term “effective referral” and the expected timing and acknowledgment of an effective referral
- Adding additional grounds to the human rights code including lifestyle habits, among others
- Removing certain portions of the advice document rather than the actual policy
- Providing additional clarity in the advice document to avoid confusion
Federal government proposes delay to MAID expansion
The federal government is proposing a delay to the expansion of MAID to people who have mental illness as their sole underlying medical condition. The delay would last three years until 2027. We will continue to work with the provincial regulators to ensure all of you understand your rights and responsibilities as they pertain to MAID.
New MAID committee
The Office of the Chief Coroner is establishing a Medical Assistance in Dying Death Review Committee to provide independent expert review of MAID deaths. The committee will evaluate potential public safety concerns and provide insights that may inform broad system changes. The OCC is recruiting committee members from diverse professional backgrounds, including various medical specialties (such as palliative care, physiatry, psychiatry, geriatrics and critical care), nursing, social work, ethics and law. The deadline to apply was Oct. 6, 2023.
Resources
The Department of Justice Canada has produced a comprehensive backgrounder summarizing the legislative changes and new eligibility requirements arising from Bill C-7.
Following the passage of Bill C-7, the OMA made a submission to the College of Physicians and Surgeons of Ontario regarding its current MAID policy.