Health Minister Jane Philpott hinted Wednesday that her government may be willing to accept a compromise Senate amendment to its assisted dying bill that would help C-14 pass in the Red Chamber.
She said including an amendment that commits Parliament to studying the possible expansion of eligibility beyond patients suffering a terminal illness, within 180 days of the bill's passing, may be in the cards.
"I would say whether they make that amendment or not, we're going to study that," Philpott said. "If it needs to be in the bill, then obviously we'll take that into consideration … I think questions that come up repeatedly, we have a responsibility to respond to Canadians because they're obviously questions Canadians have as well."
Philpott made the comments to reporters after speaking before the Senate in a rare televised appearance with federal Justice Minister Jody Wilson-Raybould. The ministers were there to defend the bill and convince senators to speed its passing by the Supreme Court of Canada's June 6 deadline.
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In the Senate, Wilson-Raybould said she was confident that her government's assisted dying bill is compliant with the Charter of Rights and Freedoms and that she was "100 per cent confident" that Kay Carter, whose case was at the centre of a Supreme Court ruling, would have been granted the right to die had the bill been law.
"In recognition of Kay Carter, she was 89 years of age, suffering intolerably from spinal stenosis and was in a state of irreversible decline," she said. "Her death had become reasonably foreseeable by virtue of her age and her frailty."
Wilson-Raybould referred to Carter, who had wished to end her life with the help of a doctor, because the B.C. Civil Liberties Association fought all the way to the high court on her behalf.
The Supreme Court's "Carter decision" ruled that denying a patient suffering with a grievous and irremediable condition the right to die with the help of a doctor was a violation of the charter and instructed the federal government to craft a law to govern the practice.
When the Liberals came to power, a special joint Senate and Commons committee was struck to listen to witnesses and produce a report that would guide the government in crafting the deadline.
When Bill C-14 was tabled in Parliament in April, it restricted doctor-assisted death to mentally competent adults who have a serious and incurable illness, disease or disability who are "suffering intolerably" and whose death is "reasonably foreseeable."
Restricting the legislation to people who are deemed to be at the end of their lives garnered criticism from those who said the top court's Carter decision was about granting relief to a patient with intolerable suffering, but who may not be at risk of imminent death.
'There is something so fundamentally wrong and discriminatory in the application of this I wonder how you have rationalized through to defence,' - Senator Frances Lankin on assisted dying legislation
Wilson-Raybould faced intense, and at times aggressive, questions from senators of all stripes. Many argued that the government was excluding large numbers of people from accessing an assisted death by including the restriction "reasonably foreseeable" in the bill.
One of those critical voices came from independent senator Frances Lankin, recently appointed to the Senate on the advice of Prime Minister Justin Trudeau.
Lankin said two people suffering from the same disease, with the same incurable and intolerable symptoms, would face different fates based on their age. Someone who is older or ready to be "dispensed" could expect a swift death while someone younger would be forced to wait in pain for years.
"There is something so fundamentally wrong and discriminatory in the application of this I wonder how you have rationalized through to defence," said Lankin.
Defending C-14's restrictions
Bill C-14 also does not include some of the most contentious recommendations from the parliamentary committee's witnesses, including extending the right to die to "mature minors" and the mentally ill.
The ministers were questioned over these omissions and over the decision not to allow advance consent for patients with degenerative mental disorders that would eventually render them unable to consent to an assisted death.
Philpott, who is also a family doctor, explained that regulating advance consent was very difficult, and it would not have been possible to implement a regime that allowed it while still protecting the vulnerable by next week's deadline.
She said she discussed the idea of advance directives with the minister of health from the Netherlands and that country has had what Philpott said was a "great deal of difficulty with the concept of advance directives."
"If I am not mistaken, the Netherlands is the only country in the world that allows advance directives for a diagnosis of dementia, so it's rarely done and in that context it's not quite working as one would hope," she said.
While the timeline is too short to deal with that issue now, Philpott noted that all the provinces that have provided guidance to doctors on assisted dying have chosen not to include advance directives.
"I think there is a very real possibility that we may one day see advance directives as a part of this legislation, although it's not up to me alone, it's up to all of us working together for that."
C-14 'reasonable and justifiable'
Wilson-Raybould defended the restrictions in the proposed law saying that, internationally, most democratic countries do not have an assisted dying law, and of the ones that do most of them restrict access to those facing the end of their lives.
"As minister of justice and the attorney general of Canada I am confident that Bill C-14 is a reasonable and justifiable policy choice ... that being said, our government has committed to studying broader forms of eligibility and in particular eligibility for individuals suffering solely from mental illness," she added.
The minister said expanding the eligibility to include patients who are not suffering with a terminal illness would introduce risks to vulnerable patients, and she disagreed with senators who suggested the Carter decision dictated that eligibility should be extended in this way.
"I do not ascribe to the view that Carter stated, and that our honourable Supreme Court justices directed, Parliament to invoke the broadest regime, potentially, in the world. What I recognize the honourable justices as saying is that an absolute prohibition on medical assistance in dying is unconstitutional."