Doctor-assisted death will be restricted to mentally competent adults who have serious and incurable illness, disease or disability under new legislation tabled in Parliament today.
The long-awaited bill also sets out safeguards to protect vulnerable Canadians, but does not include some of the most contentious recommendations from a parliamentary committee, including extending the right to die to "mature minors" and the mentally ill, and allowing advance consent for patients with degenerative disorders.
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Instead, the bill limits access to those "suffering intolerably" and whose death is "reasonably foreseeable."
Justice Minister Jody Wilson-Raybould said the government was operating under a compressed timeframe to meet a June 6 deadline imposed by the Supreme Court of Canada. She said there will be further study on those contentious proposals, and amendments could come down the road.
She said the legislation was framed around diverse views and perspectives, and conceded it will be "troubling" for some.
"For others it will not go far enough," she said. "We believe this legislation is the best approach to ensure that dying patients who are suffering unbearable pain have the choice for a peaceful death and the vulnerable are protected," she said.
The bill would also:
- Protect people from being encouraged to die in "moments of weakness."
- Include a mandatory 15-day "reflection period" so people don't make rash decision after a diagnosis.
- Re-affirm goals on suicide prevention and encourage a "consistent approach" across Canada.
- Allow doctors and nurse practitioners to provide assistance without risk of criminal charges.
Patients must also be eligible for publicly funded health care services in Canada, which precludes people from the U.S. or other jurisdictions travelling to Canada to end their lives with the help of a doctor in what some have called "suicide tourism."
Health Minister Jane Philpott called it a "historic day" for Canada and said it will come with a strategy for improved palliative care.
While the legislation removes the risk that doctors and authorized nurse practitioners will be prosecuted, she said conscience rights will also be protected.
"What today's legislation describes is how medically assisted death will be carried out — for whom and by whom," she said.
But advocacy group Dying With Dignity denounced the bill for being too narrow and restrictive. Its medical adviser, Dr. Brett Belchetz, accused the government of ignoring key recommendations from the parliamentary report around advance consent and mature minors.
He also took issue with what he called the "vague and discriminatory" term "reasonably foreseeable" death.
"It will be very hard for me to know if I'm in compliance with the law or not," he said.
The legislation was spurred by a unanimous landmark ruling on Feb. 6, 2015, when the Supreme Court of Canada struck down the ban on physician-assisted dying on the grounds that it violated Canadians' Charter rights.
Justices gave the federal and provincial governments 12 months to prepare for the decision to come into effect.
After taking office, the Liberal government asked for a six-month extension, but the high court granted an extra four months, to June 6.
One of the plaintiffs in the constitutional challenge, the British Columbia Civil Liberties Association, criticized the legislation as too restrictive.
The bill excludes several categories of "suffering Canadians" who should have the same right to a safe and dignified assisted death, said executive director Josh Paterson.
"The inevitable result is that people will be trapped in intolerable suffering, or be left with no choice but to take their own lives prematurely in potentially dangerous situations," he said.
A special parliamentary committee was tasked with making recommendations around legislation, and tabled a 70-page report called Medical Assistance in Dying: A Patient-Centred Approach.
That report said Canadians should have the right to make an "advance request" for medical aid in dying after being diagnosed with certain debilitating but not necessarily terminal conditions.
It also said assisted death should not be limited to physical conditions, and that Canadians with psychiatric conditions should not be excluded from doctor assistance to end suffering.
One of the most contentious recommendations was to consider, in three years, extending the right for doctor-assisted death to "mature minors."
More study on age requirement
Today's bill includes an age requirement of 18 years, but Wilson-Raybould said that restriction and others will be studied in more detail.
She also expressed confidence that all elements of the bill are in line with the Charter of Rights and Freedoms, and promised to release an "explanatory paper" to explain how the legislation complies with constitutional rights.
Conservative deputy justice critic Michael Cooper was pleased to see that the bill narrowed the scope of access to doctor-assisted death and excluded people under 18. But he opposed allowing nursing practitioners to carry out assisted deaths.
The bill will go to committee for further study before it goes to the House for a vote, and all Liberal, Conservative and NDP MPs will have a free vote to vote with their conscience. It must also clear the Senate before it becomes law.
Cooper said Conservatives would work diligently to meet the deadline and avoid a legal vacuum "chaos."
"There would be no direction for physicians who are following or breaking the law," he said, adding there would be no protections for vulnerable Canadians either.