A professor of health law has warned that assisted suicide in Canada has increasingly “prioritized access over protection”.
Trudo Lemmens is a professor of health law and policy at the University of Toronto. He is also a member of the Chief Coroner on Ontario MAiD Death Review Committee.
While Professor Lemmens is not against Canada’s Medical Assistance in Dying (MAiD) scheme in principle, he is warning that “Canada’s MAID law, policy and practice focuses excessively on promoting access to death, not on protection”.
In a recently published article, Professor Lemmens shared his insight of sitting on MAID’s Death Review Committee which reviews issues that arise from assisted suicide cases.
“Some cases appear to stretch the contours of MAiD law”, he said. “Some of the cases suggest a troubling prioritizing of ending patients’ lives with MAID rather than a precautionary approach.”
In 2021, MAiD’s 10-day reflection period was scrapped, and a waiver of final consent was also introduced in the same year. The waiver enables a specific date to be arranged in the future when a patient – whose death is anticipated shortly – will be euthanised without needing final consent.
While the Supreme Court’s 2015 Carter v. Canada decision stated that there could be no prohibition of assisted suicide, it emphasised the importance of clear consent as a safeguarding measure.
However, Professor Lemmens says that the waiver “moves Canada clearly away from unambiguous or clear consent…
“The coroner’s report on waiver of final consent includes cases, and notes on case discussions, that demonstrate the fine line between flexible use of such waivers and circumventing the prohibition of advance request… prohibited under the criminal code.”
Professor Lemmens cited troubling cases, including that of Mr C who was diagnosed with cancer. While he requested MAiD evaluation when he was receiving palliative care, his cognitive ability declined before he could consent. A MAiD provider then “vigorously roused Mr. C., who opened his eyes and mouthed ‘yes’” to MAiD.
To make Mr C more “alert”, pain medication was withdrawn for 45 minutes, after which a second MAiD assessor again saw him mouth “yes”, and his consent was assumed. Mr C was then euthanised.
Because of such cases, which also involve “a relatively small group of frequent [MAiD] providers”, Mr Lemmens is increasingly concerned by the “arguably overly flexible provision of MAID among these providers” who appear to place the expansion of assisted suicide over safeguarding.
Next month, on 13 June, MPs are set to debate and vote on Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill for England and Wales. Her bill would permit assisted suicide for terminally ill adults given six months to live.
However, Leadbeater admitted in March that its eligibility criteria could be expanded in the future. “That could happen”, she confessed on LBC.
In 2023, an official memo was passed to doctors in the Canadian province of Quebec requesting that they respect the limits of the law regarding assisted suicide. The cautionary note followed a massive 54 per cent rise in assisted suicides in Quebec between 2021 and 2022, and potentially 15 wrongful deaths.
There were over 15,000 MAiD deaths in Canada in 2023.
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