Justice Minister David Lametti says he thinks Canadians want more access to medical assistance in dying in the wake of a court ruling that struck down elements of the federal law.
Lametti told CBC Radio One’s The House on Thursday that’s the message emerging from roundtable discussions with stakeholders across the country and nearly 300,000 responses to an online questionnaire that closed Jan. 27 — the largest number of responses the department has ever received during a public consultation.
The questionnaire sought Canadians’ opinions on the eligibility criteria and request process for medical assistance in dying (MAID). Last fall, the Quebec Superior Court struck down portions of federal and provincial MAID laws that said only people who are facing “foreseeable death” can receive a doctor’s help to die.
“There does seem to be a clear tendency that Canadians are largely in agreement that we ought to expand the possibility for medical assistance in dying beyond the end-of-life scenario,” Lametti said.
“Obviously there are some voices that don’t agree. People living with disabilities can see this as a threat, even an existential threat, and we’re trying to achieve the right balance there to not stigmatize people in that context.”
Lametti said he understands how crucial it is for the government to get this right.
“You can only do your best in all of these circumstances, but you have to try to be compassionate, you have to try to listen to people as best you can in whatever context, whether it’s an online survey or an in-depth conversation,” he said. “It’s not easy.”
Lametti was in Quebec City on Friday for another roundtable. His office says he’s also attended similar sessions in Halifax, Toronto, Vancouver and Ottawa. Those closed-door meetings have included medical practitioners, legal groups, advocates for seniors and the disabled, patients and family members.
The goal of the government’s online survey was to gauge the public’s views on how it should respond to a September 2019 Quebec court decision, which struck down a requirement for a patient’s death to be “reasonably foreseeable.”
The Truchon decision, as it is known, refers to Quebec resident Jean Truchon, who, along with Nicole Gladu, challenged the “reasonably foreseeable” natural death and “end of life” eligibility criteria in Quebec Superior Court. Truchon and Gladu both sought access to MAID because they said they were experiencing enduring, intolerable suffering from physical conditions, but their natural deaths were not yet reasonably foreseeable and they were not at the end of their lives.
The court’s ruling will come into effect March 11, unless an extension is granted. Although the decision only applies in Quebec, the government says it has accepted the ruling and is committed to changing the MAID law for the whole country.
But Lametti said one possible result of making these changes to the law will be to extend MAID to people whose sole underlying medical condition is a mental disorder.
“That certainly is a possibility that’s raised by this expansion,” he said.
The question of extending MAID to cases where the underlying condition is a mental disorder was something the government expected to deal with in its mandated five-year review of the legislation, which is slated to begin later this year, Lametti said.
Though the issue is on Lametti’s radar now, he wouldn’t say how Parliament might address it.
“I’m not going to pre-empt my parliamentary colleagues,” he said. “We have to deal with it in some way, shape or form.”
Legal expert Jocelyn Downie agrees the Truchon decision forces the federal government to act now.
“When you remove ‘reasonable foreseeability’ from the Criminal Code, as the judge in Quebec did for Quebec, one of the things that happens is that more people with mental disorders as their sole underlying medical condition will now be eligible for MAID,” said Downie, a Dalhousie University law professor who served on the Council of Canadian Academies expert panel that studied MAID.
“It is essential that (the federal government) consider it in the context of responding to the Truchon decision because removing eligibility criteria, which they have to do, creates an expanded group of people who will be eligible.”
The government’s goal is to table the modified MAID legislation in February, in advance of the deadline imposed by the Quebec court. If no legislation or court extension is in place by March 11, the “reasonably foreseeable death” requirement would no longer apply in Quebec, but it would remain in place in the rest of Canada, the government says.
Since MAID was made legal in Canada, more than 6,700 Canadians have pursued the option, the government says.