(April 2021) The College of Physicians and Surgeons of Ontario (CPSO) is conducting public consultations on several policies including Medical Assistance in Dying, Planning for and Providing Quality End-of-Life Care, and Professional Obligations & Human Rights. The CSPCP Board prepared the attached brief and submitted it to CPSO on March 31st.
The CPSO invites all Canadians to participate. Since their policies could be precedent setting for other provincial colleges, we encourage you to take part. You are welcome to reference content from our brief, if you wish.
Links to the three consultations can be accessed from the Consultations page of the CPSO web site.
The consultation deadline is April 30th, 2021.
(March 2021). Bill C-7, An Act to amend the Criminal Code (medical assistance in dying) became law on March 17, 2021. Several of the amendments may have a significant effect on the practice of palliative care.
Key changes are summarized below.
- Removal of reasonably foreseeable death criterion. The law no longer requires a person’s natural death to be reasonably foreseeable as an eligibility criterion for MAID (Medical assistance in dying).
- Removal of the 10-day reflection period. For those whose natural death is reasonably foreseeable, the 10-day reflection period is no longer required between the written request for MAiD and the procedure.
- Waiver of final consent for MAiD. For those whose natural death is reasonably foreseeable, the requirement for consent at the time of MAiD procedure has been waived.
- Change in requirement for witness signing a request for MAiD. Only one instead of two independent witnesses are required to verify written consent for MAiD and that witness may now be a paid health care worker.
- New safeguards for those without a reasonably foreseeable natural death. There must be 90 days between the first assessment and MAiD procedure, which can be shortened if an individual is at risk of losing capacity to consent. The individual must have been seen by a medical professional with expertise in their underlying condition.
- Sunset clause on the exclusion of mental illness as a sole underlying diagnosis in 24 months. Individuals with mental illness as a sole underlying diagnosis will be eligible to qualify for MAiD starting on March 17, 2023.
Links for more details:
Department of Justice Web page “Canada’s new medical assistance in dying (MAID) law”.
The Bill and its amendment: https://parl.ca/DocumentViewer/en/43-2/bill/C-7/royal-assent
The CSPCP presented to the responsible committees studying the Bill for the House of Commons and the Senate. Our written briefs and oral presentations are posted here: https://www.cspcp.ca/cspcp-input-to-justice-committee-re-bill-c-7/. We also signed onto the attached Open Letter “Bill C-7 is not the answer”, prepared by the Vulnerable Persons Standard. While we do not support some of the language used in the letter, especially as it relates to Long Term Care, we felt it important to lend our support because of the implications this Bill may have on the practice of palliative care.
(November 2020). The Parliament of Canada is currently reviewing Bill C-7, An Act to amend the Criminal Code (medical assistance in dying). Parts of the proposed Bill have significant implications for palliative care and despite the very tight timelines involved, the CSPCP has been actively working to provide input accordingly.
The first step in the parliamentary process was review by the House of Commons Standing Committee on Justice and Human Rights. The CSPCP submitted a written brief (English; French). We were subsequently invited to give a 5-minute presentation to the Committee and to participate in a question period. CSPCP President Dr. Anne Boyle and CSPCP Member Dr. Harvey Chochinov represented the CSPCP. They focused on the evidence in the literature that addressed the Government’s proposed changes to the law. (View proceedings here. CSPCP presented at 12:25:45)
The second step was review by the Senate Standing Committee on Legal and Constitutional Affairs. The CSPCP submitted a written brief (same as the one above). CSPCP Past-President Dr. Leonie Herx gave a 5-minute presentation and participated in the question period that followed. Dr. Herx summarized the CSPCP’s concerns and recommendations for safeguards to minimize harm. View her presentation here. (Full proceedings here: SenVu (parl.gc.ca)).