How Bill C-7 will sacrifice the medical profession’s standard of care

Amendments to assisted dying laws are a stunning reversal of the central role of the medical and legal concept of the standard of care

Trudo Lemmens, Mary Shariff, Leonie Herx

As Parliament discusses Bill C-7’s expansion of the Medical Assistance in Dying (MAiD) Act, one issue has been conspicuously absent from public debate, even though it has major implications for medicine and for patients: the impact of the bill on the role of the medical profession in determining the standard of care, as it applies to MAiD.

The government introduced Bill C-7 in response to the decision of Quebec Superior Court Justice Christine Beaudouin (in the Truchon case), who ruled unconstitutional the current law’s limiting of MAiD to those whose natural death is “reasonably foreseeable.”. . . [Full Text]

Indigenous Peoples Should Not Be Compelled to Provide or Facilitate Medical Assistance in Dying

Letter to Canadian Senators, Elected Federal & Provincial Leaders, and Regulators

Tyler White, Graydon Nicholas, Nick Sibbeston, Alika Lafontaine, Lana R. Potts, Rosella Kinoshameg, Bob Sutherland, Troy Hunter, Howard Jolly, Rennie Nahanee, Kenny Blacksmith, Travis Gladue-Beauregard, Karen Sibbeston, Vincent Solomon, Barry C. Maracle

As Indigenous people in Canada, we have grave concerns over the implications of Bill C-7 on our communities.

The expansion of “Medical Assistance in Dying” (MAiD) beyond those whose death is foreseeable will have a lasting impact on our vulnerable populations. Not only has the consultation of Bill C-7 with our leaders been inadequate, it has not taken into account the existing health disparities and social inequalities we face compared to non-Indigenous people.

As sovereign nations in Canada, we have a right in determining how health services will be delivered in our communities, and the Government of Canada has a responsibility to respect this relationship.

Bill C-7 goes against many of our cultural values, belief systems, and sacred teachings. The view that MAiD is a dignified end for the terminally ill or those living with disabilities should not be forced on our peoples.

Given our history with the negative consequences of colonialism and the involuntary imposition of cultural values and ideas, we believe that people should not be compelled to provide or facilitate in the provision of MAiD. Furthermore, our population is vulnerable to discrimination and coercion in the healthcare system, and should be protected against unsolicited counsel regarding MAiD.

These civil measures should extend to all Canadians.

Regardless of one’s opinion of MAiD, the right to self-determination and to act on one’s conscience is recognized as a fundamental freedom in all peoples. We call on the Government of Canada to recognize the value of Aboriginal healing practices by respecting Indigenous peoples’ right to self-determination in spiritual matters, including the right to practise our own traditions and customs when supporting those who are dying, without discrimination in the health care system.

SIGNATORIES
Tyler White.
Chief Executive Officer,
Siksika Health Services, Siksika Nation;
Member of Blackfoot Confederacy and Treaty 7 of Alberta.

Honourable Graydon Nicholas.
Order of New Brunswick,
First Indigenous Lieutenant Governor of New Brunswick,
Member of Wolastoqey Nation.

Honourable Nick Sibbeston.
Retired Senator,
Former Premier,
Northwest Territories.

Dr. Alika Lafontaine MD, FRCPC,
Anesthesiologist
Past President, Indigenous Physicians Association of Canada.

Dr. Lana R. Potts BScN MD CCFP.
Indigenous Health Advisor,
Blackfoot Family Physician with Specialty in Indigenous Health;
Blackfoot Ceremonialist;
Member of Racism and Discrimnation Working Group of the
Federal Medical Regulatory Authorities of Canada;
Member of Indigenous Advisory at the University of Lethbridge, Alberta.

Rosella Kinoshameg. Elder, DSL hc., RN., B.Sc.N.,
Indigenous Palliative Care Consultant,
Wiikwemkoong Unceded Territory, Ontario.

Bob Sutherland.
Elder and Traditional Health Worker
Member of Moose Cree First Nation

Troy Hunter.
Indigenous Lawyer, New Columbia Law Corporation,
Member of Ktunaxa Nation, British Columbia.
February 2021

Howard Jolly.
Executive Director, First Nations Alliance Churches of Canada;
Member of the Eeyou Cree Nation, Quebec.

Deacon Rennie Nahanee.
Elder, Squamish Nation;
Volunteer at Lionsgate Hospital for Squamish People;
Advisor for Suicide Prevention for Squamish Nation, British Columbia.

Chief Kenny Blacksmith.
Former Deputy Grand Chief of Eeyou Cree Nation;
KLB Resources Inc/Chief Essential Oils;
Member of the Cree Nation of Mistissini, Quebec.

Travis Gladue-Beauregard,
Operations Director of The Buffalo Tribune;
Columnist and Writer. Former Service Member.
Member of Bigstone Cree Nation, Alberta. Treaty 8 Territory.

Karen Sibbeston. Elder,
Dene Nation, Northwest Territories.

Vincent Solomon.
Urban Indigenous Ministry Developer,
Diocese of Rupert’s Land, Winnipeg, Manitoba.<br.
Barry C. Maracle.
Founder of TakeCharge Ministries.
Mohawk from Tyendinaga Mohawk Territory, Ontario

Protection of Conscience Project supports Ontario Medical Association appeal

News Release

Protection of Conscience Project

The Protection of Conscience Project has written to the Canadian Senate’s Standing Committee on Legal and Constitutional Affairs in support the Ontario Medical Association (OMA), a professional association representing over 31,000 practising Ontario physicians. The OMA has asked the committee to add a protection of conscience amendment to Bill C-7, a euthanasia/assisted suicide bill now before the Canadian Senate.

The current and previous Liberal governments have repeatedly rejected efforts to include such protection for health care practitioners in relation to what the law calls medical assistance in dying (MAiD). A favoured (and correct) response from the government and its supporters is that protection of conscience legislation falls within provincial jurisdiction, so it is not possible to include it in the Criminal Code.

However, that is not the end of the matter.

“Bill C-7 is an exercise of the federal government’s absolute constitutional jurisdiction in criminal law because medical assistance in dying is (non-culpable) homicide and assisted suicide,” wrote the Project Administrator.

“Within that context, Bill C-7 can be amended to protect freedom of conscience without intruding upon provincial jurisdiction. Just as female genital mutilation has been made a crime, Bill C-7 can be amended to make it a criminal offence to force people to become parties to homicide and suicide.”

With the letter was the Project’s submission on this point to a House of Commons standing committee in the fall of 2020.

Contact: Sean Murphy, Administrator
Protection of Conscience Project
email: protection@consciencelaws.org

Ontario Medical Association asks for protection of conscience amendment to euthanasia/assisted suicide bill

Sean Murphy*

The Ontario Medical Association (OMA), representing over 31,000 Ontario physicians, has asked that protection of conscience provisions be included in a euthanasia/assisted suicide bill now before the Standing Senate Committee on Legal and Constitutional Affairs in Canada. The request is contained in a letter to the Chair of the committee.

Bill C-7 is the government’s proposed amendment to the current Criminal Code provisions concerning “medical assistance in dying” (euthanasia and assisted suicide provided by physicians and nurse practitioners. The current law was enacted as a result of a ruling by the Supreme Court of Canada that an absolute ban on euthanasia and assisted suicide was unconstitutional. Bill C-7 is the government’s response to a ruling by the Quebec Court of Appeal that it is unconstitutional to restrict euthanasia and assisted suicide to those at the end of life or whose death is “reasonably foreseeable.”

Bill C-7 formally repeals the requirement that natural death be “reasonably foreseeable,” vastly increasing the pool of potential euthanasia/assisted suicide candidates, particularly among disabled persons. It abolishes a ten day reflection period for those whose deaths are reasonably foreseeable and reduces the number of independent witnesses to a patient request from two to one. It will also permit the lethal injection of an approved candidate who has lost capacity if the candidate provides advance written authorization before losing capacity. While the bill explicitly excludes mental illness as grounds for the service and establishes different criteria for patients whose natural deaths are not reasonably foreseeable, the proposed amendments have reinforced concerns among practitioners who have objected to euthanasia and assisted suicide from the beginning. It seems reasonable to think that the proposals may also be causing uneasiness among practitioners who are not opposed to the services in principle.

Ontario Medical Association asks for protection of conscience amendment to euthanasia/assisted suicide bill
Download copy.

Portuguese Parliament approves euthanasia

The Siasat Daily

IANS

Lisbon, Jan 30 : The Portuguese Parliament has approved the legalisation of euthanasia “practiced or helped by health professionals” in the country with 136 votes of deputies in favour and 78 against, in addition to four abstentions.

According to the bill approved on Friday, a person aged over 18 can be medically assisted in death “whose will is current and reiterated, serious, free and enlightened, in a situation of intolerable suffering, with a definite injury of extreme severity in accordance with scientific consensus or incurable and fatal disease”, reports Xinhua news agency. . . [Full text]