We believe that the definitions of‘ independence’ are so stringent that they will effectively prevent many eligible patients from accessing MAiD |
Bill C-14 sets out some important parameters. It defines Medical Assistance in Dying; it sets out eligibility criteria for MAiD; it articulates safeguards for those who are seeking MAiD; and it provides protections for providers of MAiD, and for those who support providers or patients throughout the MAiD process.
We told the Senate – as we had told the House of Commons in an earlier written submission – that we strongly support many aspects of the Bill, including its recognition of the collaborative nature of healthcare and the involvement of different types of health-care providers throughout the MAiD process. We explained that we do, however, have some areas of concern that centre on those provisions that we believe may negatively impact patient access to care.
One of our concerns is the definition of a‘ grievous and irremediable medical condition’, as set out in Bill C-14. For instance, the definition requires that patients be in an‘ advanced state of irreversible decline in capability’. This implies that only patients with conditions that progressively worsen over time will be eligible for MAID. It would exclude conditions that cause‘ enduring and intolerable suffering’ but that do not advance in a progressive manner.
The definition also requires that death be‘ reasonably foreseeable’. This appears to signal that patients must be close to death before they can request or receive MAiD. This
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would exclude patients who may have non-terminal conditions that are otherwise‘ serious, and incurable’ and which cause‘ enduring and intolerable suffering’.
We voiced a number of other concerns that we believe have the effect of narrowing the criteria for MAiD, as set out in the Carter decision and that would otherwise impede patient access to MAiD.
While we support the principle that the process which governs the requests for and provision of MAiD needs to be rigorous, we believe that the definitions of‘ independence’ are so stringent that they will effectively prevent many eligible patients from accessing MAiD. Regarding witnesses, for example, some patients who would otherwise be eligible for MAiD will not be able to find two individuals outside their family, caregivers or health-care providers to act as independent witnesses, as required by Bill C-14. For some patients, the very condition that has led them to seek access to MAiD will have resulted in their isolation and loss of access to broader circles of support.
For a more complete explanation of our concerns, I urge you to read our full submissions to the Senate online, available from our homepage.
In the meantime, we will continue to provide the most up-to-date information to you on our website. MD
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photo: istockphoto. com |