Who should get a medically assisted death? Canadians get 2 weeks to weigh in on new limits

Hurrying to meet a looming court deadline, the federal government has given Canadians two weeks to weigh in on how far to extend access to medical aid in dying.

Online consultations, which begin today, take on potentially contentious questions such as whether to change the standard 10 day "reflection period" patients are supposed to wait, whether to make psychiatric evaluations mandatory for all patients and whether the doctor or nurse practitioner should be obligated to consult the patient's family or loved ones.

Along with the online questionnaire, federal cabinet ministers will be holding in-person discussions with experts across the country. Justice Minister David Lametti is kicking off the process with a meeting in Halifax Monday afternoon.

"Medical assistance in dying is a profoundly complex and personal issue for many Canadians," Lametti said in a statement. "The consultations we are launching today will allow us to hear directly from Canadians and guide the path forward."

The government has limited time to tackle the complex questions around expanding the right to die, with less than two months to go before a deadline set by a Quebec Superior Court judge.

Quebec court ruling

In September, Justice Christine Baudouin ruled that the federal government's medically assisted dying law was too restrictive. Under the 2016 legislation passed by the Liberals, for a person to be eligible for a medically assisted death, the patient's death must be "reasonably foreseeable."

Baudouin ruled that it was unconstitutional to limit access to medically assisted death to people who are nearing the end of their life.

The decision, which only applies to Quebec, came during the federal election campaign and gave the government six months to address the issue. If no new legislation is passed by March 11, the "reasonably foreseeable" provision in the law will be suspended in the province.

Even without the court ruling, the law was facing a review in the summer of 2020. The legislation itself requires that at least one parliamentary committee review medical aid in dying and the state of palliative care in Canada, beginning in the fifth year after the law came into force.

Lametti said the government is using the opportunity to update the legislation across the country.

"Our government has committed to updating Canada's legislation on medical assistance in dying in response to the Superior Court of Quebec's decision," Lametti said.

What is expanded access?

The consultations will also ask Canadians whether assisted death should be expanded to give people in specific situations access to a doctor or nurse practitioner's help to die:

• So-called "mature minors" — people under age 18 considered by doctors to be capable of directing their own care.
• Cases involving "advance requests" — where a patient stipulates they would like their life to end at a later time when they are no longer competent to give consent.
• And people who wish to end their lives solely because of mental illness.

During the fall election campaign, Justin Trudeau committed to changing the law.

"We recognize that we need to take more steps to move forward as a society. We recognized that court cases would come in, that people would be evolving as a society and that's what we've responded to," he told reporters in October.

Along with the justice minister, Health Minister Patti Hajdu and Minister of Disability Inclusion Carla Qualtrough will be part of the consultation process.