Evidence of meeting #11 for Justice and Human Rights in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was patients.
A video is available from Parliament.
10:35 a.m.
Liberal
Ahmed Hussen Liberal York South—Weston, ON
The next question is for Dr. Mitchell.
Bill C-14 requires a 15-day waiting period between the time the request is made for medical assistance in dying and the request is signed, and the day on which medical assistance in dying is provided. The bill also allows for medical personnel to use their discretion where a loss of capacity to provide informed consent is imminent.
In your opinion, is it generally possible to assess whether the loss of capacity is imminent?
10:40 a.m.
Paediatrician and Professor, University of Calgary Cumming School of Medicine, As an Individual
I would suggest that it's a bit like the imminence of death. It can be very difficult to assess the imminence of loss of capacity. It can be quite immediate in end-of-life situations.
10:40 a.m.
Liberal
Ahmed Hussen Liberal York South—Weston, ON
In your opinion, would the ability to use the discretion by the medical practitioner with respect to the waiting period apply to individuals with dementia, or only to those who are more likely to become unconscious?
10:40 a.m.
Paediatrician and Professor, University of Calgary Cumming School of Medicine, As an Individual
If I could ask the honourable member for clarity, in terms of the dementia, do you mean those with established dementia—
10:40 a.m.
Paediatrician and Professor, University of Calgary Cumming School of Medicine, As an Individual
—and they have something in an advance directive? Because I understand that the proposed act does not deal with.... Or, are you suggesting it's those who develop dementia in the 15-day period?
10:40 a.m.
Liberal
Ahmed Hussen Liberal York South—Weston, ON
No, those who already have dementia, versus those who are more likely to become unconscious in that 15-day period.
10:40 a.m.
Paediatrician and Professor, University of Calgary Cumming School of Medicine, As an Individual
As I understand it, those who already have dementia would not meet the Carter decision.
10:40 a.m.
An hon. member
[Inaudible--Editor]
10:40 a.m.
Liberal
The Chair Liberal Anthony Housefather
I just don't want to continue on the line of questioning. You're correct they would not be....
Go ahead, you have another minute and a half.
10:40 a.m.
Liberal
Ahmed Hussen Liberal York South—Weston, ON
My last question is for Mr. Stern.
In your opinion, does Bill C-14 respect the conscience rights of health care practitioners who do not want to participate in medical assistance in dying?
10:40 a.m.
Executive Director and Chief Executive Officer, Canadian Medical Protective Association
I think it does so, but perhaps not as strongly as we would like.
I made suggestions about adding some wording in the preamble. As I understand it—again, I'm not a lawyer, I'm a physician—adding it in the preamble sets the context and the tone of the law. We feel that by adding those words in the preamble, it will help to strengthen that protection.
10:40 a.m.
Liberal
10:40 a.m.
Chair, Working Group on Hastened Death, Canadian Society of Palliative Care Physicians
I think sometimes when we're talking about conscience protection, we tend to focus on whether people want to be involved in the act of hastening death itself. There's a very important concern about conscience for making an effective referral that isn't alluded to. I understand that the Canadian Medical Association will speak to you on this matter. Again, the solution is to have an effective coordinating system that will take care of that.
I think that is going to be a significant issue, to force physicians to make a referral that they feel complicit in the act. I'm not sure that needs to be put into the Criminal Code. I think in terms of implementation, to have a separate coordinating system will absolutely ensure access to patients and will give the conscience protection that physicians need and deserve.
10:40 a.m.
Executive Director and Chief Executive Officer, Canadian Medical Protective Association
Could I make a a small, supplementary comment on that?
10:40 a.m.
Executive Director and Chief Executive Officer, Canadian Medical Protective Association
In our submission to the joint parliamentary committee, we recommended that the wording and the way it was drafted in Quebec, I think, would be a very useful addendum for this parliamentary committee. That would ease the concerns of those people whom my colleague is concerned about, those who have even a difficulty referring. The legislation in Quebec is very thoughtful on this matter.
10:40 a.m.
Liberal
The Chair Liberal Anthony Housefather
We're going to do our lightning round right now. I have one very quick question for the panel that I'd like each of you to answer.
I understand there are some people—Mr. Rankin suggested this—who believe that the concept of reasonably foreseeable death should simply be dropped, but presuming that it is there.... You've asked for clarity. I think you've asked for clarity, Dr. Branigan. I'm interested to see, if we use the concept that they use in Oregon or in the United States, where we say that death is medically likely to occur within six months or a year, or whatever time frame we say, would you prefer that to the concept that is in the bill right now?
Dr. Stern.
10:40 a.m.
Executive Director and Chief Executive Officer, Canadian Medical Protective Association
Yes.
May 3rd, 2016 / 10:40 a.m.
Chair, Working Group on Hastened Death, Canadian Society of Palliative Care Physicians
Yes, and it would be evaluated in five years.
10:45 a.m.
Assistant Professor, University of Calgary Cumming School of Medicine, As an Individual
Yes, provided that those are the only two choices.
10:45 a.m.
Liberal
The Chair Liberal Anthony Housefather
Yes. Well, those are the choices I'm giving you. It doesn't mean that's a choice everyone else will give you, but those are the choices I'm currently asking about.
10:45 a.m.
A voice
Yes.