Thank you, Madam Chair.
Thank you for the invitation to appear before this committee to discuss Bill C-7, An Act to amend the Criminal Code (medical assistance in dying).
I want to acknowledge my colleagues Ms. Hajdu and Ms. Qualtrough.
I want to specify that François Daigle, associate deputy minister, is here with me and is ready to assist me as needed.
Good morning, colleagues.
Bill C-7 proposes an important change to our medical assistance in dying, or MAID, regime. It would repeal the eligibility criterion requiring that natural death be reasonably foreseeable, and this is in direct response to the decision in the Truchon case. This legislation will prioritize the individual autonomy of Canadians who are suffering to choose a peaceful death if they determine that their situation is no longer tolerable to them, regardless of their proximity to death.
Other aspects of Bill C-7 are associated with this important change.
First, Bill C-7 proposes to exclude persons whose sole medical condition is a mental illness, who would otherwise become eligible through the removal of foreseeable death as a condition for eligibility.
Experts disagree on whether medical assistance in dying can ever be safely made available in such cases. While those with mental illness can suffer unbearably, unpredictable illness trajectories mean there is always the possibility of improvement and recovery, and it can be especially difficult to tell whether a desire to die is a symptom of the illness, or a rational response to it.
The exclusion gives Parliament more time to reflect on this complex question, which is fraught with serious risks, to determine whether it is possible to craft a safe MAID regime for this category of persons. I fully expect this issue will be examined in the course of the parliamentary review of the MAID legislation.
Second, the bill proposes to tailor procedural safeguards to the risks associated with assistance in dying for persons who are not nearing death. Ending the life of a person whose suffering is based in the lived experience of their medical condition is different than alleviating the suffering associated with the dying process that is already under way. Bill C-7, therefore, proposes different safeguards based on whether natural death is reasonably foreseeable.
Reasonable foreseeability of natural death refers to a temporal but flexible connection to death. It does not require imminent death or a specific prognosis, but a practitioner must be able to anticipate the person's death, based on their individual medical circumstances, in the near term.
Safeguards for those whose deaths are not reasonably foreseeable are built around the existing safeguards with some important enhancement that seek to ensure that adequate time, expertise and exploration of alternatives are devoted to assessing MAID requests from this group.
The existing set of safeguards for those whose death is reasonably foreseeable would be maintained, with two modifications that my colleague will discuss, as they are tailored to this context.
We believe these changes to the safeguards strike the right balance between individual liberty and public safety, for both groups of eligible persons.
Bill C-7 also proposes to allow for the waiver of final consent in specific circumstances, so that people whose death is foreseeable don't choose to die earlier than they want, or refuse pain medication, because they fear not being able to consent on the day of the procedure. This targeted and prudent change would address unfairness in these situations.
I will turn it over, Madam Chair, to my colleagues for their remarks.
Thank you.