Ladies and gentlemen, thank you for your invitation and for this opportunity to share with you our committee's thoughts on advance requests for medical assistance in dying.
In the name of a strong consensus in the country and in order to protect the autonomy and dignity of the person, I propose that the bill before you be amended immediately to give any person suffering from a major neurocognitive disorder such as Alzheimer's the right to MAID. The urgency of the matter is clear to me. In this regard, allow me to provide a brief reminder of the elements that led us here.
In 2015, the Carter decision set out the cardinal rule that, in exercising an individual's right to life, liberty and security of the person, every person must be free to make his or her own fundamental decisions without interference by the state.
Bill C-14 was passed in 2016. It provides for the formation of an expert panel to study three situations, including that of advance requests for MAID.
In 2018, this expert panel stated the following regarding advance requests:
Having some assurance that their request for MAID would be honoured could provide comfort and relieve anxiety and distress at end of life for those who make this choice.
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Allowing ARs for MAID might have an impact on the way society values people with capacity loss, increasing stigma and signalling that it is acceptable to consider a life with capacity loss as one not worth living.
In the face of the suffering and distress of all those who receive such a diagnosis, the question is no longer whether the compassion of Canadian society should grant us MAID. The time has come to define the parameters for the granting of this assistance and to put in place guidelines both to ensure the protection of potentially vulnerable people and to respect the clearly expressed will of the person affected.
So when a person receives such a diagnosis, which is likely to progress to severe dementia, they must be allowed to give an advance directive to request MAID when their situation has reached a serious and irreversible stage, provided that the person meets the following criteria: a) they are eligible for government health care; b) they are at least 18 years of age; c) they must be able to express their will freely, without external coercion or undue influence, and must not suffer from a mental condition that affects their judgment; d) a physician must certify that the person meets the above criteria when signing the advance directive.
To be valid, this directive must be renewed in writing after a six-month waiting period from the signature of the initial directive, ensuring that the four previous conditions are still met. This period is an important guideline, which provides a sufficient period of reflection for the person affected and ensures that the decision was not made impulsively or without sufficient reflection.
It goes without saying that this directive may be revoked at any time in writing, as long as the person is capable of doing so. The representative may ask the multidisciplinary team to begin the evaluation process as soon as it has reason to believe that the advanced stage of the disease is reached.
As an added precaution, the directive should be written in a prescribed form. I have appended to my presentation synopsis a template of this directive.
What you are being asked to do today is to provide a choice for anyone diagnosed with an Alzheimer's-type neurocognitive disorder. It isn't a matter of imposing a course of action, but rather of putting in place the necessary guidelines for exercising this choice.
Inspired by our values, this citizen is asking the government to come to their aid and provide them with the necessary care to relieve their suffering, preserve their dignity and respect their decision.
Thank you.