There are a few things. One is, keep in mind that I know of no other thing we do in medicine that requires a carve-out from the Criminal Code to avoid prosecution for homicide. What we're talking about is helping people die when they're not dying—that's the bottom line of what we're talking about.
In terms of the potentially required safeguards, to answer your question, when they're not in legislation, the consequences are, let's put it this way, that there's a lot of leeway given to assessors. This is not just coming from me; this is coming from people working in the field. Dr. Li, who was the lead for the CAMAP guidelines, has specifically said that the current law permits too much latitude based on practitioners' personal values. Currently, it is a legal fiction that determinations of the eligibility of MAID are based on objective clinical judgment. In fact, I regularly witness practitioners' values influencing the interpretation of the current MAID eligibility criteria and safeguards.
If you recall when Dr. Gupta testified here—I found this quite remarkable—she seemed to use as a measure of things going all right, and thus that we shouldn't worry, the fact that no assessor has been prosecuted. That's not the sort of threshold I go by. If people aren't aware of this, CAMAP guidelines—this is not in the mental illness piece, but in a prior thing from 2022, which they called “The Interpretation and Role of 'Reasonably Foreseeable'”—quite literally go through a process of providing guidance for assessors to convert track two MAID requests to track one and for proceeding with track-two MAID, thereby bypassing all track-two safeguards, including the 90-day period, even if assessors don't agree the patient should be on track one.