Okay.
Your question touches on various aspects. I will try to answer it as best I can.
First of all, the panel's position is that the term “irremediable” is not a clinical term. It is a term found in the Criminal Code that is based on three sub-criteria: the incurability of the condition, advanced and irreversible decline in capability, and suffering. All of these terms have a clinical meaning. So we can try to understand these terms and define them in a way that is meaningful to clinicians and that is consistent with what we do in our practice and the treatments patients receive.
I think a large part of the debate between those who say that an illness cannot be deemed irremediable and those who say it can is the result of the fact that they use different definitions. That is why, in the report, the panel tried to offer a definition of an “incurable illness” for mental disorders that would be meaningful in a clinical context.
Of course, we know there are illnesses that we will never be able to cure. We are 100% sure of that. Yet there are many other illnesses that we know less about, especially as regards their long-term evolution. In such cases, what is the degree of certainty required? The devil is in the details. On the whole, that is our view. If we think about what an incurable condition is and draw a parallel with other chronic illnesses, we can say that the threshold is met once all the conventional treatments have been exhausted. This relates to your comment about the decision in Carter.
As Dr. Maher said earlier, we will certainly not force people who are fully competent to do things that are unacceptable to them. Equally, if I note that someone has an incurable illness, how do I proceed if the patient has not tried any treatments? How many treatments do we have to try? It depends on what the clinician and the patient have negotiated.