Evidence of meeting #11 for Physician-Assisted Dying in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was illness.
A video is available from Parliament.
7:15 p.m.
Associate Professor of Law and Associate Dean Academic, University of Manitoba, Canadian Paediatric Society
It's a simple answer. Carter doesn't limit to terminal illness, to a terminal phase of a terminal illness. So those are cases, with respect to withdrawal of nutrition and hydration, in a child who is terminally ill. It's simple. Carter is not just about terminal illness.
7:15 p.m.
Senator, Nova Scotia, Lib.
So is that the basis for your distinction, on whether or not the illness is terminal?
7:15 p.m.
Associate Professor of Law and Associate Dean Academic, University of Manitoba, Canadian Paediatric Society
One.
7:15 p.m.
Associate Professor of Law and Associate Dean Academic, University of Manitoba, Canadian Paediatric Society
Well, with respect to what you're specifically....
7:15 p.m.
Chair, Bioethics Committee, Canadian Paediatric Society
I think that would be an hour-long lecture unto itself. The difference between euthanasia and assisted dying is completely different from withdrawing treatments, medically provided treatments, that can confer no benefit to a child.
All I can say is that ethically and legally, that's very clear. I just don't think we have time to get into the particulars, but I feel very well versed in both of those, if we need to have further communication.
7:15 p.m.
Liberal
Julie Dabrusin Liberal Toronto—Danforth, ON
Imam Hashmi, I thank you for outlining for us what you would see as a process under Carter. One issue that we've seen come up is the issue of effective referrals. If you saw a doctor who might conscientiously object because of faith issues, or any others, we had a suggestion from the BC Civil Liberties Association that one option would be for the doctor to not refer to someone else but to report to someone within the hospital setting, “I have objected to a treatment”. That's all they do, and then someone steps in.
Does that seem like a system that would be agreeable to you?
7:20 p.m.
Spokesperson, Canadian Council of Imams
I think so. We have to respect the rights of the doctors or the health care providers with regard to their beliefs and their conscience, but at the same time we have to respect the Carter decision as well and the individual rights of the patients.
In that case, yes, if a physician went to their supervisor or whomever within the organization and told them, “This is the request that has come to me, now you take care of it”, I think that should be fine.
With regard to the proposed end-of-life team that you're talking about, if a request was made, then this team could go and present options. I think for many doctors, at least from the Muslim faith, it perhaps would not present a problem, because they're talking about the options available and they're not talking about just one option, which is physician-assisted death.
I don't really foresee any issues with regard to that.
7:20 p.m.
Liberal
Julie Dabrusin Liberal Toronto—Danforth, ON
Thank you.
My other questions were in fact for the person who has now been cut off.
7:20 p.m.
The Joint Chair Hon. Kelvin Kenneth Ogilvie
For the benefit of everyone here, it was at the other end that the conference ended.
7:20 p.m.
The Joint Chair Hon. Kelvin Kenneth Ogilvie
We're trying to make a connection, but there is no return on the contact.
February 3rd, 2016 / 7:20 p.m.
Liberal
The Joint Chair (Mr. Robert Oliphant (Don Valley West, Lib.)) Liberal Rob Oliphant
You could ask the question and get it on the record. Then we could get a written response from them.
Exactly.
7:20 p.m.
Liberal
Julie Dabrusin Liberal Toronto—Danforth, ON
I appreciate that. Thank you.
My question, then, is for Dr. Rajji.
In describing the scenarios and the assessment of whether an illness is irremediable, I'm not sure it's been taken into account that Carter does not require a patient to accept treatment. I would like to have his assessment on the eligibility question for mental health issues, somebody who has purely a mental health issue or an overlying mental health issue with a terminal illness, in the scenario where a patient under Carter does have the right to say that they do not want to pursue any further treatment for their mental health issue.
7:20 p.m.
The Joint Chair Hon. Kelvin Kenneth Ogilvie
The clerks will be in touch. We'll see if we can get an answer for you on that.
Thank you very much.
The co-chair has been granted the next Liberal turn in the cycle. I will turn the questions over to him.
7:20 p.m.
Liberal
The Joint Chair (Mr. Robert Oliphant) Liberal Rob Oliphant
I would like to ask CAMH officials, Dr. Rajji in particular, a few questions as well.
How do they engage patients in the working group they have established on physician-assisted dying? How many patients are on their committee? What has the patient response been to the questions raised?
I would similarly ask the Canadian Paediatric Society how you involve and engage children in the discussion of their health issues. You have referred to something called ethics data. Having studied ethics post-secondary in a number of courses, I have no idea what ethics data is. Perhaps you could explain ethics data, not ethical data, or ethic data—I wasn't sure what you said—and what that actually means. I even googled it and couldn't find an answer.
As well, in terms of how you engage children, Manitoba has a very robust plan for the way they engage children in some health research. I'm wondering how you have done it to get specifically the position you've presented tonight.
7:20 p.m.
Chair, Bioethics Committee, Canadian Paediatric Society
I'll start. I don't think it was my piece of the submission, and we didn't mean to be misleading or confusing in any way. Suffice to say that the Canadian Paediatric Society has not had any discussion about this as a group yet in that the provincial and territorial findings were only released at the end of November.
In terms of how we include children and families in decision-making, many hospitals have—
7:20 p.m.
Liberal
The Joint Chair (Mr. Robert Oliphant) Liberal Rob Oliphant
It was specifically referring to children who have rights, specifically children, not families. It was children.
7:20 p.m.
Chair, Bioethics Committee, Canadian Paediatric Society
Okay, I'll give you the example of chemotherapy. Explaining the chemotherapy, what's entailed, what will be happening to the child, is proportional to how much the child wants to hear, how much the child wants to give over to the parents—
7:20 p.m.
Liberal
The Joint Chair (Mr. Robert Oliphant) Liberal Rob Oliphant
I'm sorry, I wasn't clear. You've presented a position tonight and I'm wondering how you've involved children in developing your policy position, which both of you have articulated. I understand children's involvement in their care decisions, but in your policy decision.... You've spent quite a bit of time articulating a policy decision tonight. Maybe they are personal opinions. I thought they were actually from your organization, so I might be confused. Are they personal or are they organizational?
7:25 p.m.
Chair, Bioethics Committee, Canadian Paediatric Society
They're organizational in that we had six days to pull this together. It has been to the executive of the CPS. We decided to stick to the overarching themes that we wanted to get across, about which we thought there would be consensus, and what we want to be clear about is there has been absolutely no discussion with health care professionals, children, families across the country about this issue, and for that reason we think it would be absolutely premature to include it as it's not prescribed by Carter that we do so.