Evidence of meeting #6 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 nurses.
A video is available from Parliament.
President, Canadian Psychiatric Association
Again, not necessarily. The issue of capacity is specific to each question.
Senator, Quebec (Kennebec), Lib.
In that very specific context of the person deciding they want to be assisted by a physician in order to die, you would prevent that person from exercising that decision.
President, Canadian Psychiatric Association
There's a difference between imposing a treatment and saying that a person lacks capacity to get a treatment.
Senator, Quebec (Kennebec), Lib.
But in that context, you would prevent that person. In his or her opinion, the suffering is intolerable for that person in that specific condition, in relation to what that person feels himself or herself, so in fact you would substitute your capacity or your decision for the decision of the person.
President, Canadian Psychiatric Association
At that point in time, if the person lacked capacity, that is true. If the person were deemed to lack capacity, that is true.
There is a model called the recovery model. In that model, patients want to be able to make their own decisions, even if they're mistakes. The idea is that they want to learn from their mistakes. In the case of this particular decision, you can't learn from it if it's a mistake.
Senator, Quebec (Kennebec), Lib.
Yes, but which distinction do you make between a person who is in a mental condition and another person who suddenly discovers that he or she is suffering from, for instance, terminal cancer and has two or three months to live, and that person's mental capacity totally changes? Of course we cannot prevent, or we don't know, as you said yourself, how a person will react to his prospective death in front of him.
President, Canadian Psychiatric Association
Those decisions we are already making. We already make those kinds of capacity decisions.
Senator, Quebec (Kennebec), Lib.
In that case, you will not intervene to prevent that person from making that decision, because that person doesn't suffer from a permanent mental illness condition. Even though you say it doesn't happen to be remediable, in the context of somebody who is in the course of being terminally ill, that person's mental capacities totally change as much as the person who suffers from a mental condition.
President, Canadian Psychiatric Association
You can have two people with the exact same symptomatology and experience, and one may have capacity to make a decision and the other one might not. This is why I'm saying it comes back to the principles of capacity assessment.
Liberal
The Joint Chair (Mr. Robert Oliphant) Liberal Rob Oliphant
Thank you, Doctor Gaind, and thank you, Senator.
That is the end of our time for witness help this evening. We've had such a very good time that I'm going to suggest we come back tomorrow.
Liberal
The Joint Chair (Mr. Robert Oliphant) Liberal Rob Oliphant
Just as a reminder, we'll be meeting in this room. We'll have a three-hour meeting. From 5:30 until 7:30 we'll have a series of witnesses: the Hon. Steven Fletcher, the Council of Canadians with Disabilities, the disability advisory council from Dying With Dignity, and three individuals—Jocelyn Downie, David Baker, and Trudo Lemmens.
That will be our agenda. Then we'll be in camera reviewing our progress and the witness list for the following week, as much as we have available.
I want to thank the witnesses. We do know that it's part of your job, but we also know that we are greatly enriched by your taking the time to be with us. Your associations are well served by your presentations tonight. Thank you very much for being with us.
The meeting is adjourned.