First, CCD is requesting that a vulnerability assessment be mandated in order to ensure that a person requesting physician-assisted dying meets the criteria of that request. In Carter, the court acknowledged that any set of safeguards must recognize the complex and sometimes subtle and subconscious factors related to a request for physician-assisted dying. This confirms, for us, the requirement for a vulnerability, informed consent, and capacity assessment process. Not being vulnerable to inducement is a criterion.
With respect to informed consent, it demands that individuals requesting physician-assisted dying must have information regarding the supports in the community that deal with issues related to poverty, isolation, discrimination, and devaluation. Our question is whether or not a family physician can provide all of this information. It may require someone more qualified to inform the individual of these supports. For CCD, providing such information is highly relevant in determining whether a person may be vulnerable to inducement.
As stated before, it is our understanding that Dying With Dignity has indicated that they agree with CCD that persons newly diagnosed with a disability are vulnerable, and should not be permitted to have assisted dying performed. It is also our understanding, and important to note, that two national polls, one from the Canadian Association of Retired Persons, just recently put out, and the other from the external panel, when they dealt with the issue of physician-assisted dying, indicated that a majority of Canadians do not support physician-assisted dying without a prior review. With respect to people with mental health issues, very few Canadians believe physician-assisted death is a solution.
Secondly, we recommend a prior review board process. The paperwork that is necessary—for example, the vulnerability assessment, capacity and competency, along with the assessments of two physicians—would be submitted with the application by a patient requesting physician-assisted dying to a review board. A review board or a review panel, not a physician, would make the ultimate determination on whether a request for physician-assisted dying will be given.
We submit that the review panel should be chaired by a federally appointed judge to ensure consistency in reasons for judgments and facilitate Canada-wide standards. This is important. This is a Canada-wide standard. It should not be left up to individual doctors, nor individual provinces, to determine what the criteria are that have been articulated by the Supreme Court of Canada.