Medical Assistance in Dying committee  Yes, I think so. It's in the Criminal Code, and then it's in the model practice standard, which is being reproduced in the practice standards across the country, and then you have the curriculum. I would also add that the people who are going to be doing the first sets of MAID for mental disorders as a sole underlying condition are not going to be new MAID providers, but very experienced MAID providers.

Medical Assistance in Dying committee  I'll jump in first. No, it absolutely doesn't. The federal government has done more in respect of this aspect of MAID than it has for any other aspect of MAID in relation to the provincial/territorial jurisdiction. The curriculum or the medical education, the knowledge exchange workshops, the medical training and the model practice standard are all done at a provincial/territorial level.

Medical Assistance in Dying committee  I would echo all of that. We are going to have some requests, and we will have very few people who will be eligible. We will have sufficient clinicians who are able to provide it, either as assessors and providers or as playing the consultancy role. I also want to emphasize that if nobody is available...because this came up maybe two weeks ago.

Medical Assistance in Dying committee  Respecting charter rights is the highest obligation of members of the House and members of the Senate, so you should never pass legislation that you do not have confidence is consistent with the charter and consistent with the Constitution—the division of powers as well as the charter.

Medical Assistance in Dying committee  Absolutely. I think that if you look at the arguments, that's all that's left. There's no solid evidence and there are no valid arguments that justify a further delay. Therefore, the only explanation is political.

Medical Assistance in Dying committee  I'd actually answer with a structural point, which is that we have the Criminal Code and then we have the colleges of physicians and surgeons and the colleges of nurses. We have practice standards. You should not get into the weeds of the kinds of things like which specialist you need to see as your third person.

Medical Assistance in Dying committee  I think one of the things you could do is to ensure that the lack of supports and services is not driving requests for MAID—and it is not. We have good, solid evidence from the other permissive jurisdictions over the years, and we now have good data from Canada as well that it is not what's driving requests for MAID.

Medical Assistance in Dying committee  One thing clinicians will tell you is that the term “irremediable” is foreign to them. It's not even a clinical term. They recognize “incurable”. When you have certain kinds of conditions—not just mental disorders—the conventional understanding of “incurable”—there is no cure—is not available.

Medical Assistance in Dying committee  The key is to look back at Carter and recognize that the declaration was that if you create a barrier to access for people who have a grievous and irremediable medical condition causing enduring and intolerable suffering, that is unconstitutional. They did not say that mental disorders are not a part of grievous and irremediable medical conditions.

Medical Assistance in Dying committee  The expert committee review is embedded in the legislation.

Medical Assistance in Dying committee  I'm not sure whether it came from the Senate or whether it was in the original bill. It was certainly in Bill C-7.

Medical Assistance in Dying committee  No, I don't believe so. One thing we have to pay close attention to is the fact that “grievous and irremediable” is in the law—it's not a clinical term—and “serious and incurable illness, disease or disability” is in the law. It is, in fact, part of the definition of “irremediability”.

Medical Assistance in Dying committee  Good evening. Thank you for the invitation to speak with you. My name is Jocelyn Downie, and I'm a professor emeritus in the faculties of law and medicine at Dalhousie University. I've been honoured to be made a fellow of the Royal Society of Canada and the Canadian Academy of Health Sciences, and to be named to the Order of Canada for my work on this topic.

Justice committee  I think it doesn't serve the purposes of what Carter was attempting to do, which was to provide access for a certain group of people, because people are disagreeing all over the place. Physicians are disagreeing about what it means. What that tells you is that you are going to go to some physicians who will say, “Yes, you're two years away, and I'm going to read it expansively”, and somebody else is going to be fearful of being charged and read it narrowly, or they're going to be opposed to assisted death and so they will choose to read it very, very narrowly, and say, “maybe a week from death”.

Justice committee  I think this is one of the spots where the federal government deserves a lot of credit, because they recognize that this is one of those issues that is absolutely federal and provincial. How do we do this? They have taken it as an opportunity to exercise co-operative federalism.