Medical Assistance in Dying committee  I've heard several times today and from various different witnesses the idea that there really is nothing we can do for existential distress, that there is no effective treatment and that there's no effective approach. I have to say, I've been working in palliative care for the l

Medical Assistance in Dying committee  —and none beyond that in Manitoba, so we're woefully lacking.

Medical Assistance in Dying committee  Yes, absolutely. Again, congratulations on the framework. As Dr. Buchman was saying, the fact is that we don't have the services available for patients and their families. I don't think we can take any comfort in the fact that 15% to 30% of people have access to these resources.

Medical Assistance in Dying committee  Thank you, honourable Chairs. By way of background, I am a distinguished professor of psychiatry at the University of Manitoba and former chair of the External Panel on Options for a Legislative Response for Carter v. Canada. I'm also a long-time researcher and clinician, who h

Justice committee  First of all, are we committed to moving forward in a way that is transparent? Are we moving forward in a way that also acknowledges that many of the things that drive a wish to die extend beyond the purview of medicine? To ask doctors to be making evaluations on things that ha

Justice committee  That's an interesting question. There's been a great deal of debate on what it means. It's a difficult term. I think it means that somebody is on the course towards death. There has been a variety of terms used, whether “terminal” or “less than six months” or “reasonably forese

Justice committee  Sure. How is judicial oversight working now in terms of the constitutional exemption? Are there inordinate delays? My sense is that this doesn't appear to be the case. I think it's worth reviewing that data and looking at it. Certainly it is not meant to cause inordinate delay

Justice committee  I think you'll have to speak to the lawyers, who have more expertise than I have in those matters. I'm just the lowly physician on the panel. On the other hand, the Government of Canada is initiating a policy that will allow for medically hastened death. If that is the case, the

Justice committee  I was going to ask whether I could respond to that as a follow-up.

Justice committee  As Ms. Gibson said, it's true that in clinical practice one could call on any one of a number of disciplines. I think the reason for talking about palliative care consultation per se is that palliative care more than any other discipline in medicine is implicitly multidisciplinar

Justice committee  Right now the way the bill is worded, it talks about availability for those whose deaths are “reasonably foreseeable”. It's for that reason that it seems to me there is and ought to be a place for palliative care consultation. It's only reasonable that if somebody is going to giv

Justice committee  I think so. Again, two physicians are involved in making those evaluations, and certainly physicians are involved in determining things around competence, but if there is an underlying psychiatric issue that is felt to be clouding the way that person is presenting, and making it

Justice committee  I think we have to go beyond the issue of whether they have the capacity to consent. When our panel was doing our various consultations around the world, I remember when we were in the Benelux countries we met with physicians, some of whom were engaged in this practice. Those who

Justice committee  Thank you.

Justice committee  Honourable members of Parliament, my name is Harvey Max Chochinov. I hold the academic rank of distinguished professor of psychiatry at the University of Manitoba. I direct the Manitoba Palliative Care Research Unit, and I hold the only Canada research chair in palliative care. I