Medical Assistance in Dying

In December 2016, the CCA was asked by Minister of Health Jane Philpott and Minister of Justice and Attorney General of Canada Jody Wilson-Raybould to undertake independent reviews related to medical assistance in dying. Specifically, the CCA is tasked with examining three particularly complex types of requests for medical assistance in dying that were identified for further review and study in the legislation passed by Parliament in 2016. These cases are: requests by mature minors, advance requests, and requests where mental illness is the sole underlying medical condition. 

Progress Report

The Expert Panel on Medical Assistance in Dying held its first panel meeting from May 1 to 3, 2017. Five additional in-person meetings will be scheduled in 2017 and 2018. As part of the review process, the Expert Panel will review the available evidence on the three topics and seek input on evidence from organizations, health care providers, regulatory experts, stakeholders, and other groups. It is expected that three separate reports will be finalized and released publicly in late 2018.

May 10, 2017: Statement regarding the Expert Panel on Medical Assistance in Dying

The Questions

Main Question:

  • What is the available evidence on, and how does it inform our understanding of, medical assistance in dying (MAID) in the case of mature minors, advance requests, and where mental illness is the sole underlying medical condition, given the clinical, legal, cultural, ethical, and historical context in Canada?

General Subquestions:

  • What are the potential implications for individuals and other affected persons, including their families, care providers, and health professionals, related to MAID for the three topic areas?
  • What are the potential impacts on society of permitting or prohibiting requests for MAID for the three topic areas? 1
  • What are the potential risks and safeguards that might be considered related to MAID for the three topic areas?
  • What are the relevant gaps in domestic and international knowledge and research related to MAID for the three topic areas?

1 For example, suicide prevention strategies and medical response; availability and efficacy of palliative care, dementia-related, and mental health services and supports; risks to vulnerable populations; discrimination and stigma related to chronological age, dementia and related illnesses, and mental illness; risks of inducements.

Topic Area Questions:

     Requests for MAID by Mature Minors

  • What is the impact of chronological age on the legal capacity to request and consent to MAID?
  • What are the unique considerations related to mature minors requesting MAID (e.g., mature minors vs. adults and MAID vs. other healthcare decisions)?

     Advance Requests for MAID

  • How is an advance request for MAID similar to or different from advance directives for health care under existing provincial/territorial regimes?
  • What are the unique considerations to be taken into account depending on when an advance request is made?2

2 That is: 1) before diagnosis; 2) after diagnosis but before onset of suffering; 3) after all of the eligibility criteria and procedural safeguards have been met, except for the 10 day waiting period and the reconfirmation immediately prior to provision of MAID. 

     Requests for MAID Where Mental Illness is the Sole Underlying Medical Condition3

  • What is the impact of mental illness in its different forms on an individual’s legal capacity to request and consent to MAID?
  • What are the unique considerations related to individuals living with mental illness (including mature minors) requesting MAID where the mental illness is the sole underlying medical condition?4

3 For certainty, the study is concerned with requests where mental illness is the sole underlying medical condition does not include circumstances where a person with a mental illness is eligible under the existing law.

4 Both in communities or institutions

Expert Panel

The Expert Panel on Medical Assistance in Dying is comprised of 43 individuals who have expertise, knowledge, and leadership experience in many disciplines including law, medicine, ethics, social sciences, and health sciences, among others. The Expert Panel is chaired by the Honourable Marie Deschamps, C.C., Ad. E., Former Justice of the Supreme Court of Canada and Adjunct Professor, McGill University and Université de Sherbrooke. 

In order to effectively address the three types of requests for medical assistance in dying, the Expert Panel has been divided into three working groups, each with a Chair.

For a complete list of panel members visit the Expert Panel page (full biographies to come).

For questions about these reviews:

reviews@scienceadvice.ca

All media requests may be directed to:

Samantha Rae Ayoub, Communications and Publishing Director at 613-567-5000 ext. 256 or
samantha.rae@scienceadvice.ca

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