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Euthanasia debate continues

Legislation that could open the door to physician assisted suicide has hit the floor in the House of Commons.
Wheel file photo

Legislation that could open the door to physician assisted suicide has hit the floor in the House of Commons.

Foothills MP John Barlow said the proposed Bill C-14 addresses several of the concerns constituents have made about the process to amend the Criminal Code to reflect the Supreme Court of Canada’s decision to permit doctor-assisted suicide.

The Bill received first reading in Ottawa on April 14. The Liberal government introduced the legislation to the House of Commons after a special committee formed in the fall released a list of 14 recommendations on the issue earlier this spring.

The legislation does not include several of the report’s recommendations, including allowing mature minors or mentally ill to seek physician assisted death.

Foothills MP John Barlow said he is relatively pleased with the results, which addressed the primary concerns raised with Foothills constituents at public meetings held at the beginning of the month. Barlow said he did not agree with including mature minors or the mentally ill in the legislation, or allowing for advanced directives, which would permit an individual to request euthanasia potentially years in advance of their natural death or progression of a disease.

All three points were not included in the draft legislation. It’s a positive step, said Barlow.

“I wanted to make sure the legislation had the strongest protection for the most vulnerable people,” said Barlow. “It had to make sure these were mentally competent adults making decisions.”

There is still some concern regarding the obligation of physicians or practitioners with questions of conscience to refer their patients to other doctors willing to provide physician-assisted death.

There have been some more stringent rules established with regards to doctor consent, he said.

“Consent now has to come from two practitioners, which now includes nurse practitioners,” said Barlow. “The obligation to refer someone has not been removed from the legislature, but it’s being downloaded to the Provinces to handle.”

Dr. James Silvius, who practices in Calgary and has been heading Alberta Health Services (AHS) work on the issue, said Alberta Health has a good mechanism in place that should be able to handle these requests.

“It will come under the purview of Alberta Health,” said Silvius. “But I would hope they will use the mechanism we have in place rather than rebuild a system.”

The system would allow people seeking physician consent for doctor-assisted death access to practitioners willing to offer the service, he said.

Currently, Alberta Health is reviewing the draft bill and will act according to the criminal code change and in response to the surveys and public feedback received in past months.

“For us, nothing changes in our action plan right now with the federal bill, except that we won’t be proceeding with those aspects that have now been removed,” said Silvius.

The Province had already indicated it would not support allowing mature minors or the mentally ill to request euthanasia, he said.

Criteria for eligibility was also amended in the bill, which relieved some concern with determining how to define eligible cases as they arose.

Bill C-14 states a person must be in a grievous and irremediable medical condition, which is defined as a serious and incurable disease causing intolerable physical and psychological suffering, and that their natural death is reasonably foreseeable.

“To be quite honest, that’s the part we’ve struggled over,” said Silvius. “How do we deal with people in these situations, for example someone with chronic pain syndrome whose condition is not able to be managed could definitely have psychological issues, but it’s not likely their death is foreseeable.”

He said having more straightforward and strict criteria for eligibility protects physicians from being accused of discriminating against certain people.

“In this regard, the federal government has made our job a little easier,” said Silvius.

Despite clarifying eligibility requirements, there is still a lot of uncertainty surrounding doctor-assisted death legislature, and AHS is ensuring it is prepared to handle any further changes that may come down the road, said Silvius.

Silvius said it is too early to know whether the bill will pass in its current form or if there will be further amendments.

“We’re not really standing down because there’s still a lot that needs to go into this an a lot that can come out of it,” said Silvius.

Debate continued on the legislation April 22 as Bill C-14 returned to committee.

Barlow said he is not convinced the timeline is reasonable, and it will be difficult to have it done by the Supreme Court’s deadline of June 6.

He said the government would be wise to arrange for an extension to ensure enough conversation on the topic prior to making final decisions.

“We need a good, robust discussion at the committee level but also with our residents,” said Barlow. “Now that we see what’s been included, we should be able to go back to our constituencies and provide them with this insight, and have more conversation with them.

“It’s a big topic, it’s a serious topic. This isn’t something we want to be rushing to get done.”

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