In February, 2015, the Supreme Court gave Parliament some important homework: Draft right-to-die legislation that respects the Constitution and the social mores of 21st-century Canada.
Fifteen months and two governments later, the much-avoided and then cobbled-together-at-the-last-minute assignment has been handed in.
The best that can be said about Bill C-14 (medical assistance in dying) is that it deserves to be graded "incomplete" in fat red marker.
The proposed law features the key tenets of the landmark ruling in the case of Lee Carter and Gloria Taylor, namely that "persons who have a grievous and irremediable medical condition that causes enduring and intolerable suffering" have a legal right to medically assisted death, and that safeguards are required to protect vulnerable persons.
But beyond what we knew 15 months ago to be the essential elements, the proposed law is a muddle that shows a shocking disregard for the court ruling and utter contempt for thoughtful advice from an all-party parliamentary committee.
That group of MPs said that a patient's condition need not be terminal. It also – like a provincial panel before it – tackled the three most contentious issues head-on, recommending that: Psychiatric patients should not be denied assisted death, but they must be deemed competent; patients with dementia can provide prior consent to assisted death, but can only do so after diagnosis and while still deemed competent; and teens and children should be able to request assisted death, but the definition of the term "mature minor" must be clarified.
In its wishy-washy bill, the government largely failed to address these issues, saying a person must be competent and over 18 to request assisted death, and promising more study. That guarantees the law will be tied up in legal challenges for years to come.
If there's one thing that we've learned from the seemingly endless right-to-die debate, it's that the courts are not the place where deeply personal medical choices such as hastened death should be arbitrated.
Rather, these decisions should be made solemnly between a patient and a health-care provider and, for the most part, legislators should get the hell out of the way.
The single worst (not to mention puzzling) thing about the proposed law is the requirement that, for a person to be granted a medically assisted death, their demise must be "reasonably foreseeable."
What exactly does that mean? It seems to suggest that a person must be in the terminal stages of illness, something the Supreme Court explicitly said was not necessary.
The reason most right-to-die laws around the world do not have a "terminal condition" requirement is because it leads to perverse situations such as that of a Sherbrooke, Que., man who nearly starved himself to death recently to ensure he would be eligible for assisted death.
To make matters worse, the federal law calls for a 15-day cooling-off period between a formal request (which already requires two doctors or nurse-practitioners to sign off independently) and a lethal injection.
If the death is imminent and a person is already suffering intolerably, how can a cruel additional two-week wait be justified?
In fairness, there are some good elements to the proposed law. It opens the door to self-administration of life-ending medications, so that assisted death must not necessarily be performed in hospital. It also extends legal protection beyond physicians to nurse-practitioners and pharmacists. And Ottawa restated its commitment to bolstering palliative care.
The law also calls for stiff penalties – up to five years in prison – for not respecting the wishes of patients, a clause designed to protect vulnerable people from coercion.
Finally, the federal government recognizes the need to work with the provinces to ensure that the law is enacted in a similar manner in all provinces and territories to avoid things like "death tourism" between jurisdictions. (Let's not forget the provinces still have tough decisions to make, such as whether religious institutions can opt out and whether physicians have a duty to refer patients.)
In the preamble to the proposed legislation, it is stated that the approach "strikes the most appropriate balance between the autonomy of persons who seek medical assistance in dying, on one hand, and the interests of vulnerable persons in need of protection and those of society, on the other."
That is not at all true.
The draft law is not respectful of the wishes of the majority of Canadians, nor is it patient-friendly; it's patronizing and risk-averse. In trying to offend no one, the Liberal government has failed everyone.
What we have here is not a right to die, but a guarantee that too many Canadians will continue to suffer unnecessarily at the end of their lives.
André Picard