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Canada's Minister of Health Patty Hajdu takes part in a press conference at the National Press Theatre in Ottawa, Ontario, Canada February 24, 2020. Hajdu said there is a need for further debate on the application of assisted dying to people with illnesses such as Alzheimer’s.

BLAIR GABLE/Reuters

The federal government has tabled legislation to amend Canada’s assisted-dying law to remove the need for the patients’ death to be “reasonably foreseeable” and to allow advance waivers for patients who are nearing the end of their life.

Bill C-7, which was tabled on Monday, does not make sweeping changes to the legislation, such as offering assisted dying to those under the age of 18 or to patients suffering solely from a mental illness. The government said it will leave the debate over the application of assisted dying to those cases, as well as patients suffering from dementia, to a review by a parliamentary committee in June.

Health Minister Patty Hajdu said there is a need for further debate on the application of assisted dying to people with illnesses such as Alzheimer’s.

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“What practitioners have said is that this deserves very careful consideration in terms of advanced request when a person anticipates what they might feel like with the condition versus what they may actually feel like,” she said.

The Quebec Superior Court forced the government to amend the federal law last September by striking down a portion that limited access to terminally ill patients whose natural deaths were deemed to be “reasonably foreseeable.” Quebec Superior Court Justice Christine Baudouin said the law was unconstitutional under the Charter of Rights and Freedoms because it forced two patients to keep living in great pain.

Ottawa has until March 11 to amend the law, but has sought a four-month extension to comply with the ruling. Justice Minister David Lametti said he is confident the proposed amendments will ensure its constitutionality.

“I think we do, moving forward, have a piece of legislation that will pass muster under the Charter,” he said.

The proposed legislation would now apply to persons whose death is not reasonably foreseeable, while clarifying the safeguards that apply to them. In those cases, the patients and their practitioners would have to discuss “reasonable and available means to relieve the person’s suffering” as part of a 90-day assessment period. In addition, the request would have to be approved by two independent practitioners, including one who has expertise in the patient’s condition.

For patients whose death is reasonably foreseeable, the legislation would remove the existing 10-day waiting period.

“For those who are at the end of life, the decision to request medical assistance in dying is well considered and this additional period can prolong suffering unnecessarily,” said Carla Qualtrough, who is the Minister of Employment, Workforce Development and Disability Inclusion.

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The legislation would also allow for advanced waivers to address the case of Audrey Parker. In 2018, the Halifax woman received an assisted death earlier than she would have liked because she feared her cancer would prevent her from providing “late-stage consent” on the day of her death. Under the new legislation, a patient in a similar situation could obtain a “waiver of final consent” if their death is reasonably foreseeable.

Patients who decide to end their lives through “self-administration” would also have the right to waive the need for final consent to allow for a physician to follow through if there are complications during the procedure.

Since the government legalized medical assistance in dying in 2016, there have been 13,000 deaths under the regime.

The federal government launched consultations last month on proposed changes to the law, which generated more than 300,000 responses.

Mr. Lametti said the government decided to legislate on measures for which there is a clear consensus, while leaving other elements to a review of the law by a parliamentary committee in June.

“This will allow us to continue to work on this important and sensitive issue,” he said.

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Ottawa is looking to address three contentious issues later this year: cases in which mental illness is the sole reason for requesting an assisted death; cases in which patients want to make an advance, written request for assisted death before they lose the capacity to consent; and cases involving patients under the age of 18 who are deemed capable of making their own medical decisions.

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