death , seventy-three per cent of the respondents felt that they should have the right to assisted suicide . In fact , roughly half of those questioned felt there should be little or no regulation , allowing almost all adults access to medical assistance in dying . The other half felt the practice should be severely restricted or not allowed at all .
The government attempted to balance the concerns of Canadians as best they could . Bill C-14 does not allow for medical assistance in dying for minors ( those under the age of eighteen ) nor for individuals with mental illness , long-term disability , or curable conditions .
To receive medical assistance in terminating one ’ s life , death has to be “ imminent ” ( see Note ). The patient has to request euthanasia in writing , have two people witness the request , then have a further two physicians or nurse practitioners agree that they are suffering from a “ grievous and irremediable medical condition ” and that death is seen as certain in the reasonably foreseeable future . The medical practitioners must ascertain that the patient is capable of making this decision and that they are aware of their palliative treatment options . Witnesses to the signed request must have no benefit from that person ’ s death , and the physicians must be independent of each other .
After the written request is made , ten clear days must pass before proceeding with euthanasia . The patient must once again leave no doubt of their desire to proceed , just prior to administration of the service .
It sounds like a lot of red tape , and it is . The goal is to recognize the autonomy of a person seeking medically assisted death and yet provide safeguards in order to protect the vulnerable .
The government does have plans to reassess the needs of mature minors , those wishing advance requests , and people with mental health issues , but at this time there are no provisions for these cases .
Under the new legislation , physicians and nurse practitioners are exempt from criminal liability in the provision of assisted suicide ( providing a prescription for drugs for a patient to use to end life at a later time ) or medical assistance in dying ( administering a drug for the purpose of causing a patient ’ s death ). Persons assisting in providing medications for death are also exempt ( family , friends , social workers , or pharmacists who may be present ).
No doctors or nurse practitioners can be compelled to provide medical assistance in dying against their beliefs .
A person cannot arrange for euthanasia in advance of their disease progressing to a state where they are no longer able to give consent , such as Alzheimer ’ s disease or other dementia . Although a health care directive or living will can stipulate that no heroic measures are to be taken should a patient suffer a life-threatening change in health , it cannot direct health care workers to speed up the death of a person .
It is widely thought that Bill C-14 has room for improvement , but the bill is a start . Regardless of religious or moral beliefs , those who choose to seek aid in ending their life should have access to compassionate assistance . Those who feel strongly otherwise should also have their rights protected . It ’ s a delicate balance , but with 1,982 Canadians having chosen to die with medical assistance in the bill ’ s inaugural year ( Yukon , Northwest Territories , and Nunavut not included ), it appears to be a welcome alternative . ●
Note : Some of the terms in the new legislation leave room for interpretation — imminent death , for example . The law allows for some flexibility in determining the proximity of expected death and balances this with the degree of patient suffering . The medical condition causing the suffering does not have to be the condition that is likely to result in a foreseeable death .
news & views AUTUMN 2018 | 39