Medical assistance in dying legislation passes in Senate and becomes law

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Late Friday the Senate concurred with the Liberal Government and passed a bill that was more restrictive than many groups, including the courts, had argued for.

After an expedited vote in the House of Commons late Thursday, an amended Bill C – 14 (medically assisted dying) went back to the Senate for consideration Friday. The Government refused to back down on the clause that a patient’s natural death be “reasonably foreseeable” in order to qualify for medical assistance in dying – a clause that was removed by the Senate earlier in the week.

But in the end, senators deferred to the elected Commons and passed the bill in a vote of 44 to 28 late Friday.  The bill then received Royal Assent and became law.

As explanation for the Friday reversal, some senators said they worried about access issues without a federal law, while others believed safeguards would be stronger with the Senate amendments accepted by the government. And several felt it was simply not their place as an unelected body to effectively veto the wishes of the elected Commons.

Legislative history

The federal government’s controversial Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), passed the report writing stage in the House of Commons on May 30.

The bill then easily cleared third reading in a “free” vote in the House on May 31, as MPs voted 186 to 137 to send it to the Senate.

The bill received support from a small group of Conservatives including Peter Kent and Michael Chong, while most opposed it. A small handful of Liberals stood against the bill, including Rob Oliphant, Nathaniel Erskine-Smith, and Robert-Falcon Ouellette. At third reading vote, all NDP and Bloc members opposed the bill as did Green Party leader Elizabeth May.

After passing third reading in the House of Commons, the Senate made seven significant amendments (see below) to the bill. The bill then returned to the House of Commons.

After an expedited debate in the House on June 16, the government motion to amend the bill passed in a vote of 190 to 108, supported by all but three Liberals and almost two dozen Conservative MPs.

Senate amendments accepted by the Commons included presenting palliative-care options to patients, reporting requirements for the health minister, completing independent reviews of topics such as advance requests within two years, and two minor technical changes.

The government also adopted in part a proposal that beneficiaries shouldn’t be allowed to sign on behalf of patients – but removed the part of the Senate ban that said they can’t help the person end their own life, arguing that wouldn’t allow family members or friends to assist.

But the Liberal Government outright rejected the key Senate amendment that removed the criteria that a patient’s natural death be “reasonably foreseeable” in order to qualify for medical assistance in dying setting the stage for a possible stalemate with the Senate.

Background on C-14 and links to original documents.

The Liberal government stuck with Bill C-14’s contentious clause that would limit the right to assisted suicide to people with terminal illnesses and exclude anyone suffering from psychiatric diseases even after it was effectively shot down by the Alberta Court of Appeal on May 17. The case before the Alberta court dealt with E.F., a 58-year-old with a diagnosis of “severe conversion disorder” which means she has severely disabling neurological problems with no physical explanation for them. The ruling essentially stated that, in contrast with the provisions of C-14,  a woman who has a psychiatric illness and is not terminally ill has a constitutional right to aid in dying. Her husband and adult children support her request, as does her doctor of 28 years.

In terms of committee submissions, of particular interest is the Canadian Medical Association’s (CMA) presentation which largely endorsed the government’s restrictive approach. As the principal voice of Canada’s physicians, the CMA position obviously carries significant weight with the government and is likely the single biggest reason the government remained committed to the end to the more restrictive approach despite seeming to be off side with court rulings and the bill that emerged from the Senate.

In contrast with the CMA, and along with a many other groups presenting to the Commons committee, the brief from the Alliance of People with Disabilities Who are Supportive of Legal Assisted Dying Society called for a less restrictive approach in a number of specific areas.

More information on the controversial bill including the most recent  full text of the bill, party positions on the bill,  a backgrounder , departmental information, and a legislative summary  are provided.

A list of all 72 witnesses to the Justice Committee examining the bill and their full testimony, all 140 written briefs presented to the committee, and complete video and audio coverage of the presentations as well as committee member (MP’s) questions and witness responses, can be found here.

The report of an earlier select parliamentary committee looking into physician-assisted dying tabled in February can be found here. It is interesting to note that the final government bill ignored many of the recommendations of the committee and, in several areas, reflected the views of the dissenting report written by Conservative members of the committee. The Conservative dissenting report generally urged a more restrictive approach along with strong protections for the rights of physicians who choose not to participate in medical assistance in dying on grounds of conscientious objection.

In a Feb. 6, 2015 ruling, the Supreme Court of Canada  struck down the ban on physician-assisted dying on the grounds that it violated Canadians’ charter rights. Justices originally  gave the federal  government 12 months to prepare for the decision to come into effect but because of delays related to the fall federal election, granted an additional 4 months for the new Liberal government to prepare implementation legislation. That court ordered deadline was June 6.

 

 

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