New bill on assisted dying won't be as permissive as parliamentary committee urged

The Trudeau government won't be taking a permissive approach to medically assisted dying in new legislation to be unveiled as early as next week, The Canadian Press has learned.

Sources, who aren't authorized to speak publicly about the imminent bill, say it won't adopt some of the most controversial recommendations from a special parliamentary committee.

• Should 'mature minors' have right to die?
• Doctors plead ignorance on assisted death
• Report recommends mentally ill have right to die

That committee urged the government in February to place few obstacles in front Canadians who want medical help to end their suffering.

The legislation, likely to be introduced late next week, is expected to stipulate that only competent adults should be eligible to receive a doctor's help to end their lives.

No advance requests for dementia

It will not allow people diagnosed with competence-impairing conditions like dementia to make advance requests for medical help to die, which the committee advocated.

Nor will it include mature minors, to whom the committee recommended extending the right to choose assisted death within three years.

In rejecting those recommendations, the government appears to be sticking to the strict letter of a Supreme Court ruling, which concluded last year that Canada's ban on assisted suicide violates the right to life, liberty and security of the person.

The court gave the federal government until Feb. 6, 2016, — later extended to June 6 — to come up with a new law that recognizes the right of clearly consenting adults who are enduring intolerable physical or mental suffering to seek medical help in ending their lives.

The parliamentary committee, by contrast, tried to encompass what Liberal MP Rob Oliphant, the committee chair, described as the "spirit" of the court ruling, anticipating future charter challenges that could arise if the new law is too restrictive.

Competent to consent?

On that score, the committee concluded that denying those with dementia the right to make advance directives would mean leaving them "to suffer or end their lives prematurely" while still sufficiently competent to consent.

"This situation was exactly what the (Supreme Court) decision sought to avoid," the committee's final report said.

Similarly, the committee noted that the top court has already recognized the right of mature minors to make some end-of-life decisions and expressed concern that denying them the right to medically assisted death would violate their charter rights.

The committee also recommended that a new law should apply to Canadians enduring intolerable suffering from grievous and irremediable medical conditions, including terminal and non-terminal physical and psychological conditions.

The new law is expected to spell out more stringent eligibility criteria. Although sources say it will not require that an illness be terminal, the legislation is expected to be particularly cautious about psychological conditions.

Protecting the vulnerable

Critics of the parliamentary committee's permissive approach, including Conservative MPs, have argued that people with mental illnesses are particularly vulnerable and need to be protected from coercion or making life-and-death choices while not competent. They've urged the government to require psychiatric assessments for anyone seeking a medically assisted death.

The federal legislation is also expected to affirm that doctors have the right to refuse to provide assisted death but it will leave it to the provinces to figure out how to ensure that doesn't leave some Canadians without access to the service.

The committee recommended that conscientious objectors be required to provide "effective" referral for patients to another doctor who would help them.