Update on medical assistance in dying (MAID) law in Canada

December 3, 2020 | Wendi P. Crowe

The law related to medical assistance in dying (MAID) in Canada continues to evolve since the Supreme Court struck down applicable portions of the Criminal Code[1] in 2015.[2] The federal government introduced legislative reform in 2016, and proposed further amendments via Bill C-7, An Act to amend the Criminal Code (medical assistance in dying)[3](Bill C-7). The Bill passed second reading, but stalled, like so many things, due to the COVID-19 pandemic.  The federal government reintroduced these amendments in Parliament on October 5, 2020.

On July 28, 2020, our legal team wrote about the proposed amendments under Bill C-7, which would:

  1. repeal the provision that requires a person’s natural death to be reasonably foreseeable in order for them to be eligible for MAID;
  2. specify that persons whose sole underlying medical condition is a mental illness are not eligible for MAID;
  3. create two sets of safeguards that must be respected before MAID may be provided to a person, the application of which depends on whether the person’s natural death is reasonably foreseeable;
  4. permit MAID to be provided to a person who has been found eligible to receive it, whose natural death is reasonably foreseeable and who has lost the capacity to consent before MAID is provided, on the basis of a prior agreement they entered into with the medical practitioner or nurse practitioner; and
  5. permit MAID to be provided to a person who has lost the capacity to consent to it as a result of the self-administration of a substance that was provided to them under the provisions governing MAID in order to cause their own death,[4]

and which would also expand data collection through the federal monitoring regime to provide a more complete picture of MAID in Canada.[5]

We also discussed the cases of Carter v Canada and Truchon c Procureur général du Canada, as well as the 2016 amendments to the Criminal Code. For more information, you can access our previous article.

Recently, the Nova Scotia Court of Appeal has ruled that eligibility for MAID is to be determined within the health system, according to provincial policy.[6]  The Court refused a wife’s application for an injunction preventing the administration of MAID to her husband. Health care providers had determined that the husband met the eligibility requirements, but his wife alleged that he was a hypochondriac and suffered from mental delusions. The Court held that Parliament did not intend the courts to exercise judicial oversight in the administration of the MAID policy, and particularly the assessment of eligibility for MAID, in Nova Scotia.

A parliamentary review of the 2016 Criminal Code amendments, as well as the state of palliative care in Canada, was required to be conducted by June 2020.[7] This review was underway in January and February 2020 and included consultation with provinces, territories, Canadians, Indigenous groups, experts, practitioners, and other stakeholders. The government has indicated that some outstanding issues which are not addressed by Bill C-7, such as advance requests for persons newly diagnosed with a condition that could affect their decision-making capacity in the future, eligibility for persons suffering solely from mental illness, and eligibility for mature minors, will likely be explored during a broader parliamentary review of MAID in the future.

[1] Criminal Code, RSC 1985, c C-46 [Criminal Code].

[2] Carter v Canada (Attorney General), 2015 SCC 5 [Carter].

[3] Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), 1st Sess, 43rd Parl, 2020.

[4] Ibid, summary.

[5] Government of Canada, News Release, “Government of Canada proposes changes to medical assistance in dying legislation” (24 February 2020), online: Government of Canada [GOC News Release].

[6] Sorenson v. Swinemar, 2020 NSCA 62.

[7] GOC News Release, supra note 5.


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