Legislative Background: Bill C-7: Government of Canada’s Legislative Response to the Superior Court of Québec Truchon Decision
Part I – Bill C-7: Government of Canada’s Legislative Response to Truchon
Bill C-7 is the Government of Canada’s legislative response to the Truchon decision. It is identical to former Bill C-7, which was introduced on February 24, 2020 and died on the Order Paper when Parliament was prorogued in August 2020. The development of the Bill was informed by the evidence submitted before the Court in Truchon, as well as by available Canadian and international research, social science evidence and reports, such as the December 2018 reports of the Council of Canadian Academies.Footnote 4 It was also informed by the experience of existing international MAID regimesFootnote 5 (see Annex A), by the Canadian experience over the past four years and, most recently, by the Government of Canada’s consultations on MAID that took place early this year.
During the month of January 2020 and early February 2020, the Government of Canada engaged the Canadian public, as well as provinces and territories, Indigenous groups, health care providers, experts and key stakeholders to receive their feedback on expanding Canada’s MAID legislation in response to the Truchon decision:
- Over 300,000 Canadians participated in the online public consultations between January 13 and 27, 2020.
- Minister of Justice and Attorney General of Canada, David Lametti, Minister of Health, Patty Hajdu, and Minister of Employment, Workforce Development and Disability Inclusion, Carla Qualtrough, met with experts, health care providers, health professional associations and regulatory bodies, representatives of persons living with disabilities, Indigenous organizations and other key stakeholders (over 125 participants in total) to consult them directly on revising Canada’s federal MAID legislation.Footnote 6
- Ministers and senior officials also sought input from their provincial and territorial counterparts on responding to the Truchon ruling.
The proposed legislative reforms are tailored to respond to the Truchon ruling within the court-imposed deadline and to address other MAID-related issues on which there is strong support. Other broader and more complex issues, such as MAID for persons suffering solely from a mental illness and advance requests following the diagnosis of a capacity-limiting medical condition, will be examined as part of the parliamentary review of the federal MAID provisions and the state of palliative care in Canada.
To support the implementation of the proposed legislative reforms, the Minister of Health would also work with the provinces and territories, health system partners, including MAID providers and care coordination networks, and health practice regulatory and oversight bodies to help develop, monitor and report on MAID practice guidelines, training, retrospective review processes and results.
The preamble of the proposed legislation outlines the Bill’s main objective, which is to balance several interests and societal values, including respecting the autonomy of persons who are eligible to receive MAID, the equality rights protected by the Charter, the need to protect vulnerable persons from being induced to end their lives, and the recognition of suicide as a significant public health issue. It also outlines a series of affirmations and principles upon which the proposed Truchon response is founded, including the appropriateness of no longer restricting eligibility for MAID to persons whose natural death is reasonably foreseeable, the affirmation of the inherent and equal value of every person’s life, the recognition of Canada’s obligations as a State Party to the United Nations Convention on the Rights of Persons with Disabilities, and the need for additional consultation and study of MAID for certain types of situations that present more complexity and risk, such as advance requests for MAID and mental illness as the sole underlying medical condition.
Overview of Proposed Legislative Reforms
In summary, the Bill proposes the following Criminal Code amendments to the MAID regime:
- Eligibility criteria: repeal the “reasonably foreseeable natural death” criterion and exclude cases where mental illness is the sole underlying medical condition;
- Safeguards: create two sets of safeguards − one set of eased safeguards for people whose natural death is reasonably foreseeable, and a second set of new and clarified safeguards for people whose natural death is not reasonably foreseeable;
- Advance consent: permit the administration of MAID on the basis of advance consent (in other words, the requirement for final consent at the time of the MAID procedure would be waived by operation of law) for persons whose natural death is reasonably foreseeable and who have been assessed and approved for MAID, if they lose capacity to consent before their preferred date for MAID and have a written arrangement with a practitioner; permit advance consent to the administration of MAID by a practitioner in cases of failed self-administration;
- Monitoring regime: enhance the reporting requirements based on experiences with the federal MAID monitoring regime to date.
The following sections will explain each proposed amendment in more detail.
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