Vulnerable Canadians 'at risk of being encouraged to seek an assisted death,' panel hears

People suffering with illnesses that are terminal or causeintolerable suffering are at risk of being encouraged to seek an assisted death, aspecial Commons-Senate committee heard Tuesday.

"All persons are potentiallyvulnerable,"BenotPelletiertold the committee."Being vulnerable does not disqualify them from seeking an assisted death, but it does put them at risk of being encouraged to seek an assisted death," he said.

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Pelletieris aprofessor of law at the University of Ottawa. He was one ofthree people appointedtoapanelby the previous governmentto study the issue of assisted dying and report back to Parliament.

The panel was struck in response to a Supreme Court of Canada decision in early 2015 which ruled that a ban on physician-assisted dying violated Canadians'charter rights, and gave the government a year to pass new legislation. The high court recently extended the deadline until June to allow the Liberal government time to hold public consultations and deliver a newlaw.

Five senators and 11 MPs including six Liberals, three Conservatives and two New Democrats form the committee, which convenedMonday. Theyare holding a series ofpublic consultations to hear fromexperts and stakeholders with thegoal of reporting back with legislative suggestions by Feb. 26.

Based on the answers contained in the15,000questionnaires filled out by stakeholders during the panel's consultation process,Pelletiersaid it became clear there was broad backing for such a law but there wasmore support for the legislation to apply to peoplewith physical illnesses than there was for it to applyto people with mental illnesses.

"The implementationof physician-assisted death has to be managed in a consistent manner across the country,"Pelletiersaid.

Pelletier went on to tell the committee thatthereis a strong public desire for the practice of physician-assisted dying to be studied once implemented, to see how it works in practice and also to better comprehend its impact on human rights.

Mental competency should determine eligibility

Pelletiersaidthat any assisted-dying law should be guided by four principles:

• All Canadians should have equal access to end their lives if they fit the criteria.
• There has to be efficient oversight of the service.
• Patients must have improved access to palliative care services.
• There must be robust safeguards for the vulnerable.

Jennifer Gibson and Maureen Taylor, co-chairs of the Provincial-Territorial Expert Advisory Group on Physician-Assisted Dying, also attendedthe session.

Gibson, director of the University of Toronto's Joint Centre for Bioethics,said that if assisted-dying services aremade available to Canadians, they should be a part of an integrated end-of-life strategy for patients that includes improvements to palliative care services which are currently underfunded.

She also said that when it comes to the law being applied to people under the age of majority, mental competency,not age, should be used to determine eligibility.

"Some children, especially adolescents, have the competence and capacity to make end of life decisions," said Gibson. "What that turns on is not their age, not what their birth certificate says, but it's really their ability to appreciate their diagnosis, their options."

Taylor, a physician's assistantwhoselate husband, Dr. Donald Low, shot to public attention during theSARScrisis, and was again in thepublic eye when he madea video plea for physician-assisted death in the final days of his fight with brain cancer,also gave evidence. Taylor said after his death that she would keep advocating for medically-assisted dying.

Not family's decision

Taylor, who has previously worked as a health reporter for CBC News, told the committee that appropriate safeguards need to be in place to protect vulnerable persons from having their decisions overturned by family members if they make a request for an assisted-death.

"We do not believe the family should be able to overturn a patient's request if they do not agree," she said. "At the same time we do not believe a family should be able to initiate this for a patient whether competent or not."

Taylor and Gibson also told the panel that while the high courtdecision references 'physician assisted-death', nurse practitioners should be able to perform the service in some cases.

OnMonday,the panel heard from constitutional lawyer Peter Hogg,who said thefederal government should ensure any newlaw covers all Canadiansregardless of whether provinces have their own assisted-dying laws.Quebec is currently the only province that has enacted doctor-assisted death legislation.

The committee will continue to hear witnesses Wednesday.