Canada’s assisted dying laws should be expanded to include minors, a parliamentary committee has recommended in a report tabled in the House of Commons.
After hearing from nearly 150 witnesses and reviewing more than 350 briefs on Canada’s medically assisted dying (MAiD) program, the special joint committee of MPs and senators concluded that minors deemed to have the appropriate decision-making capacity should be eligible for assisted death.
A number of witnesses noted Canadian minors are already allowed to make decisions about withholding or ceasing medical treatment, even when such decisions may hasten death, while others said they felt the decision to seek MAiD is simply too weighty for a minor to make.
Many witnesses told the committee they strongly believed the capacity for a minor to make an informed health-care decision is not a function of age, nor is the level of suffering they might endure during an illness, a view supported by clinical observations, the report said.
In the end, the committee agreed that many factors can influence a minor’s decision-making capacity, therefore it “believes that eligibility for MAID should not be denied on the basis of age alone.”
Parliamentarians also recommend the federal government appoint an independent expert panel to evaluate Criminal Code provisions for assisted death for “mature minors.”
But also said access to assisted death for minors should be restricted to those “whose natural death is reasonably foreseeable.”
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Funding should also be provided for researching the views and experiences of minors when it comes to assisted dying, the committee said.
The Conservatives offered a dissenting opinion, however, saying they cannot endorse every recommendation, notably those related to minors.
They stressed that “significant knowledge gaps” exist when it comes to minors and MAiD and that issues around the decision-making capacity of mature minors “remain unresolved.”
“So long as these issues remain unresolved, it would be irresponsible for the Liberal government to move ahead with any expansion of MAiD for mature minors,” the Conservative members of the committee state in the report.
The recommendations to expand MAiD eligibility were among 23 proposed changes to improve Canada’s assisted-dying regime made by the special committee.
Another called for the Liberal government to improve access to palliative care and boost financial support for people with disabilities.
Without more financial supports and better access to social support, the report says, “persons with disabilities might see MAiD as a way to relieve suffering due to poverty and lack of services.”
The report also recommends better engagement with Indigenous communities and persons with disabilities about how Canada’s assisted-dying program works.
It says the federal government should convene an expert panel to “study and report on the needs of persons with disabilities” as they relate to medically-assisted death.
The report recommends developing a system that harmonizes access to the program across Canada.
It also says Health Canada should do a review of “promising therapies, such as psilocybin, for both research purposes and for individual use as part of palliative care supports.”
As for the Liberal government’s plans to delay expanding the eligibility for medical assistance in dying for Canadians whose sole condition is a mental disorder, the committee expressed support.
Members of Parliament are expected to pass a government bill during the present sitting to delay that expansion until March 2024. Federal officials have said a one-year delay is needed to allow the federal government to develop practice standards and clinical expectations for physicians and nurse practitioners who administer MAiD to complex cases involving mental illness.
The committee expressed concern about ensuring adequate time to develop these practice standards, and wants to ensure they are fully in place before MAiD is expanded to mental health patients.
That’s why it is recommending another joint parliamentary committee should be created five months before that “in order to verify the degree of preparedness attained for a safe and adequate application of MAiD.”
— With files from The Canadian Press