by John Hayward
The Canadian government on Tuesday introduced a bill that would allow Medical Assistance in Dying (MAID), Canada’s preferred euphemism for euthanasia, to be conducted on people who have lost the mental capacity to give informed consent for the procedure.
According to Justice Minister Sean Fraser, the idea is to give Canadians a way to authorize euthanasia in advance, when they are of sound mind, “so their wishes could be respected if they are diagnosed with an incurable illness that could take away the ability to make this decision.”
Fraser promised there would be “rigorous safeguards to protect people and ensure the decision remains voluntary and free from external pressure.” He said, for example, that MAID would not be conducted automatically based on pre-authorization, but only for patients who are undergoing “intolerable suffering” and have lost the mental capacity to ask doctors to end their lives.
Fraser said the bill was drafted after a “rigorous study” by parliament demonstrated it was necessary, so that people in an “advanced state of irreversible decline in capability” would not be denied the life-ending services they had previously requested, based on existing rules against euthanizing people who have lost their mental competence.
The justice minister said individual provinces would “determine the extent to which they wish to embrace the next frontier on Medical Assistance in Dying.”
“From my point of view, this is going to be the start of a national conversation that will largely play out at the provincial level around the extent to access,” he said.
The concept of requesting euthanasia in advance is not unknown among nations that have embraced physician-assisted suicide. Belgium, the Netherlands, and Spain have provisions similar to what Canada is contemplating, and Canada’s province of Quebec already allows advance requests.
Canada has been criticized, both from within and abroad, for expanding MAID too quickly and pushing it too aggressively on patients who are not terminally ill. The Liberal government acknowledged some of this criticism earlier this month by halting its plans to provide MAID for patients who are suffering from purely mental illnesses.
Fraser and other Canadian officials said on Tuesday that the rules have been bent to authorize euthanasia for the mentally ill, a “gap” in the laws that would be closed by the same bill that allowed advance requests for MAID. The two issues were deliberately paired because blocking MAID for the mentally ill would prevent people with reduced mental capacity from requesting the procedure even if they met other criteria that would normally make them eligible.