Medical Assistance in Dying (MAID) Update

  • January 20, 2020
  • Alexandra Manthorpe, O’Connor MacLeod Hanna LLP

Medical Assistance in Dying (“MAID”), formerly called physician- or doctor-assisted suicide, is a topic that has captivated the Canadian public since Sue Rodriguez and her brave, emotional challenge all the way to the Supreme Court of Canada in the early 1990s (Rodriguez v. British Columbia (Attorney General), [1993] 3 S.C.R. 519), if not beforehand. 

While Ms. Rodriguez was unsuccessful, the Court itself was split 5-4, perhaps reflecting the tensions Canadian themselves were feeling at the time. When this issue was re-visited in 2015 in the landmark Carter decision (Carter v. Canada (Attorney General), 2015 SCC 5, [2015] 1 S.C.R. 331), the Court unanimously held that the Criminal Code’s prohibition on physician-assisted suicide violated Section 7 of the Canadian Charter of Rights and Freedom (being the “life, liberty and security of the person” provisions) and was not saved under Section 1 of the Charter.  The Court gave the federal government 12 months to remedy this problem (later extended due to a federal election).

In 2016, and after a robust back-and-forth between the House of Commons and the Senate, the federal government unveiled its response in Bill C-14. It was decided that to qualify for MAID an individual must have a “grievous and irremediable medical condition,” meaning that:

(a) s/he has a serious and incurable illness, disease or disability;

(b) s/he is in an advanced state of irreversible decline in capability;

(c) that illness, disease or disability or that state of decline causes him/her enduring physical or psychological suffering that is intolerable to him/her and that cannot be relieved under conditions that s/he considers acceptable; and

(d) his/her natural death has become reasonably foreseeable, taking into account all of his/her medical circumstances, without a prognosis necessarily having been made as to the specific length of time that s/he has remaining.

The introduction of “advanced state of irreversible decline” and that a person’s natural death must be “reasonably foreseeable” in particular were not found in Carter, and many critics quickly noted that this would serve to exclude people suffering debilitating medical conditions that perhaps were not yet advanced and/or terminal, and also people suffering solely mental or psychiatric conditions (e.g. schizophrenia).

The federal government promised to re-visit the issues of (a) mature minors, (b) advance directives or advance requests, and (c) people suffering solely mental or psychiatric conditions in the future.

Fast forward to January 2020: What are some of the key developments happening with respect to MAID in Canada right now?