What We Heard Report
A Public Consultation on Medical Assistance in Dying (MAID)

March 2020

You are currently reading a simplified, accessible version of this report. Please visit this webpage to consult the original version.

Introduction

In early 2020, the Government of Canada consulted with people about the medical assistance in dying (MAID) law. Medical assistance in dying is when doctors help people to die when they are very sick and suffering a lot.

The Government did an online survey that the public could fill out. The survey was open for two weeks in January 2020.

The Government also consulted with other people. This included experts and stakeholders. Stakeholders are people who are very concerned about the issue.

These consultations took place in January and February 2020.

This report is a summary of the information that was collected. It is called What We Heard.

Background

MAID became legal in Canada in June 2016. The Criminal Code of Canada was changed so that people who provide MAID can do it without breaking the law. Doctors and nurse practitioners can provide or help to provide MAID.
There are two ways that MAID can happen.

Canada’s MAID law has conditions that people have to meet to be able to get to have it. There are also safeguards in the law. Safeguards are protections in the law to make sure it is used properly. Doctors and nurse practitioners must follow the safeguards before providing MAID. They must make sure the person requesting MAID understands what it means. They must also make sure the person has given their consent freely. Consent is when a person agrees and gives permission for something to happen.

There is more information on medical assistance in dying on the Government of Canada’s website. The following topics are covered.

How MAID developed in Canada

Before it became law, the MAID legislation was called Bill C-14. It became law in 2016. The MAID law gave a choice to Canadians who were suffering extremely during the dying process. It allowed them to have a medically assisted death.

After MAID was law, the Government of Canada asked for some study on these three complex issues:

The Government asked the Council of Canadian Academies (CCA) to look at these issues. The reports on these issues are available on their website (CCA’s website).

The 2016 MAID law said there had to be a way to monitor the system to make sure it is working properly. There are rules around what information needs to be shared about a MAID request, and when MAID is given to a patient. Doctors and nurses who provide MAID would have to report this information. These rules came into effect in November 2018.

The federal government will use this information to report to the public on MAID in Canada. The first report from the federal government is expected in spring 2020. For now, Health Canada has four shorter reports on their website (Health Canada’s website). These reports are based on information the provinces and territories give.

The 2016 MAID law also requires a review by Parliament. The review is supposed to happen five years after the law was passed. The review should start in 2020. This review will give Canadians another opportunity to tell the government what they think about MAID. They can let the government know if any changes should be made.

Since MAID became law, there have been four court challenges in Canada. In British Columbia there was the Lamb case. In Quebec, there was the Truchon case. Both of these cases challenged the MAID law based on the eligibility conditions. The eligibility conditions are the rules around who is allowed to get MAID. The persons who brought the case to the court said the MAID law went against the Canadian Charter of Rights and Freedoms because it was too limiting.

In Ontario, there was the Foley case. In Saskatchewan, there was the Katzenback case. Both these cases also said the MAID law went against the Charter. But they said that the safeguards were not enough to protect people. They said people might be offered MAID instead of getting enough support services or other ways to reduce their suffering.

Background and purpose of the consultations

In the Truchon case, the Superior Court of Quebec ruled on September 11, 2019. The court found that it was against the Charter to limit access to MAID to only people who are expected to die.

This case was brought by two people living with disabilities. One was Mr. Truchon. He has lived with cerebral palsy since he was born. The other was Ms. Gladu. She lives with paralysis and severe scoliosis caused by poliomyelitis. The practitioners who assessed them said they met all the conditions for MAID except for one: they were not expected to die.

The court found that a condition in the Criminal Code was against the Charter and so was invalid. Quebec also has a provincial law on MAID. The court also found the same thing for a similar condition in Quebec’s provincial law on medical assistance in dying. It was also against the Charter. Both the conditions are about the fact that the person is expected to die.

The Truchon ruling only applies in the province of Quebec. But the Government of Canada has accepted the ruling. And it has committed to changing the MAID law so it is the same for the whole country. The law was meant to help people who are suffering and dying to die more peacefully. The Government wants to change the law so that it would also help people who are suffering and who are not expected to die. This will mean that MAID can be used by people who are not expected to die, if that is what they choose.

Because of the changes it wants to make to MAID, the government wanted to know what Canadians think. The consultations asked their views on additional safeguards needed with the change. They also wanted to know what Canadians thought about circumstances where people say they want to use MAID after they lose the ability to give their consent for it. The Government made a survey available online from January 13 to 27, 2020. The Government also held meetings across the country.