Letter to Senators on Bill C-7: Medically assisted death

15 December 2020
Dear Senator,
I appreciate your service to our country and the Senate’s careful, considered approach to policy and legislative changes.
Bill C-7 proposes watershed changes to law, medicine and society that require a careful and thorough study. The timing of these changes is troubling. They are being rushed through when we have yet to make real progress in ensuring high quality palliative care is available to all Canadians. We are in the middle of a pandemic when people with disabilities and chronic illness face even greater financial and medical challenges that undermine their ability to live with security. And procedural problems with the existing regime have been identified, but not yet addressed.
I was one of the many witnesses who appeared before the Legal and Constitutional Affairs Committee in its pre-study of Bill C-7. The Evangelical Fellowship of Canada is deeply concerned about the changes to the assisted dying regime in Bill C-7 and its impact on those who are vulnerable.
National disability rights organizations clearly and strongly oppose expanding access to euthanasia to persons who aren’t dying. Making hastened death available outside an end-of-life context—only to people with disabilities or chronic illness—is discriminatory. It puts persons with disabilities outside the protections offered to other Canadians.
Bill C-7’s proposed removal of ‘reasonably foreseeable’ death is a significant change. The fact situation addressed in the Carter case was an end of life context. One of the stated objectives of the 2016 law (known as Bill C-14) sought to “…affirm the inherent and equal value of every person’s life and to avoid encouraging negative perceptions of the quality of life of persons who are elderly, ill or disabled.” This critical objective must not be set aside.
The removal of the end of life criteria was prompted by the decision of one judge in Truchon and the decision was not tested by higher courts. The government can and should reintroduce an alternative, unambiguous end of life requirement to replace “reasonably foreseeable” death. If there is concern about the constitutionality of an end of life criterion, it could be tested by asking the Supreme Court to review its constitutionality.
We remain firmly opposed to hastened death, but we offered these recommendations in our brief to the committee to minimize the harm and the risk of the legislation:
  • introduce an end of life requirement to replace ‘reasonably foreseeable’ death
  • maintain the exclusion of mental illness, but require assessment for concurrent mental illness
  • delete the provisions that remove the mandatory 10-day reflection period, create a waiver of final consent and reduce the requirement from two independent witnesses to one witness who may be a paid caregiver
  • extend the new safeguards proposed for those whose death is not foreseeable to also protect those whose death is foreseeable
  • add specific conscience protection for health care workers and institutions in the Criminal Code
It is essential to maintain these safeguards because research shows that people change their minds. The First Annual Report on Medical Assistance in Dying 2019 indicates that 263 patients withdrew their request for MAID in one year. The report indicates over half (54%) changed their minds and 26% found palliative care measures were sufficient. Of all the patients who withdrew their request, 20% withdrew their request immediately before MAID.
The existing legislation already allows for the 10-day reflection period to be waived if the medical practitioners believe the person is likely to lose their capacity to consent or their death seems imminent. This important safeguard should remain in place, especially given that ‘foreseeable death’ is a subjective term without a clearly defined timeframe. In fact, in the Lamb case, it was suggested that ‘reasonably foreseeable’ could be very widely interpreted by medical practitioners to include people who may not die for years, if not decades.
It is unconscionable that we would make it easier to access hastened death in Canada than it is to receive quality palliative care or for individuals living with disability to access the medical and social supports they need to enjoy living on an equal basis with other Canadians.
We urge you to take the time and care this issue warrants. This legislation is too important to be rushed.
We share some of the important commentary on Bill C-7 in the summary following this letter. I would be happy to discuss this issue further, if you wish, or to provide additional information.

Julia Beazley
Director, Public Policy
The Evangelical Fellowship of Canada
Author: Julia Beazley