Medical Assistance in Dying (MAID) in Canada: A Tale of Two (or more) Perspectives

  • May 14, 2021
  • Blair L Botsford, Dentons

For some, the scope and pace of access to MAID services is narrow and glacial, while to others Bill C7’s recent royal assent represents a move that is too wide and fast. Before considering the implications of Bill C7, a brief summary of how we reached this juncture is helpful:

  • Sue Rodriquez, who suffered from ALS, challenged subsection 241(b) of the Criminal Code on constitutional grounds in the early 1990s. The Supreme Court of Canada (“SCC”) ruled in a 5-4 decision[1] to affirm the provision as not violating the Charter of Rights and Freedoms. Ms. Rodriquez committed suicide in 1994 with the assistance of an anonymous doctor and for two decades afterwards, physician-assisted death in Canada remained unlawful under the Criminal Code.
  • Re Carter[2] was decided by the SCC in February 2015 with a unanimous vote to permit medical assistance in dying for certain persons and with certain restrictions. In June of 2016, The Medical Assistance in Dying  (MAID) Act[3] was enacted and set out the framework in which MAID was to operate.
    • Eligibility was restricted to:
      • Persons who are at least 18 years of age
      • Persons with a grievous and irremediable medical condition
      • Medical conditions that cause enduring physical or psychological suffering that is intolerable to the person requesting MAID
      • Persons in an advanced state of irreversible decline whose natural death had to be reasonably foreseeable
    • In addition, the following safeguards formed part of the initial MAID legislation:
      • The doctor or nurse practitioner had to meet eligibility criteria to be able to provide MAID
      • A second assessment had to be done by a independent qualifying provider
      • The person requesting MAID had to make the request in writing after having been advised that their natural death was reasonably foreseeable, and the request required two witnesses
      • Patients had to be informed that they had the right to withdraw their request at any time
      • There was also a waiting period of a minimum of 10 days between the initial request and provision of MAID
      • The practitioner providing MAID was obligated to confirm the patient’s consent again immediately before provision of assistance.