MAID Policy Alert Update - June 22, 2016

Canadian Hospice Palliative Care Association
Policy Alert – UPDATE II
Bill C-14 Medical Assistance in Dying (MAID)

Bill C-14, called An Act to amend the Criminal Code and to make related amendments to other Acts (or Medical Assistance in Dying) was passed by parliament on Friday June 17, 2016 and has received Royal Assent.

To view the CHPCA’s previous Policy Alerts and resources on MAID:

MAID Policy Alert from April 15 2016

MAID Policy Alert UPDATE from May 27 2016

MAID Webinar June 14 2016

To view the process, committee reports, debates and proposed amendments CLICK HERE.

The key highlights of the final iteration of the legislation are as follows:

The more restrictive version of the legislation preferred by the government has been enacted into law. The Senate proposed several amendments when they sent the bill back to the House of Commons on June 15 including removing the requirement that a person’s death must be reasonably foreseeable in order to be eligible for medical assistance in dying. The final criteria for eligibility are as follows:You must:

  • be eligible for health services funded by the federal government, or a province or territory (Generally, visitors to Canada are not eligible for medical assistance in dying.)
  • be at least 18 years old and mentally competent (this means capable of making health care decisions for yourself);
  • have a grievous and irremediable medical condition; This means:
    •  have a serious illness, disease or disability
    • be in an advanced state of decline that cannot be reversed
    • be suffering unbearably from your illness, disease, disability or state of decline; and,
    • be at a point where your natural death has become reasonably foreseeable, which takes into account all of your medical circumstances (Note: You do not need to have a fatal or terminal condition to be eligible for medical assistance in dying.)
  • make a request for medical assistance in dying which is not the result of outside pressure or influence; and,
  • give informed consent to receive medical assistance in dying (this means you have consented to medical assistance in dying after being given all of the information needed to make your decision. This includes information about:
    • your medical diagnosis
    • available forms of treatment
    • available options to relieve suffering, including palliative care
Source

A full summary of the law now in place including eligibility, how it may impact patients, health care providers, family members, and can be found at healthycanadians.gc.ca

What’s Next:

As noted in the preceding policy alert update, all 10 provincial medical regulating bodies and one territorial body now have MAID guidelines in place. Provincial legislation is now in various stages of the legislative process in most provinces.  The Federal Government has compiled a list of provincial resources for end-of-life care which can be viewed on the aforementioned website.

With a Medical Assistance in Dying law now in place, it is the CHPCA’s hope that the government will move on to addressing the serious need for a comprehensive integrated hospice palliative care strategy that is properly funded.

The joint statement between the Minister of Health and the Minister of Justice upon the passage of Bill C-14 by parliament recommends that Canadians looking for resources on end of life care should visit healthycanadians.gc.ca. With information about Palliative Care including links to CHPCA, CSPCP, Pallium Canada, CMA and provincial palliative care associations, the government is promoting hospice palliative care more actively.

Additional sections on options and decision making at end of life and medical assistance in dying provide a more fulsome picture of resources available.

Also of note, a private member’s bill (C-277) was tabled at the end of May 2016. Bill C-277 An Act providing for the development of a framework on palliative care in Canada was introduced by MP Marilyn Gladu. It has reached first reading but will not be given further consideration until the House of Commons resumes sitting after their summer recess, likely toward the end of September 2016.

The government has indicated that it will commit to providing $3 billion over four years to improve home care, which will include palliative care. However, funding hinges on the successful renegotiation of the Health Accord with the provinces, which, while now underway, is realistically not likely to conclude before late 2016.

Stay tuned for further CHPCA Policy Alerts as more information becomes available.

Sharon Baxter
Executive Director
Canadian Hospice Palliative Care Association
Wednesday June 22, 2016