What physician witnesses had to say at the special joint committee examining MAiD

The special joint committee for Medical Assistance in Dying (MAiD) has finished hearing from witnesses as they review legislation on the issue. Several physicians spoke before the committee as witnesses. The next meetings of the joint committee will deal with drafting its report. The joint committee was formed in March 2022 and is examining the provisions in Canada’s Criminal Code to permit MAiD and how those provisions are applied. It includes representatives from the House of Commons and the Senate of Canada, with Marc Garneau and Yonah Martin serving as co-chairs. The committee is looking at issues including: providing MAiD to mature minors advance requests for MAiD when death is not reasonably foreseeable granting requests for MAiD when mental disorder is the sole underlying medical condition the state of palliative care in Canada protecting Canadians with disabilities The committee has been hearing from witnesses since April 13. Witnesses speaking about mental disorders spoke after another group, the Expert Panel on MAiD and mental illness, submitted their report to Parliament on May 13, 2022. The final meeting with witnesses occurred on Nov. 27, 2022. The joint committee provided an interim report on June 22, 2022, and the Minister of Health Jean-Yves Duclos responded on Oct. 20, 2022. Read: Comments from Quebec College of Physicians about possible expansion of MAiD alarm disability advocates Physicians appearing before the joint committee spoke either as individuals or on behalf of an organization. Each had five minutes to make a statement and were later asked questions by the committee. Many also submitted a short three-page-long brief, which are available on the committee’s website. MATURE MINORS Physicians who spoke recently about providing MAiD to medical minors included Dr. Arundhati Dhara, generalist family physician in Halifax and MAiD provider. Dr. Dhara noted that the conditions for providing MAiD are the same for others as they would be a mature minor, including assessing the capacity to consent. She said on Nov. 4 that there’s a visceral revulsion that a child would suffer so much that they would seek MAiD. “We are obligated to see past our revulsion,” she said. “The right thing to do doesn’t always feel good.” “We need to approach MAiD in mature minors the same way we do in every patient. It is unique and must be treated with careful consideration of their personal circumstances and the context of their lives.” Dr. Gail Beck, chief of staff at Royal Ottawa Healthcare Group said that the areas where physicians struggle is cognitive and psychosocial development of mature minors. She said the development of cognitive skills continues past age 18 and that must be taken into account. The patients’ culture is always a consideration. Dr. Eduard Verhagen, pediatrician at Beatrix Pediatric Hospital in the Netherlands also spoke. He contributed to the Groningen protocol, which permits providing MAiD to newborns. Dr. Verhagen spoke about how children aged 12 and up can access MAiD, with parental consent needed for those under 16 years old. In the past 15 years, there were seven cases where MAiD access was granted. In each case the patient was around 17 and suffering unbearably from terminal cancer. For children under 12 months, there have been three cases of providing MAiD in 15 years. The Netherlands is in the processes of considering allowing children aged one to 12 to access MAiD, after a four-year-long review of how children those ages die. Should it be passed, Dr. Verhagen said he expects the number of cases will remain low, but “the biggest strength is that it allows a discussion of quality of life and quality of death that can currently not be held as it should,” he said. Read: Chronically ill, but 'dying of poverty' ADVANCED REQUESTS Dr. Chantal Perrot, community-based MAiD provider and chair of the board of MAiD house in Toronto, spoke as an individual on November 1. She spoke about how her patients fear that they will not be able to request or consent to MAiD in their final stages of life. She suggested that there could be a central database of advanced requests for MAiD. “I believe it can be done and can be done well with careful planning and guidance,” she said. “Over time and with experience, templates for MAiD advanced directives can be drafted, refined and improved.” Dr. Alice Maria Chung, a geriatrician in Vancouver spoke against advanced directives. “I am opposed to advanced directives to MAiD as people cannot predict with accuracy how they would feel in a future situation they have not yet experienced. There is no ability to withdraw consent,” she said. “These directives may open up another avenue of potential abuse of vulnerable elderly.” The full meetings of the special joint committees can be viewed on the committee's website. Read: Controversial MAiD bill passes

What physician witnesses had to say at the special joint committee examining MAiD

Register for free access or login.

Related Topics