House Call with Carol Hughes

Medical assistance in dying law should have been more patient-centred

A Supreme Court decision forced Parliament to act on the issue of medical assistance in dying, but the government has chosen to make this  a more fractured discussion on a number of fronts that could have been avoided, or at the very least tempered with a little foresight and planning. The right to decide on how one wants to end their life has been deemed a Charter right and the government knew they had to address this. It isn’t helpful that they are rushing through debate and have introduced closure, which limits discussion, on the most contentious bill before parliament in a very long time.

That’s a big about-face for the Liberals who never missed a chance to lecture the Conservatives on how anti-democratic closure was. What’s more worrisome is how unprepared they have been to preface the debate with policies and initiatives that would reduce the number of Canadians who may seek a doctor’s help to end their life. With no money in the budget for palliative care-despite an electoral promise to invest $3 billion on this front-the government has knowingly made end of life care more difficult to obtain for many Canadians. Currently we have a patch-work of provincial programs and less than 30 percent of Canadians are able to access quality palliative care.

This is not news or new to parliamentarians either. In the last Parliament we passed a National Palliative Care Strategy that was intended to reduce the gaps in services across the country. It was well supported by members of all sides of the House, but has never been acted upon. Moreover, New Democrats have brought the issue back since the election with Motion No. 46, which calls for the establishment of a pan-Canadian palliative end-of-life strategy. It has already been supported by Parliament, but there was nothing in the budget to reflect that.

Additional concerns that could have been addressed ahead of this debate relate to improving mental health services for vulnerable individuals, which are notoriously difficult to obtain when people are actually in crisis; improving Employment Insurance for caregivers who are attending to end-of-life patients; and beefing up health care, especially for items that make a big difference like pain management clinics. All of those items put the horse squarely in front of the cart and would help make medically assisted dying less of an option for more patients. Yet the Liberals haven’t made the changes that would make a difference and jumped right into a rushed debate on legislation they knew they had to introduce all along.

Now we have legislation which seems to be the bare minimum that will let the government off the hook, but fill up the courts with challenges to further define the law. Instead of taking a patient-centred, floor-to-ceiling approach like was recommended by a Joint Special Committee of Parliament that preceded the legislation, the government seems content to reside in the basement and let the courts decide.

It is also important to note that there is no going back through the looking glass on this debate. The Supreme Court has made it clear that medical assistance in dying is a Charter right and has mandated parliament to fill the legislative void after consecutive governments refused to act. What they couldn’t mandate was a comprehensive strategy that addressed the issue headlong and fully, or legislation that wasn’t designed to just barely work. That is the job of parliament and the government hasn’t distinguished themselves with their efforts at all.