Medical Assistance in Dying committee  I think it is so important that to the extent that there are gaps.... We understand there are gaps, especially between urban and rural regions, for example. There are some questions about when palliative care is considered an insured service versus an extended service, and I think clarity is needed on those questions to ensure uniformity and consistency in the provision of palliative care.

Medical Assistance in Dying committee  Yes, that's exactly right. Again, I think a lot of people, me included, have a lot of misconceptions and misunderstandings about what palliative care is. I think a lot of people assume that it's just this last-minute attempt to help people. It's something that really does a lot for a lot of people at various stages of life with various conditions.

Medical Assistance in Dying committee  I believe there was a statement of claim issued by Roger Foley. I would have to go back and check where that litigation currently stands. At this point, this issue hasn't been explicitly addressed by the courts in a written decision, but we do feel there are charter issues engaged here.

Medical Assistance in Dying committee  These are all questions that need to be looked at. At the end of the day, even though both MAID and palliative care may be provided to the same patient, I think it is important that a person who is seeking MAID continues to be offered palliative care. That's absolutely crucial. We shouldn't look at it as a binary where either you choose palliative care or you choose MAID, and if you choose MAID there's no palliative care available to you.

Medical Assistance in Dying committee  Thank you so much for those thoughtful questions. I'll do my best to address them. They are very important. At the outset, though, you indicated that you thought you heard me say that palliative care and MAID are part of a continuum. That is not what I am suggesting. In fact, I think it's important to recognize that these are distinct practices.

Medical Assistance in Dying committee  Yes, I think Carter is clear that a patient cannot be forced to undergo treatment that is unacceptable to them, so that is certainly part of the consideration. As you said, the emphasis here is on a patient's choice. What we're trying to emphasize today is the choice for patients who are seeking palliative care, or at least who want to explore it but currently don't have the ability to do so because of a lack of access or information.

Medical Assistance in Dying committee  That is such an important question. I think first and foremost there needs to be a prioritization of this issue at the federal government level. They've done some great work with the framework, but that needs to be implemented. That requires very close and concerted coordination and implementation with the provinces.

Medical Assistance in Dying committee  I think it's important to remember how the court in Carter framed the issue. The court said that MAID would be an exception, a stringently limited exception, that would be “scrupulously monitored”, and the stringent limits would be scrupulously enforced precisely because there are inherent risks in any regime that permits assisted death.

Medical Assistance in Dying committee  To address that, I would direct the committee to legal principles in a couple of areas of our case law and legislation, starting with Carter. In the trial decision in Carter, the trial judge defined palliative care and assisted dying separately. The court defined palliative care as treatments aimed at alleviating suffering.

Medical Assistance in Dying committee  Yes. That was also discussed in Carter. One of the aspects is ensuring that a patient who receives MAID or at least seeks MAID has the benefit of informed consent and has information about all available options. In Carter, the trial judge said that the range of treatment options described would have to encompass all reasonable palliative care interventions in order for that informed consent standard to be met.

Medical Assistance in Dying committee  Thank you, Mr. Chair. Good morning, and thank you to the committee for this opportunity. My name is Derek Ross. I'm the executive director and general counsel for Christian Legal Fellowship. We are a national organization of lawyers and an NGO that has special consultative status with the United Nations.

Justice committee  Yes, we do think that these additional wordings are necessary. We recognize that the preamble is a good start and that it addresses suicide as a public health issue. It does not, though, specifically affirm that suicide prevention remains a public policy goal. It simply states that it's a public issue and can have negative effects.

Justice committee  Good afternoon. Thank you, Mr. Chair. I am Derek Ross. I serve as executive director and legal counsel to the Christian Legal Fellowship. With me is Jon Sikkema, associate legal counsel at the CLF. We wish to thank this committee for affording us the opportunity to make these submissions.