Medical Assistance in Dying committee  Thank you very much, Madam Chair.

Medical Assistance in Dying committee  I might be able to begin. Very quickly, I'd refer you again to the Council of Canadian Academies' report because it overviews those jurisdictions. In the Netherlands, for instance—to your earlier question, Monsieur Thériault—if you're between 12 and 16, parental consent is required.

Medical Assistance in Dying committee  Okay. Thank you.

Medical Assistance in Dying committee  I understand there's some variation. I'd refer you again to the Council of Canadian Academies' study, because I believe there is a useful summary there that compares the jurisdictions. I understand there is variation, and in particular in some jurisdictions it may not be as specific as the British Columbia statute you mentioned.

Medical Assistance in Dying committee  If Parliament wanted to allow MAID for mature minors, then—

Medical Assistance in Dying committee  —it may need to address what is meant by a “mature minor”. It could do that in relation to provincial legislation or it may need to set out a specific term. It really depends on what the objective of Parliament is in doing that.

Medical Assistance in Dying committee  If there's 10 seconds, Madam Chair, I would like to add to this.

Medical Assistance in Dying committee  When Bill C-7 was passed, the safeguards related to a death that was not reasonably foreseeable included a safeguard that required the person to be offered consultations with various professionals, including disability support services. That was part of, as I understand it, responding to concerns that were expressed by the disability community.

Medical Assistance in Dying committee  Thank you, Madam Chair. What I might offer is to recall what the criminal law does: It exempts the practitioner who administers MAID from criminal responsibility. The criminal law would need to provide a level of certainty and a level of specificity to understand, for the practitioner's purpose, when they are able to proceed.

Medical Assistance in Dying committee  At a very high level, what I would offer you is that the provisions of the code are designed so that they're sort of condition-agnostic, so to speak; they don't focus on particular medical disorders or one disease or the other. As part of the safeguard regimes, for example, Bill C-7 added that a person be offered consultations and has given serious consideration to other means of alleviating suffering.

Medical Assistance in Dying committee  I might begin by just saying that one significant difference between, say, Belgium and the Netherlands and Canada in terms of our MAID frameworks is that Belgium and the Netherlands have a criterion that effectively requires the other treatments or alternative means of alleviating the suffering to have been tried and failed, whereas in the Canadian MAID legal framework it's for the individual, the person seeking MAID, to determine whether any particular treatment is acceptable to them, or not, as a means of alleviating suffering.

Medical Assistance in Dying committee  I might answer very briefly on the first question. I would just note that advance directives and MAID are very different things, and that advance directives as they currently exist are for refusal of care, which people have always had a right to do, whereas MAID legally is an act that requires a criminal exemption because it actively ends a person's life.

Medical Assistance in Dying committee  I can perhaps start with a response to the senator's question. The scope of a federal regime for advance requests, if that's the will of Parliament, is one issue that this committee should certainly consider. Some of the features, as I mentioned earlier, are if it is desirable for Parliament or if there is interest in putting in frameworks on both of the points in time I mentioned.

Medical Assistance in Dying committee  As I mentioned—

Medical Assistance in Dying committee  —for health law, very quickly, provinces, as a matter of regulating their health professionals, could impose requirements about how they are to do the assessment of a patient, for instance, over and above what the criminal law safeguards do. Recall that the criminal law safeguards effectively set a standard minimum floor across the country because a provider can only offer MAID and be exempt from criminal liability if they comply with all the federal requirements, but a province or a regulatory body, as a matter of health law or health practice, could impose additional and more specific requirements that exceed the criminal law, if that was their intent.