Should the ‘right to die’include advance consent, minors and the mentally ill?

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Canadians are walking into new territory on the right to die, commencing a debate over whether Parliament should allow minors and the mentally ill to end their lives with the help of a doctor.

Just days before breaking for the holidays, the Liberal government received three expert panel reports from the Council of Canadian Academies which looked at the possibility of extending medical assistance in dying (MAID) to ‘mature’ minors — people under age 18 considered by doctors to be capable of directing their own care — people with psychiatric conditions and those making requests in advance.

The reports don’t offer specific recommendations, but are intended to guide discussion around potential legislative changes.

Shanaaz Gokool, chief executive officer of the advocacy group Dying With Dignity, said the restrictive law passed by Parliament two years ago has led to unnecessary suffering, forcing people to end their lives before they’re ready to go.

She said it’s time for the government to ease the rules, especially those around personal consent.

Right now, someone who already has been assessed and approved for MAID must give consent a second time right before undergoing the life-ending procedure. Some Canadians, like Audrey Parker of Halifax, have decided to end their lives early because they fear losing the capacity to consent — a situation Gokool describes as “a bit perverse.”

“The tragic irony is that the law should allow for people to live the longest they can, the best quality of life they can,” she said.

Parker drew national attention to the issue of advance consent, raising public awareness in the final weeks of her life. Breast cancer had spread through her bones and to her brain, and she feared she would lose the cognitive capacity required to carry out her medically assisted death when the time came.

Audrey Parker, 57, ended her life earlier than she wanted to because of restrictions under Canada’s medical assistance in dying laws. (Kayla Hounsell/CBC)

When she died, she left federal lawmakers with a plea to drop the requirement that someone approved for a medically assisted death must be conscious and mentally sound in order to give final consent.

Parliament passed landmark federal legislation allowing Canadian adults to request medical assistance in dying in June 2016, following a Supreme Court of Canada ruling that struck down the longstanding ban as unconstitutional.

‘Grave tragedy’ to expand access

The law was criticized by some who argued it’s too restrictive. Applicants must be at least 18 years old and mentally competent, and natural death must be “reasonably foreseeable.”

Critics, including many religious groups, opposed the law because they believe it diminishes the sanctity of life.

The Conference of Catholic Bishops said the church is against all forms of assisted death and suicide, calling it “contrary to the most profound natural inclination of each human being to live and preserve life. ”

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