Suicide had been a crime in Canada since its colonization. It was also considered immoral and sinful in many religions. In 2016 the Supreme Court of Canada (SCC) decided it could no longer be a crime. Legislation soon followed making it legal under certain conditions, now known as Medical Assistance in Dying (MAID). Our blog has written extensively in the past on this subject. What follows is an update on some of the ongoing legal developments occurring across Canada.
We know that there are doctors opposed to having any involvement with MAID. Their numbers are not known. However, McGill University recently published a national survey of 1,200 graduating physicians on their willingness to perform MAID. The result was that overall, 71% of the respondents would be open to providing MAID. The graduates from the province of Quebec were the most supportive at 85%, and those from Alberta were the least supportive at 63%. Religious belief was the main reason cited for non-support amongst the respondents.
Jean Truchon and Nicole Gladu are asking the Quebec Superior Court to rule that the federal and provincial MAID requirements are too restrictive and constitutionally invalid. Nicole had polio as a child and has since developed post-polio syndrome. She suffers from a lack of mobility and function due to her deteriorating muscles and relies on an electric wheelchair. Jean has cerebral palsy and has lost the use of all of his limbs. Although these conditions will progressively worsen, it is not a certainty that their lives will end soon naturally. They both wish to end their lives through MAID, with Gladu stating that for her, living is mere existence, and not a life with real quality or meaning. Both Gladu and Truchon have undergone evaluations which concluded that they are competent and do not suffer from any condition that would affect or impair their judgement.
To be considered eligible for access to MAID at the federal level, the applicant's natural death is imminent and foreseeable. The provincial legislation in Quebec goes a step further, requiring that the applicant is at the end of their life. The thrust of their argument is that the SCC, in their Carter decision, gave the right to MAID for all patients with a grievous and irremediable medical condition. There was no additional requirement imposed that the person must also be close to death or that their death was foreseeable. These requirements in the legislation are subjective and dependent on the assessment of doctors and not the patients. The counterargument is that these provisions protect the vulnerable patient who although seriously ill, is not close to death. The results of Gladu and Truchon's federal challenge would apply nationally, subject to appeal.
There is also an ongoing debate and study on the following issues:
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In recent weeks, the CPSO has placed restrictions on the certificates of practice of certain physicians, banning them from providing medical exemptions in relation to COVID-19 vaccinations, mandatory mask requirements and testing for COVID-19.
On October 27, 2021, the CPSO suspended one physician from practice entirely related to such activity.
How is the CPSO able to take such action?
As of July 1, 2021, all Ontario long-term care homes must implement COVID-19 immunization policies for their staff, students, and volunteers — regardless of the frequency or duration of these individuals’ attendance in a home. Current staff, students, and volunteers will have until July 31, 2021 to meet the policy requirements, subject to reasonable extension for unforeseen circumstances. Newly hired individuals will have 30 days from the first day they begin attending at the home.
It is no surprise that the COVID-19 pandemic continues to affect the delivery of health services and the regulation of various health professions.
In a welcomed move, the College of Physicians and Surgeons of Ontario (CPSO) Council recently approved a new registration policy allowing the Registration Committee to issue a Certificate of Registration authorizing Independent Practice to applicants who have not completed Part II of the Medical Council of Canada Qualifying Examination (MCCQE).