Physician assisted dying should be publicly funded: advisory group

Expert advisory group releases report in wake of Supreme Court decision

TORONTO — The practice of physician-assisted dying should be publicly funded by Canadian provinces, should be available regardless of age and should not put doctors at risk of criminal prosecution, an expert advisory group on the issue said Monday.

The recommendations were among 43 made in the final report from the panel, which had input from 10 of the country’s 13 provinces and territories.
While the recommendations are not binding, they are expected to be influential as Canada prepares to act on a Supreme Court ruling that made the practice legal across the country.

Last February, the nation’s highest court overturned a previous ruling and recognized the right of clearly consenting adults who are enduring intolerable physical or mental suffering to end their lives with a physician’s help. It also gave Parliament a year to craft a set of laws to govern assisted suicide.

Monday’s report focused on the role to be played by provincial governments, which are largely responsible for health-care funding in Canada.
The group advised that physician-assisted dying should be publicly funded by those governments and not subject to exclusions for inter-provincial reciprocal billing, though only patients who qualify for public coverage would be eligible.

The group also offered a definition for the term “grievous and irremediable” condition, the phrase cited by the Supreme Court to describe those who should have recourse to doctor-assisted death.

The report defined the term as “a very severe or serious illness, disease or disability that cannot be alleviated by any means acceptable to the patient” and further specified that those conditions could describe patients of any age.

“Access to physician-assisted dying should not be impeded by the imposition of arbitrary age limits,” the report said. “Provinces and territories should recommend that the federal government make it clear in its changes to the Criminal Code that eligibility for physician-assisted dying is to be based on competence rather than age.”

The issue of competence was also addressed in the report. The group recommended that competency be established using existing health-care guidelines, but said two doctors must sign off on any given file.

Telemedicine services such as videoconferencing should be used in cases where access to doctors is scarce.

Other suggested changes to the Criminal Code include protections for doctors who choose to offer their services to those wishing to end their lives.

Physicians who object to the practice and choose not to provide the service would be obliged to inform their patients of all their options and transfer their care to a doctor who is willing to participate, according to the recommendations.

The provincial group’s findings come a day before a similar report is expected to be issued by a panel advising the federal government.

The former Conservative govermnent indicated that an extension would be necessary to bring the practice into law. The new Liberal government has not formally made the request, but Justice Minister Jody Wilson-Raybould has acknowledged that such a request is possible.

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