In the midst of a whirlwind coast-to-coast tour to consult Canadians about medical assistance in dying, federal Justice Minister David Lametti interrupted his Vancouver breakfast Friday.
Under pressure of a March 11 deadline set by the Quebec Superior Court, Lametti hopes to quickly craft amendments he can put to parliament that will make the still-controversial law, often called MAID, constitutionally compliant.
“We’ve all been touched by it,” he confided, setting down his coffee. “I’ll tell you my story if you want to hear it.”
As with so many individuals and families, Lametti has personally confronted an excruciating life-and-death decision involving a loved one.
“In 2016, when we were passing the original legislation, I watched my mother die of a rather negative form of dementia, and it wasn’t easy,” he explained.
“I knew, I had spoken to her (about medical assistance in dying) 10 years before. She was a devout Catholic, and I knew what her beliefs were. So I never would have considered assisted dying for her.”
The 57-year-old former McGill law professor, more comfortable quoting legal precedent than an example from his own life, continued:
“My brothers and I were well aware of what her feelings were. That being said, we did at a certain point have to make a decision that she not undergo further treatment — which is in a sense a delegated decision, although fully within her belief structure, within the church’s belief structure, and within the medical structure.”
Lametti said Canadians have long accepted such delegated decisions when a life was at stake.
“This MAID provides another way for people to chose in an autonomous fashion how they wish to end their life given certain conditions, and usually under very tragic circumstances or sad circumstances or personal circumstances. And it allows for people to do it in a positive, oftentimes spiritual, oftentimes uplifting way.”
Still, in September, the Quebec court said the federal law was too restrictive — allowing MAID only to those facing “reasonably foreseeable” or, depending on your vocabulary, “imminent” death.
Ottawa decided not to appeal the ruling, but was hampered in responding because the decision came down as the federal election campaign started. Now, time is running out.
“We’re consulting experts, MAID providers, we’re consulting persons who feel vulnerable because of the legislation, some people with disabilities,” Lametti said.
“While we’re doing it, we’re trying to touch base with Canadians on a couple of specific issues around advance requests, which we know some Canadians are interested in. … Would people allow for someone who had been evaluated and approved to benefit from MAID even after they have lost consciousness or capacity?
“And then another advance request from someone who had been diagnosed with a well-known progressive disease, so Alzheimer’s, if you get the diagnosis and say, ‘Look, when I reach this stage, I would like the benefit of MAID.’ We’ll see … if there is consensus among Canadians.”
As well as the consultation process under way, the government has posted an online questionnaire.
The MP for the Montreal riding of Lasalle-Émard-Verdun, Lametti said more than 150,000 have responded already.
He pointed out the review was also a bit of an advance scout because the original 2016 MAID legislation contained within it a five-year evaluation process that will begin in June.
Lametti said it will “deal with the really tough issues — mature minors, mental disability and advance requests more generally.”
But he did not think the law itself was under threat:
“The experience that we’ve heard now from caregivers across Canada, from families who have had a loved one benefit from MAID has been I think relatively positive. I think maybe even overwhelmingly positive. … And I think there is a large acceptance of the practice amongst practitioners, amongst people who are facing, in particular, terminal illness. So I think the practice is here to stay and the question is how much farther do we push the boundaries.”
Still, he acknowledged there were passionate critics of MAID, especially among some faiths.
“I hope we don’t reach the same kind of polemics that we do with a question like abortion,” the justice minister said. “But there are a number of legitimate concerns that are raised by people who worry, people living with disabilities, for example, feel vulnerable, and legitimately feel vulnerable. They see themselves as being susceptible to being influenced by others who say, ‘Well, you know, you’d be better off dead.’”
This is about individual autonomy, he insisted.
“But we also, as a government, have to be sensitive, as a society we have to be sensitive, to what one might call quality-of-life issues. We need to make sure the quality and value of care is as best as it can be for people who choose not to have assisted dying but to end their days following a more natural progression,” Lametti said.
“Same is true for other life issues, people living with disabilities or people living with other forms of suffering who want to live and — whether it’s because they want to see their kids grow up, or whether it’s because they want to share more time with loved ones, or they have other things they want to accomplish in life — we need to make sure people can live fulfilling and productive lives even with the suffering they are going through.”