For people living with MS, the journey from diagnosis to end-of-life may range from a nearly normal life expectancy with death from natural causes, cancer, or heart disease to a more progressive disease course with severe disability and debilitating symptoms. Medical assistance in dying is a topic that has had much coverage and debate in Canada and abroad.
The MS Society respects and values the autonomy of all persons with MS in making decisions that affect the quality and outcome of their lives. That includes the choice to live a full and rich life in dignity in a place of one’s choosing with adequate and appropriate supports, surrounded by loved ones, as well as the choice to die with dignity through palliative care, end of life care, and MAID.
In February 2015, the Supreme Court of Canada ruled in Carter v. Canada that some sections of the Criminal Code would need to change to comply with the Canadian Charter of Rights and Freedoms. Specifically, sections which prohibit medical assistance in dying under certain conditions would no longer be valid. The Supreme Court gave the government until June 6, 2016, to create a new law. In response, the federal government introduced legislation that allows eligible adults to request medical assistance in dying. Bill C-14, legislation on medical assistance in dying, received royal assent on June 17, 2016. At that time, the MS Society commented that it lacked clarity and was limiting for some people living with MS to access, as the eligibility precluded those whose death was not ‘reasonably foreseeable’.
On March 17, 2021, Bill C-7 was passed, replacing the former Bill C-14, expanding the eligibility of MAID to include individuals for whom natural death is not reasonably foreseeable. Procedural safeguards have been put in place for this expanded eligibility including a 90-day assessment period before receiving MAID. While the limitations have been removed from Bill C-7, we have serious concerns about the safeguards put into place for the expanded eligibility which has the potential for societal conditions such as extreme poverty or lack of access to treatments to confound medical conditions that could be prevented or improved if the societal conditions did not present a significant barrier. In 2023, Bill C-7 will continue to expand to include mental illness as a sole underlying condition, and mature minors given the ongoing mental health crisis in Canada. The MS Society has concerns about the expansion, especially considering the impact the pandemic has had on all aspects of the MS community and beyond.
The MS Society has called upon the government to 1) diligently re-examine the current safeguards using a post-pandemic lens, 2) pause continued expansion of Bill C-7 until the safeguards have been re-examined and access to mental health services is not a barrier, 3) collect and report data related to the use of MAID across Canada in a timely and transparent manner, and 4) improve access to palliative and other end of life care that is accessible, timely, and quality.
For additional information about MAID please visit Medical assistance in dying on the Government of Canada website.