432-00647 (Justice)

On March 17, 2021, Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), received Royal Assent. Bill C-7 responds to the September 2019 Superior Court of Quebec ruling in Truchon,which struck down the eligibility criterion of “reasonably foreseeable natural death” from the Criminal Code medical assistance in dying regime.

Bill C-7 amended the Criminal Code to ensure consistency of the medical assistance in dying law across the country. The reasonably foreseeable natural death criterion no longer applies as an eligibility criterion that could exclude persons from obtaining medical assistance in dying, but is instead used to determine which of two different sets of safeguards applies to a particular medical assistance in dying request.

The first set of safeguards applies to persons whose natural death is reasonably foreseeable, where risks are reduced given the overall proximity of death and the fact that their suffering is most likely linked to the dying process itself. The removal of the requirement of a second independent witness and the repeal of the 10-day reflection period responds to the concerns raised by healthcare professionals and other stakeholders to the effect that: finding two independent witnesses is a challenge for many patients and poses an access barrier to medical assistance in dying; and, the 10-day reflection period prolongs patient suffering unduly, as persons who request medical assistance in dying do so after careful consideration.

The second set of safeguards reflects the more serious consequences of error for persons who request medical assistance in dying and whose death is not reasonably foreseeable. It recognizes the diverse sources of suffering and vulnerability that could potentially lead a person whose death is not reasonably foreseeable to request medical assistance in dying. The new safeguards for this group include a minimum 90-day assessment period, a requirement that an expert be consulted if neither of the two practitioners assessing eligibility has the required expertise, and clarifications related to informed consent.

The Bill C-7 amendments were informed by consultations with Canadians, the provinces and territories, Indigenous groups, key stakeholders, experts, and practitioners. They support greater autonomy and freedom of choice for eligible persons, and provides appropriate safeguards to protect those who may be vulnerable.