Presentation in Ethics and Law course. Fairleigh-Dickinson 2022. Medical Assistance in Dying

1. A S S I S T E D - D E AT H : A
R E C E N T PA R A D I G M
B Y C A N A D I A N
G O V E R N M E N T
Fairleigh Dickinson University
MADS 6644_V2 – Law, Ethics and Policy
Health Services
Professor Louai Rahal
Students: Barbara B. Magalhaes
Navpreet Kaur
Matias Michalewicz
Anveet Singh

2. A G L I M P S E …
• “On his last day, Dad was ready. He was in his
own suite, in his favorite recliner, surrounded by
those who loved him, not alone in a hospital bed.
While an acoustic guitar played softly in the
background, we lit candles and set up
photographs of deceased family members who
were waiting on the other side. Dad was a
strong, stable, independent man always in
control of his life and now ultimately, in control of
his death”.

3. T O Y O U R
R E F L E C T I O N …
Do you think it is
legitimate for an
individual to decide
to die?
This Photo by Unknown Author is licensed under CC BY

4. I N J U N E 2 0 1 5 , T H E C A N A D I A N P A R L I A M E N T
P A S S E D F E D E R A L L E G I S L A T I O N T H A T W O U L D
A L L O W E L I G I B L E C A N A D I A N A D U L T S T O
R E Q U E S T A S S I S T A N C E I N D Y I N G , A N D I N 2 0 2 1
A D D I T I O N A L A M E N D S W E R E E A S I N G T H E
P R O C E S S O F E L I G I B I L I T Y A N D P R O C E D U R A L
S A F E G U A R D S F O R T H I S P R O G R A M .

5. C A R T E R V
C A N A D A – A N
E M B L E M AT I C
B AT T L E
• Carter v Canada has
established a new paradigm
regarding “assisting in dying”
cases, where concepts such as
“life,” “death,” and “health”
have been put under the light
for further reflection and their
relevance to the infringement of
chapter 7 of the Canadian
Charter of Rights and
Freedom, as the Criminal
Code.

6. W H O I S C A R T E R ?
• T. was diagnosed with a fatal
neurodegenerative disease in
2009. For that matter, she
appealed to the Supreme
Court of Canada to request
that permission for assisting in
dying would be adjudicated on
her behalf. Supporting T. were
C. and J., who have assisted
C’s mother in her care when
diagnosed with a fatal
neurodegenerative disease,
and a physician that agreed to
assist T. in dying if the
procedure was no longer
legally prohibited in Canada
(Canada, SCC case
information - search 2012).

7. W H Y W A S T H I S C A S E A M A R K I N T I M E ?
• Before February 6th, 2015, the concept of assisting in dying would infringe
on the three pillars of the constitutional right to life, and Carter had
challenged all of them:
• Chapter 7 of the Canadian Charter of Rights and Freedom:
• “the right to life, liberty, and security of the person, and the right not to be
deprived thereof except in accordance with the principles of the fundamental
justice.” (The Constitution Act, 1982, schedule B to the Canada Act 1982 (UK),
1982, C 11: Federal Statutes / Lois Fédérales 2015)

8. W H Y W A S T H I S C A S E A M A R K I N T I M E ?
• Before February 6th, 2015, the concept of assisting in dying would infringe
on the three pillars of the constitutional right to life, and Carter had
challenged all of them:
• Criminal Code of Canada ss. 14:
• “No person is entitled to consent to have death inflicted on them, and such
consent does not affect the criminal responsibility of any person who inflicts
death on the person who gave consent,”

9. W H Y W A S T H I S C A S E A M A R K I N T I M E ?
• Before February 6th, 2015, the concept of assisting in dying would infringe
on the three pillars of the constitutional right to life, and Carter had
challenged all of them:
• Criminal Code of Canada s. 214(1):
• “Everyone is guilty of an indictable offense and liable to imprisonment for a term
of not more than 14 years who, whether suicide ensues or not, counsels a
person to die by suicide or abets a person in dying by suicide; or aids a person
to die by suicide (Criminal code, RSC 1985, C C-46: Federal statutes / Lois
Fédérales 1985)

10. S U P R E M E C O U R T ’ S D E C I S I O N
• The Supreme Court adjudicated in favor of Carter, claiming that
the prohibition of assisted death violated section 7 of the Canadian
Charter of Rights and Freedoms. A competent and oriented adult
who has been suffering from irremediable medical degenerative
disease would not be justifiable under section 1 of the same
document, being unconstitutional to prevent a person from seeking
assistance to terminate life (Canada, SCC case information –
search, 2012).

11. C O N S I D E R A T I O N S …
Carter v Canada established case law for all the cases
that would come after its decision
Let’s reflect and discuss Gillian-Bennett’s decision to
die:https://www.youtube.com/watch?v=rmD1Vx8f3Ik
Gillian-Bennett’s case was in 2012, prior to the
Supreme Court’s decision adjudicating in favor of
Assisted-Death.
Since the Supreme Court’s decision, a program has
been provided by the Canadian Government to assess
and assist individuals that have terminal diseases and
do not wish to have palliative care.

12. M A I D
MAID stands for Medical
Assistance in Dying and it
was the Government’s
response to regulate,
assess and provide such
service.
Regulations are strict
regarding the eligibility to be
accepted into the program.
Undergo medical
assessments.
Your request for MAID must
be assessed by two
independent practitioners.
Your physician or nurse
practitioner must make sure
that you are eligible to
receive medical assistance
in dying according to all of
the listed criteria.
The physician or nurse
practitioner providing the
original assessment and the
one giving the second
opinion must be
independent.
Submit a signed written
request for MAID.
(Medical assistance in
dying, 2022).

13. R E C O M M E N D AT I O N S T O H E A LT H C A R E
P R O V I D E R S
A more humane, empathetic, and unbiased approach is recommended to
physicians and general health care providers
A thorough assessment of medical conditions and minutious scrutiny by the
professionals involved in the diagnosis.
Mental health programs and support for the families are required not only for
the process of assisted death but also to cope with the difficulties in managing
a loved one with a terminal disease.

14. L A S T N O T E S A N D T H O U G H T S …
But to only be awake physiologically is
a shallow concept. To be alive is a
broader concept that includes
philosophical considerations, such as
“give your own meaning to life,”
acknowledging the fact that human
consciousness, expectations, and
desires are part of the whole concept of
being “alive” that only a “thinking” being
would be able to conceive.
A person that would be deprived of life
should have the autonomy to choose
whether it is worth completing the
natural cycle of being alive or
terminating the enduring endeavor of
pain, mental absence, and seeking
assistance in shortening the process.

15. R E F E R E N C E S
• Canada, S. C. of. (2012, December 3). SCC case information - search. Supreme Court of
Canada. Retrieved June 26, 2022, from https://scc-csc.lexum.com/scc-csc/scc-
csc/en/item/1054/index.do
• Criminal code, RSC 1985, C C-46: Federal statutes / Lois Fédérales. Criminal Code, RSC
1985, c C-46 | Federal Statutes / Lois fédérales. (1985). Retrieved June 26, 2022, from
https://qweri.lexum.com/w/calegis/rsc-1985-c-c-46-
en#!fragment/sec14/BQCwhgziBcwMYgK4DsDWszIQewE4BUBTADwBdoJC4BGAFgEoAaZ
bUwiARUUNwE9oA5AMaUwuBFx78hIwmIQBlPKQBC-
AEoBRADKaAagEEAcgGFNjUmABG0Utjj16QA
• The Constitution Act, 1982, schedule B to the Canada Act 1982 (UK), 1982, C 11: Federal
Statutes / Lois Fédérales. The Constitution Act, 1982, Schedule B to the Canada Act 1982
(UK), 1982, c 11 | Federal Statutes / Lois fédérales. (2015). Retrieved June 26, 2022, from
https://qweri.lexum.com/w/calegis/schedule-b-to-the-canada-act-1982-uk-1982-c-11-
en#!fragment/sec7/BQCwhgziBcwMYgK4DsDWszIQewE4BUBTADwBdoJC4B2ASgBpltTCIB
FRQ3AT2gHI+9SmFwIOXXgKGERCAMp5SAIV4AlAKIAZdQDUAggDkAwuvqkwAI2ilscWrSA
• Medical assistance in dying. Fraser Health. (n.d.). Retrieved June 26, 2022, from
https://www.fraserhealth.ca/health-topics-a-to-z/end-of-life-care/medical-assistance-in-
dying#.YrjmFezMLvU