Feds acknowledge Senate debate, but near-death proviso non-negotiable: ministers

The Trudeau government has said thanks but no thanks to a proposed Senate amendment that would make it easier for Canadians to get medical help to end their lives.

Health Minister Jane Philpott and Justice Minister Jody Wilson−Raybould announced Thursday that the government will accept most of the seven amendments the Senate approved to their controversial assisted−death bill, known as C−14.

As expected, however, they stood firm on the legislation’s central pillar: that only those who are near death should qualify for medical assistance in dying.

The Senate scrapped that requirement during two weeks of lengthy debate in the upper house before passing the amended bill late Wednesday by a vote of 64−12, with one abstention.

"(Philpott) and I are confident that the original language in Bill C−14 strikes the necessary and appropriate balance ... in balancing personal autonomy and eligibility for medical assistance in dying with the necessary and fundamental protections that need to be in place to protect vulnerable people," Wilson−Raybould said.

A government motion accepting some of the Senate’s more minor amendments but rejecting the primary change must now be debated and voted upon in the Commons before the bill returns again to the upper chamber.

The government is hoping senators will back down on their insistence that the near−death proviso must be deleted in order to comply with the charter of rights and with last year’s landmark Supreme Court ruling, which struck down the ban on assisted dying.

Canada has been without a criminal law governing assisted dying since June 6, when the court’s ruling went into effect, and Philpott said many doctors are reluctant to provide medical assistance in dying in the midst of legal uncertainty.

"We realize that the Senate is aware of that as well," she said. "We hope that they will recognize that it’s important that we get the legislation in place."

Prime Minister Justin Trudeau appears to be counting on senators to eventually back down on the issue. Liberal backbenchers privately say Trudeau told MPs during their weekly, closed−door caucus meeting Wednesday that it would be "appropriate" for appointed senators to defer to the will of the elected House of Commons on the matter and he seemed confident they would do so.

Senators could agree to pass the next version of the bill unchanged. Or they could "insist" upon their amendment and send it back to the Commons, repeatedly if necessary, until one side or the other gives in. Or they could defeat the bill outright.

Even before Wednesday’s vote, senators were anticipating that the government would reject their major amendment and were wrestling with whether they should stand firm on deleting the near−death provision or bow to the will of the elected parliamentary chamber.

Independent Liberal Sen. Serge Joyal, author of the amendment to delete the near−death proviso, cited several examples where the Senate has in the past defied the will of the Commons on a matter of principle. He argued that the Senate has a duty to uphold the Constitution and charter of rights and to protect minority rights.

Joyal’s amendment would replace C−14’s restrictive eligibility criteria with the more permissive parameters set down by the top court, which directed that medical assistance in dying should be available to clearly consenting, competent adults with "grievous and irremediable" medical conditions that are causing enduring suffering that they find intolerable.

C−14 would allow assisted dying only for consenting adults "in an advanced stage of irreversible decline" from a serious and “incurable” disease, illness or disability and for whom natural death is “reasonably foreseeable.”

While the government is refusing to change that eligibility criteria, it has accepted other Senate amendments, some of them just minor technical changes.

Among other things, the other amendments would put a two−year deadline on the government’s promise to study whether to extend the right to assisted dying to mature minors and people suffering solely from mental illnesses, and whether to allow people with competence−eroding conditions like dementia to make advance requests for an assisted death.