Ottawa must reconsider assisted dying for dementia patients: advocates

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OTTAWA — Now is the time to call on Ottawa to ensure that people with disorders such as Alzheimer's and dementia are able to seek medical help if they die before they experience cognitive decline, the CEO of an influential group says.

Helen Long, executive director of Dying With Dignity Canada, says society strongly supports allowing people with neurocognitive disorders to seek help before the illness takes away their ability to consent.

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“I think a lot of people have family experience with one of these diseases,” he said in a recent interview.

“So it's easy for them to see themselves.”

The push for greater access to such patients follows months of debate after Ottawa decided to delay extending eligibility only to those suffering from mental illness.

The government took a three-year hiatus after several provinces told the federal health minister their systems weren't ready to implement the policy.

Long's organization, along with other advocates, believes that those suffering from intolerable mental illness should have the same right to the same procedure as someone suffering from a debilitating physical condition.

“Given what's happened with mental health delays, I think it's time for us to focus on expanded requests,” Long said.

“You know, mental disorders are still something we feel strongly about.”

The group commissioned an Ipsos poll in which they found that 83 per cent of Canadians polled supported pre-trial detention for people with “severe” conditions that would eventually lead to loss of decision-making capacity.

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The poll polled 2,000 Canadians in March and has no margin of error.

A special joint committee of senators and MPs has recommended that Ottawa move forward with allowing requests before cognitive decline to consider expanding access to assisted dying, Long noted.

For this, it is necessary to amend the criminal legislation.

Quebec passed a law last year that would allow people in the early stages of serious degenerative diseases like Alzheimer's disease to request assisted death and have the procedure performed when their condition worsens.

The province has said a change to the Criminal Code is still needed to prevent doctors from committing crimes, but Ottawa has yet to grant its request for an amendment.

“I'm hopeful that there are enough parts that there might be political will to change course in that direction,” Long said.

The Alzheimer Society of Canada has said that those living with dementia deserve equal access to assisted dying and should be able to make advance requests after diagnosis and future care plans.

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The federal government introduced its first assisted dying law in 2016 after the Supreme Court of Canada ruled last year that adults with “severe and irreversible medical conditions” have the right to assisted dying.

About three years later, a Quebec court ruled that it was unconstitutional to require a person to foresee his or her death in order to qualify for assisted dying.

In 2021, the Liberals updated the law to reflect the lower court ruling.

Parliament then passed a Senate amendment to remove the restriction on people whose only underlying condition is mental illness.

The government legislated a two-year period for systems and practitioners to be ready, then added a one-year extension in early 2023.

But that's not long enough, critics testified before a special meeting last fall because key questions about the eligibility expansion remain unanswered.

For example, how do practitioners assess whether a person has suicidal thoughts, determine whether they are likely to recover, or whether they are inaccessible to treatment due to circumstances such as poverty?

The Canadian Mental Health Association and others have warned that those suffering from mental illness first need better access to support, and disability advocates have raised fears about how this could put vulnerable people at risk.

Federal Health Minister Mark Holland ultimately proposed the extension to at least March 2027.

But he said the government still believes that mental suffering is equal to physical suffering.

The leader of the opposition Conservatives, Pierre Polievre, has vowed to scrap the expansion altogether if he wins the next election.

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