Speaking to MPs, civil servants and others at the packed Parliamentary Restaurant Feb. 23, Jocelyn Downie said doctors “have an obligation to ensure access” to assisted death.

Downie is one of the foremost proponents of physician-assisted death in Canada.  The debate is no longer about whether to allow assisted death, she said. “That ship has sailed.”

Suggesting that trying to exclude minors and the mentally ill from access to assisted death would likely fail a Charter challenge on equality grounds, she proposed several contentious issues that must be addressed. These include: assisted death for competent minors; advanced directives to allow someone to authorize their future death for a time when they are no longer competent; and whether assisted death should be available for the mentally ill.

She also said there needs to be debate over whether only physicians will carry out assisted death, or whether other health professionals may do so under a doctor’s supervision.

She called for collaboration across party lines, and across federal and provincial jurisdictional lines.

 Responding to a question about the advisability of investing in assisted death at a time when palliative care is unavailable to 60 per cent of the population, Downie said good palliative care is necessary. But she added that the field is changing as pioneer palliative care physicians “who were heavily influenced by religion” give way to younger physicians who are not.

More and more people who work in palliative care are coming to support assisted-death as part of palliative care, she believes, probably because “they no longer feel it is unsafe to do so.” She cited polls showing 70 to 80 per cent of Canadians support assisted death.