The national conversation about assisted dying isn't over yet and is worth having, writes John Milloy. Graphic by David Chen

Comment: debate over assisted dying isn’t over yet

By  John Milloy
  • January 26, 2017

Are there circumstances where assisted suicide should be among the range of options available to someone dealing with serious mental health issues? Should we routinely euthanize people with diseases like Alzheimer’s based upon their advance wishes? Are there times when mature kids and teenagers should be able to get a doctor’s help to die?

No, this is the not the plot of Margaret Atwood’s next dystopian novel. These are actual questions currently under review by the federal government.

Many Canadians probably breathed a sigh of relief when the assisted dying legislation was passed last June and figured the debate was over. Although many might have preferred that Canada not go down this road, the new law is relatively narrow. The procedure is only available to those whose natural death is “reasonably foreseeable,” are 18 or older, have fully consented and are aware of their right to withdraw the request at any time.

Those who followed the debate will remember many wanted the law to go further. Citing the primacy of personal rights, they argued that the state had no place preventing a suffering person from seeking medical assistance to kill themselves, even if they weren’t dying.

Canada’s Senate unsuccessfully tried to amend the bill to allow anyone facing intolerable suffering to access the procedure, regardless of whether the person’s death was imminent. The majority of members on the parliamentary committee that studied the matter held a similar view. They called for a much broader piece of legislation that would not simply apply to those on their deathbed but to anyone with “grievous and irremediable medical conditions,” including those with severe psychological suffering.

The committee also recommended the use of advance directives. This would allow people diagnosed with a condition that would likely lead to a “loss of competence” to ask for assisted dying in the future once certain criteria are met. In other words, someone with early stage Alzheimer’s could ask to be euthanized at the point when they no longer recognize family.

The final legislation contained a typical Canadian compromise. Under its terms, within six months the government would begin a review of three key issues: requests by mature minors, requests by persons whose only medical condition is mental illness and advance directives.

Just barely meeting the deadline, the government announced on Dec. 13 that it had asked the Council of Canadian Academies (CCA) to look at the issue. The CCA, an arm’s-length academic organization that performs independent expert assessments of public policy issues, agreed to establish expert panels and report back to government within two years.

Although just before Christmas, I still expected to see screaming headlines of this news, pithy columns and television panels kick-starting a national debate on whether we should expand our assisted dying law. With the exception of a handful of brief news stories, we heard nothing.

Surprisingly, the CCA was not asked to come up with recommendations but merely report their findings. These findings, according to the government, will provide the basis for “an informed, evidence-based dialogue among Canadians and between Canadians and decision makers.” At that point, we can have our national debate.

I disagree. Although I recognize the importance of hearing from experts and understanding the experience of other jurisdictions, no amount of research is going to unearth the final answer to these questions. Ultimately, they are about the values that we collectively hold as a society and reflect an ongoing tension that exists within Canada.

Yes, suicide is legal, but it is also seen as a great tragedy. We allow physician-assisted suicide in some circumstances while, in other cases, empower our law enforcement officers and medical community to physically prevent people from taking their own lives. As a society we need to determine where the line should be drawn, and no academic research is going to provide that answer.

As a former politician, I understand the temptation of punting a controversial matter to a panel of experts and hoping no one notices. But we need to begin the discussion now to ensure a robust and informed debate when the CCA finally reports. On a more practical level, it appears highly likely that court decisions may speed the need to consider these questions.

So let’s start the discussion. Although these are heavy, complex and emotional matters, at their core is the question of the type of society that we want. That is a national conversation worth having.

(Milloy is co-director of the Centre for Public Ethics and Assistant Professor of Public Ethics at Waterloo Lutheran Seminary. Originally published on

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