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Advance requests for assisted death nixed

OTTAWA—The Senate has rejected a proposal to allow individuals who are diagnosed with competence-eroding conditions like dementia to make advance requests for medical help to end their lives.

By a vote of 47-23, with two abstentions, senators late yesterday rejected an amendment that would have added the right to make advance directives to the federal government’s proposed new law on assisted dying.

The amendment, proposed by the Senate’s independent Liberal leader, James Cowan, would have allowed individuals to spell out the circumstances in which they would want an assisted death at some future time when they’re no longer competent or able to communicate their wishes.

Cowan’s proposal was a step too far for many senators, who already are on a collision course with the government over their decision last week to knock out the central pillar underpinning Bill C-14: the proviso that medical assistance in dying be available only to suffering Canadians who are near death.

“We are risking, with a plethora of amendments, losing credibility in the [House of Commons],” Conservative Sen. Dennis Patterson warned during prolonged debate on advance requests.

“Let us venture onto this new ground with caution, and with full knowledge of all the implications and nuances of such a complex issue as advance directives,” he added.

“This amendment, I say with respect, will rush to a conclusion on a very complex issue.”

C-14 does not include a provision for advance directives but it commits the government to launch a study into that issue within six months.

The Senate was expected to consider another amendment today which would put an end date on the study—guaranteeing it would not simply drag on without resolution for years.

While the Supreme Court did not address the issue of advance requests when it struck down the ban on assisted dying last year, Cowan argued that parliamentarians have a responsibility to anticipate future court challenges to C-14.

By failing to include advance directives, he said C-14 discriminates against individuals on the basis of their disease.

“Canadians are looking to us to fill what they see as a gaping hole in this bill,” Cowan said, adding that senators have received more e-mails on advance requests than any other subject.

“They see it as a matter of personal autonomy and personal choice. I agree.”

However, many senators appeared to be disturbed by a question posed by independent Liberal Sen. Art Eggleton, for which no one had a definitive answer.

“Let us say somebody is diagnosed with dementia, decides at that point in time while they’re still competent that they want to make an advance request, determines at that point a stage at which they think that request should be carried out,” Eggleton noted.

“What if that time comes and the person, although not considered competent at that point in time, does have some sense of the difference between life and death and says that they do not want to die?”

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