Physician-assisted death should be based on decision-making capacity, not age: Ontario report

Patients opting for physician-assisted death should not be denied it based on age and should also be able to die wherever they're being treated, aslong as they have the capacity to make an informed choice, says a provincially appointed panel.

The panel'sreport, released Monday, also laid out several other recommendations that pertain todoctors andpatients.

• Read the report on physician-assisted dying

• Ontario forms expert panel on assisted dying

Doctors, the report recommends, should be able toobject to helping someone die, butit wouldthen be their responsibility to transfer the patient to a doctor willing to accommodate such a request.

Two doctors, the report says, must assess the patient to make sure he or shequalifiesfor a physician-assisted death. The assessment should bebased on the patient'scondition andcompetence to make an informed decision, the report says.

The report also delvesinto who would qualify.

"Access to physician-assisted dying should not be impeded by the imposition of arbitrary age limits,"one of the report's recommendations said, noting that in its ruling, theSupreme Court of Canada refers to a "competent adult person" but doesn'tdefine adult.

Instead, a patient's capacity to make an informed decision should guide who qualifies.

Young children, therefore, would be considered incapable of forming a competent decision, though it's possible a "mature minor" could, said Maureen Taylor, who ison the expert panel.This is in line with current medical treatment laws in Ontario, she added.

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Patients should not be denied based on age and should also be able to die wherever they're being treated

Defining 'irremediable condition'

The report also encourages the province to define "grievous and irremediable medical condition" as: "a very severe or serious illness, disease or disability that cannot be alleviated by any means acceptable to the patient."

Patients, meanwhile, who haveirremediable conditions should be able to make an advance directive that requests a physician-assisted death once they meet certain criteria.

The report also recommendsthat publicly funded health institutionsnot issuea blanket objection to providing physician-assisted suicide.

Ontario formed the expert panel to study the issue in August. The province has until February to preparenew laws surrounding physician-assisted dying after a landmark Supreme Court ruling earlier this year.

The advisory group is co-chaired by Jennifer Gibson, a director of the University of Toronto Joint Centre for Bioethics, as well asTaylor, a formermedical journalist with the CBC and physician assistant in infectious disease. Taylor's husband, Donald Low, a famed microbiologist in Toronto, advocated for physician-assisted suicide before his death.

Ontario to hold public meetings in new year

Ontario Health Minister Eric Hoskins thanked the expert panel and in a statement said the government will take the recommendations "under advisement."

"As we carefully look at the complex and sensitive issues related to end-of-life care and physician-assisted dying that are outlined in this report, we will continue listening to Ontarians,"Hoskins said.

The government will hold in-person meetings in nine communities in January, it announced on Monday, though it didn't say where exactly those meetings would take place.The government also asked for the public's ideas on the topic in an online survey.

Canada's Supreme Court ruled in February that those with grievous and irremediable medical conditions should have the right to ask a doctor to help them die.

The federal government is also working toward its own guidelines in the area, which Prime Minister Justin Trudeau said would be based on policies that already exist in Quebec. Earlier this month,however, the governmentasked the Supreme Court for a six-month extension, saying it needs more time to study the "complex" issue.