Canada: Euthanasia for minors, for mental health reasons and via directives may now be on the table.

The debate on 'Medical Assistance in Dying' or MAiD in Canada in the spring of 2016 could not be said to be a shining moment in Canada's legislative history.

Responding to the Canadian Supreme Court decision in January 2016 , the Parliament was somewhat hamstrung by that decision in as much as it provided a deadline for legislative reform, in line with the Court decision, by June of that year.

The Parliament was further constrained by a Canadian Constitutional idiocy that does not allow the Ottawa Parliament to override the Court decision by amendment to the law so as to render the judgement inoperable or to limit its remit.

The then Harper Conservative Government could have invoked the 'notwithstanding' clause, which would have provided a delay of five years for a legislative response.

However, with a National Election pending, it is understood that Prime Minister Harper did not want to expend political capital on the issue, fearing a backlash at the ballot box. He should not have worried; the Conservatives were roundly defeated by Trudeau's Liberals and the rest, as they say, is history.

The wording of the Supreme Court decision in Carter v Canada was also problematic. It caused significant headaches for the drafting and amending of the bill; some, such as the Canadian Civil Liberties Union, among others, claiming that the Trudeau Government's interpretation was far too narrow; that the law should include provision for euthanasia for emancipated minors, via advance directives and should include provision for euthanasia for mental illness.

And so, the new Trudeau government was in something of a cleft stick; being pulled in both directions simultaneously and trying to navigate a path of compromise.

And compromise they did. The Standing Committee on Justice and Human Rights reviewed the legislation before the debate commenced in the Commons. In what can only be described as an appeasement to silence a squeaky wheel, the committee made a recommendation (accepted as an amendment) that "no later than 180 days after the day on which this Act receives royal assent, initiate one or more independent reviews of issues relating to requests by mature minors for medical assistance in dying, to advance requests and to requests where mental illness is the sole underlying medical condition.‍" This was eventually adopted as clause 9(1) of the Act.

In essence, the Committee and the Parliament had committed to taking the line of least resistance in order to overcome 'legislative constipation' by appeasement. The bill passed both chambers and was assented to on the 17th of June.

The chickens are now returning to the hen house. On December 13, the government announced that it was initiating studies onto 'requests by mature minors, advance requests, and requests where mental illness is the sole underlying medical condition.' The studies will be undertaken by the Council of Canadian Academies.

This does not, of course, presage adoption of euthanasia for minors, by directive and for mental health reasons, as a result. But I'm not holding my breath on that one.

Why? Two reasons: Firstly, MAiD now exists in Canada. Though less than a year old, Canadians will be beginning to get used to the idea that the government allows for people to be made dead. The report on the first seven months of the operation of the Quebec law shows that, already, there's a certain accommodation of laxity in relation to what the statute allows. This is likely ony ever to widen.

Secondly, the pro-euthanasia lobby, the Civil Liberties organisations etc., will push just as hard, if not harder, this time around. They will have now additional strength to the argument for inclusion because the law is now operational and that Canadians in these three categories are now being denied their rights as compared to others- or so the argument goes.

Should they fail, we can be sure that 'hard cases' will quickly emerge along with lodgement of documents in the Supreme Court.

Most troubling is a quote attributed to Health Minister, Jane Philpott in announcing the studies:

"Passing the medical assistance in dying legislation in June was crucial for supporting improvements to a full range of options for end-of-life care, including the choice of a medically assisted death for eligible Canadians. The reviews that we have launched today will help us to better understand three complex issues not addressed in the legislation."

How, pray tell, was the passage of euthanasia and assisted suicide legislation 'crucial for supporting improvements to a full range of options for end-of-life care'? How did MAiD improve palliative care? Perhaps in the same way that provisions for minors might improve paediatrics or suicide for mental health patients improve psychiatric clinical care?

The monster's appetite is insatiable!