 is the umbrella term that we use in Canada that captures what in the past would have been called assisted suicide and euthanasia. So assisted suicide is when a physician gives you a prescription and tells you how to take the drugs to end your own life when your suffering has become intolerable. Euthanasia is when the physician provides you with a lethal injection knowing that that will cause your death at your request. A big source of the problem with dealing with this issue is that there are differences of opinion about the core values that are at stake. So you have people who for instance believe that sanctity of life is the ultimate value and that will take you to saying you should have no assistance in dying. Others will say autonomy is the key principle. That's the value of respecting people's capacity for self-determination. So I have the right to decide what happens with my life and in fact with my death. Well that takes you to a much more expansive view of what should be available by way of assisted dying. Others are looking at the value of equality and you might think why is that relevant to assisted dying? Well here's the situation. Suicide, attempted suicide, used to be illegal. Then it was made legal. Well that means that people who are able-bodied can end their own lives legally when life has become intolerable to them. But somebody who is severely physically disabled can't because they require the assistance of somebody else to end their life. So there's actually an argument that to prohibit medical assistance in dying is to discriminate against those who have physical disabilities. We also have challenges with respect to the evidence and that is that a lot of people claim oh if you allow this if you allow medical assistance in dying we'll slide down the slippery slope and you'll start with competent adults and you'll end up with involuntary or non voluntary assisted dying. I've been writing about this for a while luckily I'm patient because along came the Carter case what is now known as the Carter case and I got involved in that case. I worked on the pro bono legal team helping with the expert evidence in particular trying to bring the people together and the evidence together that we needed to fuel to support the arguments that were being made in court so I worked on that case. Subsequently I am working on the response to the federal legislation that was in response to the Carter case. What I'm trying to do right now is bring individuals together to help articulate an interpretation of the legislation. This is not the challenge to the legislation. This is just how do we interpret it. So let's get doctors and nurse practitioners and lawyers and regulators of doctors and all those who have some say in what it means and in helping people to understand what it means into a room develop a statement an interpretive statement and put it out into the world. I'm also a member of the expert panel that's been put together for the government to look at three remaining issues that they didn't deal with in the legislation. One is do we include mature minors so those are individuals they're not yet adult but they have the full capacity of someone who's 18 and a half years old. They understand the nature and the consequences of the decision should they have access to medical assistance and dying. The second issue is should you have access to medical assistance and dying through a request made in advance of loss of capacity and that's the Alzheimer's situation predominantly for a lot of people and quite concerned about that. Right now you can't have access either as a mature minor or through an advanced request and the third group is what about somebody who has a mental illness that is their sole underlying condition. So their natural death is not reasonably foreseeable they don't qualify a subgroup of those don't qualify should they have access to medical assistance and dying so a large group of people have been pulled together to study the evidence on these issues and to report back to the government on the evidence so that the government can then consider the policy question of whether access to medical assistance and dying should be expanded through the legislation through a revision to the legislation. When the federal government put in place its new legislation setting out the framework for assisted dying in Canada it is too narrow. It's narrower than the Springfield Canada decision in Carter. I think it's narrower than the charter requires and what do I mean by that? Well in the Carter decision it said that people have a grievous and irremediable condition that's causing enduring and intolerable suffering should have access to medical assistance and dying. The federal legislation narrowed that by saying you have to have an incurable condition, an advanced state of decline of capabilities, be suffering enduring and intolerable suffering and and this is the kicker natural death must be reasonably foreseeable. There's all kinds of problems with that clause one of them being what does it mean but the other is it it seems to narrow who can have access. So my goal is to help Canada achieve what I think is an absolutely attainable objective and that is for us to have the best system in the world for end of life care. What that means is that patients have their wishes respected whether that be that they get access to aggressive treatment or palliative pain management or medical assistance and dying we can do it we just have to want to.