I do have an amendment, and it was presented in advance.

Honourable senators, as most of you know by now, I believe the issue of MAID is profoundly personal, that each of us has the right to make our own decisions when it comes to the end of our own life — a right that can only be realized with the guidance and direction of a legally respected advance request.

As someone with a history of dementia in my family, I seek the peace of mind that an advance request — and consent to it — will provide. I am certainly not alone in this belief. The majority of Canadians have come to the same conclusion.

During my own ongoing consultation regarding this bill, I have heard from so many people who have shared their experiences in either providing MAID or who are looking at MAID as an option to end their life.

I spoke with Dr. Stefanie Green of the Canadian Association of MAiD Assessors and Providers , who said that allowing for advance requests is the most important change we can make to improve the law, a sentiment echoed across the medical community, especially by practitioners who bear the burden of criminal liability in determining and performing medical assistance in dying.

I also spoke with Ron Posno, an 81-year-old former RCAF test pilot and beloved teacher for students with special needs, who shared with me his current experiences with mild cognitive impairment, MCI, a precursor to dementia. He explained his frustration with accepting the law as it now stands, that his loss of memories, experiences, context, and certainly dignity, will be something both he and his wife will be forced to accept, unless we can make this bill better.

It’s a sad truth that our current MAID laws create these gaps in accessibility. Ron shared stories of others he has met along the way, who chose to take their own life through suicide, rather than suffer alone and afraid through an end of life over which they would have no control.

That’s why I’m introducing these amendments today, because of people like Ron or my late mother or my grandmother or the thousands of Canadians diagnosed with Alzheimer’s each year — that silver tsunami so quickly approaching — and for all of those who do or did not want to leave this life in pain, or live on without knowledge or awareness of family, friends or even oneself. And I do it for the loved ones and caregivers and doctors and assessors on whom so much responsibility has fallen because we have delayed our responsibility as legislators to make this law clear.

My amendment will allow anyone to make a signed written declaration to consent to MAID before being diagnosed with the grievous and irremediable medical condition. It will give those who are fearful of losing their conscious capacity the certainty that they can access MAID before they reach a place where consent may not be possible.

Right now, the safeguards in clause 3 of Bill C-14 and subclause (3.1) of Bill C-7 require a signed agreement to MAID after someone is diagnosed with a grievous and irremediable medical condition. This has created that Catch-22 for some who can no longer consciously agree to MAID because they have been diagnosed with a cognitive impairment condition. This amendment will fix that and allow anyone to declare their consent to receive MAID while still of sound mind and with conscious decision-making capability.

This change in approach should also give one the option to waive the final consent waiver for MAID for those whose death is not reasonably foreseeable — when it’s inevitable, but not imminent. Currently, Bill C-7 only allows an advance request when death is reasonably foreseeable. This is Audrey’s amendment, and it makes sure that those who have a naturally foreseeable death and who are approved for MAID do not have to end their life early before losing their capacity to consent.

It’s an essential step in the right direction, but that right also needs to be extended to those whose death is not reasonably foreseeable. If you are approved for MAID due to MCI, dementia or Alzheimer’s, and your death is not imminent, you should still be allowed to make an advance request.

I spoke of this the other night here in the Senate — of people who get trapped in the perverse illness lottery. A foreseeable death, one that comes with a serious cancer diagnosis, would allow a request for MAID, but if the lottery deals you the Alzheimer’s card, then you may not be allowed to make an advance request because the diagnosis alone may be considered disqualifying.

There are some who believe that more committees, more time, more academic scholarship, more consultation with the public or more bureaucrat review is required. I fully support any motion to ensure that the required parliamentary review of Bill C-14 takes place immediately, and I have for more than five years. But it has been stalled. There’s always a reason — maybe an election or the need for more COVID-related legislation or whatever. Enough. The consensus on advance requests is clear and overwhelming. The government’s own public consultation on MAID from March last year found that almost 80% of Canadians support advance requests for MAID and a growing number, over 75%, support advance requests for MAID for cases of dementia or Alzheimer’s.

It has taken five years to include Audrey’s amendment, found here in Bill C-7, in the law. The government now believes we should give the right to an advance request to those whose natural death is foreseeable. Why not do so for those whose death is not imminent but whose life is hell? And why not give us the right to prior consent before being diagnosed? Why let this bill create more even more accessibility gaps?

Some believe that allowing advance requests means running the risk of administering MAID to the unwilling, but I believe that the current safeguards in this bill prevent this from happening. Of course, no one should be forced against their will to undergo MAID. In fact, it would be very difficult to make that happen.

Dr. Chantal Perrot said the following in committee just last week — and I received a very long email from her today reinforcing these notions:

Vulnerable people need to be protected, and this includes people who want MAiD, who would be denied MAiD under severely restrictive criteria and safeguards. Part of the assessors’ and providers’ responsibility is to assess for the vulnerability of the patient, while also respecting the individual’s right to make decisions with which others may not agree. . . .

I believe it is important to listen to the vast majority of Canadians who support advance requests to help ensure people’s wishes are respected. This is what autonomy means. It is what our constitutional right to choice means.

The changes I propose are designed to give the option to sign and date an advance request for MAID before a diagnosis is given by a medical practitioner — a diagnosis that may be disqualifying. They will also make the text of this bill consistent and will ensure that the option to waive final consent applies to both those with a reasonably foreseeable death and those for whom their death is not foreseeable.