Dr. Konia Trouton:

In regard to the controversy around the data on palliative care, the annual report from Health Canada is quite helpful. The Health Canada data are the reported data on MAID deaths and they include data on palliative care.

I want to emphasise the point that requests for assisted dying come from the patients themselves. Let us turn back to that fundamental starting point for assisted death. It does not come from a practitioner saying that a patient must or should do this; it comes from the patient accessing the information, filling out a form, getting a witness to witness the request and submitting it. It does not come from the MAID practitioner. It never comes from those of us who are providing the assistance; it comes from the patient. That is fundamentally the beginning point and that element of education for the public is incredibly important. People might feel that is their only option but they may not qualify or be found eligible. That information is absolutely essential.

In terms of what is essential for the committee to consider in the context of putting a law into place, one is the need for standardised and thorough training of all of the clinicians that do the assessing and the provision. That is a different group of people from the group of people who might be telling patients about it or informing them of what is assistance in death. The way in which such assessment and provision is documented is not the same as for any other medical care. It is documented very differently to make sure that clinicians attend to every single aspect of the law and understand each element of it. It is a different kind of process and that is crucial. Also crucial is understanding that capacity is correctly obtained; in other words, that the patient does have the capacity to make the decision and is aware of all of the options. Documenting that and allowing practitioners to network together is essential. That is what CAMAP had to do. We had to create a network of clinicians who were voluntarily coming forward and wanting to do the work because not every clinician wants to do this work. They are coming from a wide variety of backgrounds. I do not come from a palliative care background. I have colleagues who come from neurology, cardiology and so on. Clinicians come from a wide range of backgrounds and it is important to let those people network separately because there will not be a pre-existing organisation.