Decisions about assisted death for ‘mature minors’ need broad consultation and more data

OTTAWA—A three-year deadline to enact legislation on physician-assisted dying for “mature minors” may not be enough time to gather adequate and appropriate information about whether the practice should be extended to children and youth.

In a submission to the Report of the Special Joint Committee on Physician-Assisted Dying earlier this month, the Canadian Paediatric Society recommended that the first iteration of legislation be restricted to patients over the age of 18 years.

While the CPS believes it is prudent to learn from the experience of physician-assisted death among adult (over 18 years) patients before considering the practice among minors, it is concerned that the essential outcomes research may not be available within 3 years. The Special Joint Committee recommended legislation for minors be developed by 2019.

“To our knowledge, there is no Canadian data on either requests for physician-assisted death for children and adolescents, the opinions of Canadian paediatricians about physician-assisted death, or their willingness to participate in it,” said Dr. Dawn Davies, chair of the CPS Bioethics Committee. “Without that data, and a great deal of other information, it is premature to set a deadline for enacting legislation.”

Whether physician-assisted death should be offered to children and youth deemed to have decision-making capacity is an ethical question that has yet to be contemplated by Canadian society, added Dr. Davies.

Before considering any legislation on physician-assisted death involving children and youth, the CPS strongly recommends comprehensive consultation with:

• parents of children who are severely disabled or have terminal illness;
• youth with terminal or life-limiting illness;
• bereaved parents whose children died after terminal illness or severe disability;
• pediatric health care professionals, (at minimum representatives from pediatric medicine and nursing, respiratory therapy, pediatric psychology, and social work associations).

The CPS also supports a physician’s right to conscientiously object to being involved in physician-assisted death, especially where children or youth are involved.

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About the Canadian Paediatric Society

The Canadian Paediatric Society is a national advocacy association that promotes the health needs of children and youth. Founded in 1922, the CPS represents more than 3,300 paediatricians, paediatric subspecialists and other child health professionals across Canada.