The Law Commission of Ontario’s Improving the Last Stages of Life project considers how the law shapes the rights, choices, and quality of life for persons who are dying and those who support them. The project seeks to address the experiences of everyone involved in the dying process, including: individuals, caregivers and other family and friends, health care institutions and professionals, government, other professionals and community organizations.
The “last stages of life” is the broad and inclusive term we use in this project to capture the experience of dying as a process or a continuity of events, whether as a result of terminal illness, chronic conditions or serious frailties.
Our review addresses a range of issues, including equitable access to palliative care, caregiver benefits, aspects of medical assistance in dying, decision-making over the withdrawal and withholding of treatment, supports for faith and cultural communities, and dispute resolution.
Our goal is to hear from these groups to better identify and recommend law reforms that are concrete, precise, and responsive to the experience of persons in the last stages of life. Following the May-September 2017 consultation period, the LCO will release additional information and report on interim findings and preliminary recommendations in early 2018.
Discussion Paper – 250 Pages
Executive Summary – 15 Pages
Our consultations have begun. Please see our consultation page for more information.
- In June 2017, the LCO’s Last Stages of Life project partnered with Ryerson’s Diversity Institute to co-host a multi-faith roundtable on the issues particular to faith and spiritual needs in the last stages of life. The roundtable brought together a broad diversity of two dozen faith leaders, spiritual advisers and chaplains, academics, legal advocates, and health practitioners in conversation about these issues, with the goal of identifying issues and practical recommendations for law reform. Results of the roundtable will be summarized in a brief report that will be publicly disseminated later this summer.
- Between August 2016 and April 2017, LCO released seven research papers commissioned from external experts across Canada. Each paper considers a specific aspect of the last stages of life.
- In June 2016, LCO hosted the Roundtable on Legal Ethics and Practice for the Last Stage of Life at the Law Society of Upper Canada. The roundtable brought together legal professionals from diverse backgrounds to discuss the practice and ethical challenges they face in this area of the law, including private practitioners, academics, government counsel and lawyers working in policy.
- In January 2016, the Board of Governors approved the project methodology, which includes a project scope statement describing the issues to be addressed in the project.
- Between April-Sept 2015 LCO conducted about 70 preliminary consultations with groups that included health professionals, ethicists, lawyers who give advice on these issues, and representatives of professional regulatory bodies, administrative tribunals, community organizations and government. In September 2015 LCO convened an Advisory Group to advice on the development of the project.
Project Reports and Documents
- Multifaith Roundtable Background Document
- Discussion Paper
- Project Scope and Statement
- Advisory Group
- Dr. Arne Stinchcombe, Dr. Katherine Kortes-Miller & Dr. Kimberley Wilson: Perspectives on the final stages of life from LGBT elders living in Ontario
- Dr. Mary Chiu, Dr. Adrian Grek, Sonia Meerai, LJ Nelles, Dr. Joel Sadavoy & Dr. Virginia Wesson: Understanding the lived experience of individuals, caregivers and families touched by frailty, chronic illness and dementia in Ontario
- Dr. Donna Wilson & Dr. Stephen Birch: Improved care setting transitions in the last year of life
- Judith A. Wahl, Mary Jane Dykeman, Tara Walton: Health Care Consent, Advance Care Planning, and Goals of Care Practice Tools: The Challenge to Get it Right
- Rosario G. Cartagena, Alison K. Thompson, Kaveh Katebian, Trudo Lemmens, Rose Geist, Harvey Schipper, Sandy Buchman, Heesoo Kim, Mark Handelman: Understanding the Relationship between Suffering and Capacity at the End-Of-Life: A Pilot Study
- James Downar, Laura Hawryluck, Alexi Wood, Susan Brown, Joy Richards, Robert Sibbald, Jennifer Gibson, & Csilla Kalocsai: Balancing The Interests Of Patients, Substitute Decision-Makers, Family And Health Care Providers In Decision-Making Over The Withdrawal And Withholding Of Life-Sustaining Treatment
- Omar Ha-Redeye, Ruby Latif, & Kashif Pirzada: Integrating Religious and Cultural Supports into Quality Care in the Last Stages of Life in Ontario
- Call for Research Papers
- Announcement of Commissioned Research Papers