Project Overview
The Law Commission of Ontario’s Last Stages of Life: Final Report examines how legal and policy frameworks in Ontario shape the rights, choices, and quality of life of people who are dying, as well as those who support and care for them. The term “last stages of life” is used to capture a broad range of legal issues related to palliative care, end-of-life care, and medical assistance in dying.
Legal and policy approaches in Canada and Ontario have changed significantly in recent years. The LCO’s report provides a blueprint for ensuring that the law keeps pace with these developments and continues to meet the needs of individuals, families, caregivers, and professionals involved in end-of-life care.
The Final Report should be read alongside the LCO’s complementary report, Last Stages of Life for First Nation, Métis and Inuit Peoples: Preliminary Recommendations for Law Reform (2023). That work was undertaken as a distinct process, with oversight from an Indigenous Engagement Advisory Committee, to support meaningful engagement with First Nation, Métis, and Inuit communities in Ontario.
Advisory Committee
The following people served on the Advisory Committee at different times:
- Nancy Cooper – Ontario Long Term Care Association
- Julie Darnay – Quality Hospice Palliative Care Coalition of Ontario & Hospice Palliative Care Ontario
- Professor Michelle Giroux – University of Ottawa, Faculty of Law
- Dr. Doris Grinspun – Registered Nurses Association of Ontario
- Mark Handelman – Whaley Estate Litigation
- Pia Hundal – Ontario Bar Association
- Dr. Denise Marshall – Division of Palliative Care, McMaster University
- Imam Abdul Hai Patel – Ontario Multifaith Council
- Wendy Porch – Centre for Independent Living in Toronto
- Frank Wagner
- Judith Wahl – Wahl Elder Law
- Professor Joan Gilmour – Osgoode Hall Law School
- Dena Maule – Ontario Caregiver Coalition
- Dr. Jeff Myers – Sunnybrook Health Sciences Centre, Palliative Care Consult Team
- Sara van der Vliet – Health Boards Secretariat
- Tara Walton – Ontario Palliative Care Network Secretariat
Key Recommendations
The report makes 56 law and policy reform recommendations across five interconnected areas.
1. Earlier Planning and Engagement
- Strengthen public health promotion and formal supports for advance care planning and goals-of-care discussions, encouraging earlier and more informed conversations about end-of-life choices (Recommendations 1–16).
2. Support for Care Providers
- Improve workplace wellness supports for professionals and paraprofessionals who provide care during the last stages of life (Recommendations 17–22).
3. Flexible Supports for Families and Caregivers
- Expand and modernize leave and workplace provisions so families, friends, and community members can respond to the unpredictable and evolving nature of care needs (Recommendations 23–30).
4. Equitable Access to Care
- Address unmet needs among vulnerable communities, including people who are incarcerated, socially isolated individuals, children, and those considering medical assistance in dying (Recommendations 31–49).
5. Earlier Dispute Resolution
- Improve access to rights-based information and mediation, and expedite formal legal proceedings related to end-of-life issues (Recommendations 50–56).
These recommendations are grounded in extensive province-wide consultations, including input from more than 850 participants across 74 sessions, nearly 600 pages of public submissions, seven commissioned expert reports, and guidance from an external expert Advisory Group.