Project Purpose

The Law Commission of Ontario’s Last Stages of Life: Final Report how Ontario’s legal and policy frameworks shape the rights, choices, and quality of life for persons who are dying and those who support them. The “last stages of life” is an adopted term that gives the project scope to look at legal issues arising in relation to palliative care, end-of-life care, and medical assistance in dying in Ontario.

Canadian and Ontarian approaches to these matters have changed profoundly in the last five years. The LCO’s Last Stages of Life: Final Report is a blueprint to ensure the law keeps pace with these changes and continues to meet the needs of all those impacted.

The LCO’s Final Report should additionally be read alongside our complementary report on the Last Stages of Life for First Nation, Métis and Inuit Peoples: Preliminary Recommendations for Law Reform (2023). The LCO developed and undertook this as a distinct process to engage with Inuit, Métis, and First Nation members in Ontario, with oversight from an Indigenous Engagement Advisory Committee.

In order to ensure that the LCO fully considered the practical and theoretical implications that this project raised, we established an Advisory Committee. The Advisory Committee was made up of legal practitioners, health care providers, professional associations, academics, ethicists, representatives from community and advocacy organizations, and government representatives with particular expertise in the area. The role of the Advisory Committee was to provide advice on the issues raised by documents released in this project, provide input into a consultation strategy and provide feedback on the impact and effectiveness of potential LCO recommendations.

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 Areas for Reform

The report makes 56 law and policy reform recommendations across five major areas. These would:

  • activate the earlier involvement of people in discussing and planning for their last stages of life, including through public health promotion mandate and formal supports for advance care planning and goals of care discussions (Recommendations 1-16);
  • better support the professionals and paraprofessionals who provide care in the last stages of life through expanded workplace wellness supports (Recommendations 17-22);
  • update and expand workplace wellness and leave provisions so families, friends and community members have flexible supports responsive to the unpredictable trajectory of care needs over time (Recommendations 23-30);
  • increase access to equitable care for vulnerable communities with unmet needs, including prisoners, isolated individuals, children, and persons contemplating medical assistance in dying (Recommendations 31-49); and
  • help resolve disputes by making rights-based information and mediation available earlier and expedite formal legal proceedings concerning the last stages of life (Recommendations 50-56).

The LCO’s extensive province-wide consultations confirm these recommendations as timely, thoughtful, and very much needed. Our work reflects the lived experience of the 850 Ontarians we heard from across the 74 consultation sessions we convened; the nearly 600 pages comments submitted by the public; the seven expert reports we commissioned; and from the oversight provided by an external expert Advisory Group.

Project Documents

Commissioned Papers

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