And Miles to Go Before I Sleep: The Future of End-of-Life Law and Policy in Canada

This paper reviews the legal status of a number ofend-of-life law and policy issues that have, to date, been overshadowed by debates about medical assistance in dying. It suggests that law reform is needed in relation to palliative sedation without artificial hydration and nutrition, advance directives for the withholding and withdrawal of oral hydration and nutrition, unilateral withholding and withdrawal of potentially life-sustaining treatment, and the determination of death. To leave the law in its current uncertain state is to leavepatients vulnerable to having no access to interventions that they want or at the other extreme, being forced to receive interventions that they do not want. This can either inappropriately shorten life or extend suffering. It can also leave individuals at risk ofbeing declared dead earlier than appropriate or much-needed organs not being available for transplantation because individuals are being declared dead later than appro