Carter and the right to die in Canada


RoseLast year, the Supreme Court of Canada released a landmark decision in allowing physician-assisted suicide in Canada. The Court gave the federal government until April of this year to pass legislation allowing this; the government got an extension to June as it wasn’t completed before the election last fall. The proposed law was released recently, to be debated and, if necessary, amended in time for the June deadline.

The proposed bill defines “medical assistance in dying” as either the administration of a substance that causes death, or prescription of a substance that a person can self-administer to cause death, either by a doctor or a nurse practitioner. To be able to apply, a person must be eligible for health benefits in Canada (to prevent tourism for this purpose); be at least 18 years of age and mentally capable; have a grievous and incurable medical condition; make a voluntary request; and give informed consent. A “grievous and incurable medical condition” is defined as a serious and incurable illness, disease or disability that causes enduring and intolerable physical or psychological pain with reasonably foreseeable natural death, that leads to an advanced state of irreversible decline in capacity.

In order to protect against the law being used improperly, two independent doctors must confirm the patient meets the criteria. The patient must also sign a request (by proxy if the patient can’t write) in front of two independent witnesses. There must also be a 15-day waiting period, express consent must be confirmed by the doctor or nurse assisting at the time of the procedure or prescription, and the patient must be informed of his or her right to withdraw consent at any time. Medical professionals who act under these regulations are protected from criminal prosecutions, unless they knowingly violate any of the safeguards or act contrary to the rules.

The government also confirmed in the bill that accessing the right to die would not result in any loss of federal pensions or benefits, and has committed to reviewing the bill in the future to potentially expand it to cover mature minors and people with intolerable mental illness, as well as allowing for advanced directives.

This is a very thorny issue. In my opinion, the government has taken the right approach: make this available for those most seriously and immediately in need of it, and leaving room to study its applicability to other areas, such as mental illness, in the future. Given the very strict and tight timelines, I think that it will offer the right protections for the time being, but I hope to see it expanded going forward.