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Supporters of Death with Dignity laws in the US point to the Supreme Court of Canada’s ruling decriminalizing physician-assisted death as a catalyst for their work. The ruling decriminalized physician assisted death for a broader range of people than the laws being promoted in the US: competent Canadians with a grievous and irremediable medical condition, including an illness, disease or disability, that causes enduring suffering that is intolerable to the individual. The court did not define “grievous and irremediable” but it is clear it is not limited to terminal illness. In addition, someone who has dementia but is still competent to provide informed consent would qualify, provided their suffering is, at the time of the request, intolerable to them. The remedy from the courts includes both the prescription and administration of medication, so that individuals will not be compelled to end their lives too early out of fear they will lose the capacity to do so later on.
The Court has given lawmakers a year to write new legislation, either Federal or Provincial lawmakers can pass legislation, both can, and neither has to do so, though it is unknown which level(s) of government decide to act. The provision of healthcare is a responsibility that is shared by both federal and provincial governments. Naturally, if the federal government passes legislation on assisted dying that are within its legal jurisdiction, those laws would apply across the country. However, each province has the power to craft its own framework for assisted dying.
Opponents of the Supreme Court ruling immediately asked for the Federal Government to overturn the Supreme Court’s decision by using the notwithstanding clause in the Canadian Charter of Rights and Freedoms, essentially an override rule, to be applied in order to overturn the decision of the court, but that drastic course of action option does not seem likely. Should neither the federal nor provincial governments pass laws applying the Court’s ruling, physician-assisted death would then be regulated by existing healthcare legislation and professional standards surrounding the practice of medicine, the same way that other end-of-life treatments are regulated.
In any case, in a year’s time, the current legal bans on prescribing and administering medication will be invalid in circumstances set out in the decision. Physicians will be able to assist either by providing the knowledge or the means for a person to end their own life, e.g. by prescribing life-ending medication or by administering life-ending medication. The SCC decision does not compel physicians to comply with requests for assisted dying. “Nothing in this declaration would compel physicians to provide assistance in dying,” the ruling reads. However, whether a doctor will have a duty to refer such a request to another doctor or healthcare institution if they are unwilling to provide the service will likely be addressed through legislation or regulatory standards governing the conduct of physicians. Similarly, the duty to provide physician-assisted death by hospitals, hospices, and other institutions will likely be addressed in federal or provincial legislation. If it is not addressed in legislation physician assisted death will be a right, but it might not be an accessible option for all Canadians.
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