The Supreme Court of Canada says a law that makes it illegal for anyone to help a person commit suicide should be amended to allow doctors to help in specific situations.
The ruling only applies to competent adults with enduring, intolerable suffering who clearly consent to ending their lives.
The court has given federal and provincial governments 12 months to craft legislation to respond to the ruling; the ban on doctor-assisted suicide stands until then. If the government doesn't write a new law, the current one will be struck down.
The case was brought by the B.C. Civil Liberties Association on behalf of two women, Kay Carter and Gloria Taylor, both of whom have died since the legal battle began. Both women had degenerative diseases and wanted the right to have a doctor help them die.
A lawyer on behalf of Carter and Taylor argued that they were being discriminated against because their physical disabilities didn't allow them to kill themselves the way able-bodied people could.
Carter went to Switzerland with her daughter, Lee, to die. Taylor died of amyotrophic lateral sclerosis (ALS) in 2012.
The ruling is not limited to those with a physical disability who require a physician's assistance to end their lives.
All nine justices share the writing credit on the ruling, an unusual action meant to signal particular institutional weight behind the decision.
'Impinges' on security of the person
The court says the charter right to life doesn't require an absolute prohibition on assistance in dying.
"This would create a 'duty to live,' rather than a 'right to life,' and would call into question the legality of any consent to the withdrawal or refusal of lifesaving or life-sustaining treatment," the court wrote in the decision.
"An individual's choice about the end of her life is entitled to respect."
The court also found an individual's response to "a grievous and irremediable medical condition" is a matter critical to their dignity and autonomy. The law already allows palliative sedation, refusing artificial nutrition and hydration and refusing life-sustaining medical equipment.
"And, by leaving people ... to endure intolerable suffering, it impinges on their security of the person," the court wrote.
The court also agreed with a trial judge in British Columbia that the safeguards work where they've been set up in jurisdictions that allow physician-assisted suicide.
The top court agreed that doctors are capable of assessing the competence of patients to consent, and found there is no evidence that the elderly or people with disabilities are vulnerable to accessing doctor-assisted dying.
While the ruling sets out specific criteria, it leaves some questions.
The decision is silent, for example, on whether depression or mental illness counts as a medical condition. The court does include psychological pain under the criteria of enduring and intolerable suffering.
Most Canadians support change: Fletcher
Conservative MP Steven Fletcher, who became a quadriplegic after an accident in 1996, was at the court to react early to Friday's decision.
He has already introduced a private member's bill — which was also introduced in the Senate before Christmas — to make physician-assisted death legal under Canadian laws.
"That bill could be used as a foundation for parliamentarians going forward," he told reporters, although it's not scheduled to come up for debate any time soon and he concedes "those decisions are made at a higher pay grade then mine."
"I guess it depends ... if people want this to be an election issue or not," he said. "If it went to a free vote in Parliament, it would pass."
"There does need to be some Criminal Code provision, I think, to prevent abuse," he says. "I don't want people, because they have a bad hair day, to get their car mechanic to take them down."
"The vast majority of Canadians — 84 per cent — support physician-assisted death with appropriate caveats."