Four Liberal MPs — including a parliamentary secretary — clashed with the rest of their party by voting against the passage of Bill C-14, with some suggesting it could be unconstitutional.
In Tuesday night's final reading, the bill was approved by the House of Commons in a 186-137 vote, with the vast majority of Liberal and a few Conservative MPs voting in favour.
David Lametti, parliamentary secretary for international trade, voted against Bill C-14. (Photo: The Canadian Press)
Three Liberal MPs who didn't support the bill during the free vote, including Parliamentary Secretary for International Trade David Lametti, voiced concerns that the legislation does not do enough to help vulnerable Canadians seeking assisted death.
The constitutional problem
They also suggested the legislation conflicts with the Charter of Rights and Freedoms and won't satisfy the Supreme Court.
In a Facebook post addressed to the residents of his riding of LaSalle-Émard-Verdun, Lametti explained that while he supports the right to assisted dying, Bill C-14 has too many restrictions and could ultimately be shot down.
"As a professor of law in Canada for 20 years and a member of two Canadian Bars, I also worry about passing legislation that is at serious risk of being found to be unconstitutional. On these grounds, I was not able to give it my vote in good conscience," he wrote in the post.
Nathaniel Erskine-Smith, MP for Beaches-East York, voiced similar concerns about the bill in an address to the House on May 2.
Liberal MP Rob Oliphant, who co-chaired a parliamentary committee on the issue, announced last month that he could not support the bill. Oliphant cited the additional need for the right to advance directives, in combination with his belief that it does not comply with constitutional requirements.
"As a professor of law in Canada for 20 years and a member of two Canadian Bars, I also worry about passing legislation that is at serious risk of being found to be unconstitutional. On these grounds, I was not able to give it my vote in good conscience."
— David Lametti
"To me, we had a huge opportunity from the Supreme Court to end some suffering, to alleviate suffering," he said at the time. "My conscience won't let me vote for something that I think could add pain to a person's life."
But Liberal MP Robert Falcon-Ouellette voted against the legislation for a different reason.
Falcon-Ouellette cited his spiritual beliefs and the suicide crisis in indigenous communities as his reasons for opposing the bill. Falcon-Ouellette also took to Facebook in April to explain his position, describing the impact of suicide in Attawapiskat and in Cross Lake, Man.
"So while I recognize the Supreme Court's decision, it is also important for me as an Indigenous man to stand up and say to First Nations who are considering suicide that their life is precious, that pain may be temporary, and to hold on to hope," he said in his post.
Liberal veteran skips vote
Hedy Fry was one of seven Liberal MPs who declined to vote on the issue or were absent. Fry published an op-ed explaining that the need for advance directives was among the reasons she sat out the vote.
"As a physician who has practised for 20 years with patients who are actually concerned because they're in irremediable pain, for them, this was the issue they wanted to know about," she told reporters on Wednesday.
Fry spoke about patients who issued advance directives that stated their wishes, only to have families fight over the decision.
MP battling cancer 'had to' vote
Despite the outspoken Liberal opponents of the bill, the majority of the party voted in favour.
Liberal MP Arnold Chan, who is battling cancer, made sure to be there to cast his vote to help pass the bill.
"Had to vote on this. Absolutely had to," he told The Huffington Post Canada.
The bill will now move to the Senate for a final review before a rapidly approaching June 6 deadline.
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With files from Althia Raj, The Canadian Press
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A look at some jurisdictions where right-to-die laws are in place. (Information courtesy of The Canadian Press)
A right-to-die bill was adopted last year, the first legislation of its kind in Canada. The law, scheduled to go into effect in December, stipulates that patients would have to repeatedly ask a doctor to end their lives on the basis of unbearable physical or psychological suffering. They would have to be deemed mentally sound at the time of the requests. The law, however, is being challenged in court by two Quebec-based groups on the grounds that it undercuts sections of the Criminal Code that outlaw assisted suicide and euthanasia. The federal government has expressed its opposition to the legislation but is named as a defendant in the court challenge because it is responsible for the Criminal Code.
The results of a referendum made Oregon the first U.S. state to make it legal for a doctor to prescribe a life-ending drug to a terminally ill patient of sound mind who makes the request. However, doctors cannot administer the life-ending drugs and the patient must swallow them without help. Patients must state three times -- once in writing -- that they wish to die, and those statements must be made at least 15 days apart. They must also obtain a concurring opinion from a second doctor that they have less than six months to live and are of sound mind. The law took effect in late 1997, and through June, 2014, just over 800 people had used the law.
The state became the first in the U.S. to allow a person's right to die through legislation rather than through a court decision or a referendum result. Vermont's law, which took effect in May 2013, is closely modelled on the system in Oregon and uses the same safeguards. Patients must state three times, including once in writing -- that they wish to die. They must also obtain a concurring opinion from a second doctor that they have less than six months to live and are of sound mind.
In January 2014, a judge ruled that competent, terminally ill patients have the right to seek their doctors' help in getting prescription medication if they want to end their lives on their own terms. The state's attorney general is appealing the ruling, and a decision on whether it will be upheld is expected later this year.
A referendum saw the state enact right to die legislation in 2008. As in Oregon, patients with less than six months to live must administer the doctor-prescribed lethal medication on their own. According to a government report, 549 people applied for the right to die between 2009 and 2013. Of those, 525 actually took their own lives.
In 2009, the state's Supreme Court ruled that Montana's public policy supports mentally competent, terminally ill patients being able to choose aid in dying. Physicians are allowed to prescribe medication that patients must administer themselves. More detailed legislative bills have been introduced in the state but have not passed. The court ruling still stands today, but data about its usage is not available.
A law passed in 1942 forbade anyone from helping someone kill themselves for selfish reasons. As a result, people arguing that they are assisting with a suicide for unselfish motives are not considered to be committing a crime. Suicides can be assisted by people other than doctors and no medical condition needs to be established. Switzerland is the only country that allows foreigners to travel there for the purpose of ending their own lives.
In the Netherlands, euthanasia is legal under specific circumstances and for children over the age of 12 with parental consent. In Europe, patients don't have to prove that they have a terminal illness -- establishing unbearable suffering is usually sufficient. Dutch doctors are allowed to perform euthanasia if a patient whose unbearable suffering has no hope of improvement asks to die with a full understanding of the situation. A second doctor must agree with the decision to help the patient die.