OTTAWA — Prime Minister Justin Trudeau expressed optimism till the final hours, but there is now no way the government can enact doctor-assisted dying legislation before the Supreme Court of Canada's deadline on Monday.
Senators gave the controversial legislation, known as Bill C-14, second reading and approval in principle on Friday and sent it to the Senate committee on legal and constitutional affairs.
However, after the vote, the upper chamber adjourned until Tuesday — the day after the deadline.
Justice Minister Jody Wilson-Raybould participates in a committee of the whole in the Senate, Wednesday June 1, 20016. (Photo: Adrian Wyld/CP)
Sen. Peter Harder, the government's representative in the Senate, said he had always described the Monday deadline as ambitious and dismissed any notion senators had not worked as quickly as they could — sitting late into the night and starting earlier than usual the next morning — given how late they received it.
"I think any objective observer would say the Senate is being both deliberate and expeditious," Harder said Friday.
Still, only a short while earlier, Trudeau had said he still hoped the bill would make it through in time.
"We've been very clear that it is our hope that by June 6 the government legislation on a framework for assisted dying will be in place," Trudeau said Friday in Winnipeg.
"I think any objective observer would say the Senate is being both deliberate and expeditious."
— Sen. Peter Harder
The Supreme Court delivered a landmark ruling in February 2015 that lifted the ban on physician-assisted death and gave Parliament a one-year window to enact legislation.
With the deadline approaching after the Liberals came to power, the court granted the new government a four-month extension.
Medical regulators in every province have already issued guidelines for physicians on providing assistance in dying.
Those rules impose safeguards similar to — and in some cases, even stronger than — those proposed in C-14.
Justice Minister Wilson-Raybould and Health Minister Jane Philpott issued a joint statement Friday urging the Senate to act quickly, saying there will be a "legal vacuum" once the deadline passes.
Fear of 'legal vacuum'
"While provincial regulatory bodies will provide guidance to physicians, there will be significant variability across provinces and territories," they said in the emailed statement.
"There will also be inadequate support and protection for health-care providers, including nurses and pharmacists. We trust that the Senate will swiftly, yet carefully, consider Bill C-14, while keeping in mind that Canadians, particularly those that are most vulnerable, need a legal framework in place as soon as possible."
Dr. Jeff Blackmer of the Canadian Medical Association also said the guidelines do not provide enough clarity.
"We are being asked to put our patients to death," said Blackmer, the vice-president of medical professionalism for the association.
"It's that simple and to be asked to do so without clear legal protections, for most physicians, is simply a bridge too far and I think most people would understand that," he said.
A 'preventable' situation
But Shanaaz Gokool, CEO of the advocacy group Dying with Dignity Canada, said there was always bound to be some trepidation in the early days.
"Some doctors will feel more comfortable and others will take some time to come on board, but for the doctors who are able to go ahead, they do have guidelines from their colleges, including pharmacology guidelines," said Gokool.
Conservative MP Michael Cooper said the government should have asked the Supreme Court for another short extension.
"It was preventable," he said.
NDP MP Murray Rankin said he always believed the government was exaggerating the urgency of meeting the deadline in order to push C-14 through the House of Commons.
"It's more important to get it right than get it done right now and I believe that the Senate is taking that to heart," he said.
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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.