OTTAWA — The Senate has sent the federal government’s controversial bill on assisted dying back to the House of Commons with a major amendment that guts the central premise of the proposed law: that only those who are near death should qualify for medical help to end their lives.
The bill, as amended over the past week of lengthy debate in the upper house, passed Wednesday by a vote of 64-12 with one abstention.
Senators agreed to seven amendments, the most significant being deletion of the near-death proviso.
Minister of Justice and Attorney General of Canada Jody Wilson-Raybould participates in a committee of the whole in the Senate, Wednesday June 1, 2016. (Photo: Adrian Wyld/CP)
That amendment replaces the bill’s restrictive eligibility criteria with the more permissive parameters spelled out last year in the Supreme Court’s landmark ruling, which struck down the ban on medical assistance in dying.
Justice Minister Jody Wilson-Raybould has signalled that the government will not accept the change.
And Prime Minister Justin Trudeau is telling Liberal MPs he expects the appointed Senate to eventually back down on the issue and bow to the will of the elected Commons.
A message will now be sent to the Commons informing MPs of the changes senators have made. The government will then introduce a motion accepting or rejecting some or all of the changes, which must be debated and put to a vote in the Commons.
Trudeau reassures Grit MPs
The Commons will then send a message back to the Senate, informing senators of the amendments that have been accepted or rejected.
Senators will then have to decide whether to "insist" upon the rejected changes or accept the will of the elected chamber — a question that has already divided senators.
Liberal backbenchers privately say Trudeau made it clear during their weekly caucus meeting Wednesday that the government won't accept the amendment to delete the near-death proviso. Moreover, he told MPs it would be "appropriate" for the Senate to defer to the judgment of the elected house of Parliament on the matter.
'Constructive parliamentary process'
Backbenchers were also told the government hopes the back-and-forth procedure between chambers can be wrapped up and the bill formally adopted as early as Tuesday.
Government House leader Dominic LeBlanc said it's hard to predict the timing of the next steps with any certainty. But he praised the Senate, which Trudeau is trying to reform into a more independent, less partisan chamber of sober second thought, for its handling of the assisted dying bill.
"Whatever ultimately the House of Commons decides to do in terms of a response ... the government believes that the Senate has significantly enriched the public debate on these issues, public consciousness on these issues," LeBlanc said after a cabinet meeting.
"We see this as a very constructive parliamentary process."
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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.