The Minister of Justice introduced Bill C-14 on medical assistance in dying. The government states that the proposed legislation will give dying patients who are suffering intolerably from a serious medical condition the choice of a medically assisted death.
It will not extend that choice to as many people as the Supreme Court of Canada apparently contemplated in its landmark ruling in Carter v. Canada, that organizations such as the B.C. Civil Liberties Association and Dying with Dignity Canada maintain it must, or that Parliament's special joint committee recently recommended it should.
Excluded are those seeking medical aid in dying strictly on account of mental illness, mature minors otherwise authorized to consent to the withholding and withdrawal of life-saving treatment, and individuals who wish to make advanced directives to have their lives ended at a time when they are no longer competent to make that decision themselves.
What the requirement of a "natural death" becoming "reasonably foreseeable" actually means is anyone's guess.
Moreover, it appears that those suffering intolerably from a grievous and irremediable medical condition but for whom "natural death" has not become "reasonably foreseeable" will not have access to medical assistance in dying, either.
The bill would therefore appear to raise the threshold set in Carter, since the Court never mentioned anything about a person's condition needing to be terminal. As it turns out, nowhere does this proposed piece of legislation feature the word "terminal," either. Nor does it mandate that a prognosis as to one's time remaining be made.
Apart from that, what the requirement of a "natural death" becoming "reasonably foreseeable" actually means is anyone's guess. In an otherwise illuminating breakdown of the bill, the Department of Justice website unfurls canopies of shade in response to the question: "Would the person have to be dying from a fatal disease to be eligible?"
"No. A person who is dying as a result of one condition, is in a state of decline due to another condition, and is suffering unbearably from a third condition, would still be eligible to receive medical assistance in dying."
The fact of the matter is that as the bill stands, this opaque phrase is doing most of the heavy lifting. One suspects that is exactly how the drafters intended it. Both the previous and the present government's reticence on the matter is well known.
There are a lot of considerations to weigh when legislating in this area, as evidenced by the lengthy set of provisos with which Bill C-14 begins. It is rare for ordinary legislation to include preambles. It is reminiscent of the preamble to the Protection of Communities and Exploited Persons Act passed in the wake of the court's decision in Bedford, on another contentious issue.
The government was (perhaps understandably) reluctant to legislate either a) in support of medical assistance in dying "on demand" for anyone with an intolerable medical condition or b) in a manner that directly contravenes the relatively permissive parameters laid out by the Supreme Court.
You surely can't please everyone. There are those who will maintain that anything short of prescribing medical aid in dying on demand is too restrictive, meanwhile others who believe anything but a criminal ban is overly permissive.
Sometimes the most prudent way to make a difficult decision is to defer it. And sometimes the surest sign of a sound political compromise is that nobody is that thrilled with it. Other times, such deferral amounts to an abdication of responsibility. And in this instance, such ambivalence owes not just to balance but ambiguity.
It may very well be that the legislation the government has proposed more closely approximates majority opinion on the matter of medical aid in dying than either the reasoning advanced by the court in Carter or the erstwhile legal status quo. But it is literally hard to tell.
Is it too much to ask others -- doctors, nurse practitioners, disciplinary committees for the medical professions and, eventually, the courts -- to shoulder the burden of offering the definition the government is reluctant to give?
That's a question worthy of debate.
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Here's a look at the state of Euthanasia laws in Canada and their history.
Suicide hasn't been a crime in Canada since 1972. (Shutterstock)
Doctor-assisted suicide is illegal, although the ruling of the B.C. Supreme Court will force Parliament to alter the law within one year. The Criminal Code of Canada states in section 241 that: "Every one who (a) counsels a person to commit suicide, or (b) aids or abets a person to commit suicide, whether suicide ensues or not, is guilty of an indictable offence and liable to imprisonment for a term not exceeding fourteen years." (Alamy)
Passive euthanasia involves letting a patient die instead of prolonging life with medical measures. Passive euthanasia is legal in Canada. The decision is left in the hands of family or a designated proxy. Written wishes, including those found in living wills, do not have to be followed by family or a proxy. (Alamy)
Sue Rodriguez, who suffered from amyotrophic lateral sclerosis (also known as Lou Gehrig's disease), launched a case asking the Supreme Court of Canada to allow her to end her own life on the grounds that the current law discriminated against her disability. Because suicide is legal in Canada and Rodriguez was unable to end her life because of a lack of mobility, she argued it was discriminatory to prevent her from ending her own life with the aid of another. The court refused her request in 1993, but one year later she ended her life anyway with the help of an unnamed doctor. (CP)
Robert Latimer was convicted of second-degree murder in the 1993 death of his severely disabled daughter Tracy. A lack of oxygen during Tracy's birth led to cerebral palsy and serious mental and physical disabilities, including seizures and the inability to walk or talk. Her father ended Tracy's life by placing her in his truck and connecting a hose to the vehicle's exhaust.The case led to a heated debate over euthanasia in Canada and two Supreme Court challenges. Latimer was granted day parole in 2008 and full parole in 2010. (CP)
Former Bloc Québécois MP Francine Lalonde tried repeatedly to get legislation legalizing euthanasia in Canada passed. Bill C-407 and Bill C-384 were both aimed at making assisted suicide legal. C-384 was defeated in the House 228 to 59, with many Bloc MPs and a handful of members from all other parties voting for the legislation. Tetraplegic Tory MP Steven Fletcher, pictured, made the following statement after C-384 was defeated: "I would like to be recorded as abstaining on this bill. The reason is I believe end of life issues need to be debated more in our country. I believe that life should be the first choice but not the only choice and that we have to ensure that resources and supports are provided to Canadians so that choice is free. I believe, when all is said and done, the individual is ultimately responsible. I want to make this decision for myself, and if I cannot, I want my family to make the decision. I believe most Canadians, or many Canadians, feel the same. As William Henley said in his poem Invictus, "I am the master of my fate: I am the captain of my soul."(CP)
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