The Supreme Court of Canada on Friday struck down laws banning physician-assisted suicide for patients with “grievous and irremediable” medical conditions.
The unanimous decision, which reverses a position taken by the court 22 years ago, came more quickly than expected and might become an issue in Canadian federal elections to be held this year.
“The prohibition on physician-assisted dying infringes the right to life, liberty and security of the person in a manner that is not in accordance with the principles of fundamental justice,” the court wrote, adding that an absolute ban is not needed to ensure that vulnerable people are not coerced “to commit[ing] suicide at a time of weakness.”
Photo: Reuters
The decision, which follows hearings last fall, comes as Canadians are debating assisted deaths.
In June, Quebec passed legislation that would allow the practice starting at the end of this year. Until the Supreme Court ruling on Friday, the move seemed likely to be overturned under Canadian criminal law.
In August, the Canadian Medical Association (CMA) altered its established opposition to doctors’ assisting in suicides. Its new policy allows physicians, within the bounds of laws, “to follow their conscience when deciding whether to provide medical aid in dying.”
However, some groups that advocate for people with disabilities and some religious groups urged the court not to revoke the law.
“This is a sensitive issue for many Canadians, with deeply held beliefs on both sides,” Canadian Minister of Justice Peter MacKay said in a statement on Friday. “We will study the decision and ensure all perspectives on this difficult issue are heard.”
Canadian Member of Parliament Steven Fletcher, a Conservative Party member who was paralyzed in 1996 in an automobile accident, praised the ruling.
“It will allow people to live longer because they will have the peace of mind knowing that they won’t have a horrible death,” he told reporters at the Supreme Court, adding that some people with worsening health problems kill themselves while they are still capable of doing so because they do not have later options.
The decision does not immediately allow physicians to assist patients in their deaths. Existing legislation and regulations are to remain in place for a year to allow the Canadian federal government — which enforces criminal law — and provinces, which administer healthcare, to adopt new measures.
Fletcher, who previously introduced a bill to allow assisted suicide, declined to speculate on the government’s plans. His proposed legislation was not formally supported by the government, making its likelihood of approval remote.
The two women from British Columbia whose legal cases led to the court’s decision did not live to learn about it. Five years ago, Kay Carter, who was suffering from a degenerative condition known as spinal stenosis, was taken to Switzerland, where assisted deaths are legal, to die.
The decision was “a huge victory for Canadians and a legacy for Kay,” her daughter Lee Carter said at the court.
In 2012, Gloria Taylor died from amyotrophic lateral sclerosis (ALS).
As is the Supreme Court’s custom in a significant unanimous decision, the authorship of the ruling was attributed to: “The Court,” rather than an individual justice.
Canadian Medical Association president Chris Simpson said in a statement that it would work with governments to ensure that physicians will not be required to assist in patients’ deaths because of the court ruling.
“The CMA supports physicians being able to follow their conscience in choosing whether to participate in medical aid in dying and we note that the court quoted directed from our policy,” Simpson said in the statement.
In 1993, the court upheld laws against physician-assisted death in a case brought in British Columbia by Sue Rodriguez, who had ALS.
Despite that ruling, a physician who has never been publicly identified and a member of parliament were present when Rodriguez killed herself a year later.
In that decision, the court said that it feared that legalized assisted suicide could be abused at the expense of “weak and vulnerable people.”
However, Friday’s decision suggested that the legal and medical systems had evolved to the point where prohibition is not needed.
“We agree with the trial judge that the risks associated with physician-assisted death can be limited through a carefully designed and monitored system of safeguards,” the court wrote. “A theoretical or speculative fear cannot justify an absolute prohibition.”
The court’s decision leaves it up to federal and provincial governments and physicians to define the medical conditions that would allow doctors to assist in a patient’s death, and the ruling does not indicate whether mental as well as physical conditions should be among the criteria.
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