Canada is in a state of legal limbo when it comes to doctor-assisted dying.
As of Monday morning, there is no law in place governing medically assisted death after the federal Liberals failed to get new rules in place before the midnight deadline.
The Supreme Court struck down the ban on medically assisted dying in the February 2015 ruling in the Carter v. Canada case. The ban remained in place for a year while Parliament came up with a new law.
The grace period is now over, and while Senators approved Bill C-14 in principle last Friday, it still requires a committee review and a third reading.
A vote is not expected to happen before Friday, and it could be several weeks before the new legislation is officially enacted.
Dr. Eric Hoskins, Ontario’s Minister of Health and Long-Term Care, and Madeleine Meilleur, Ontario’s Attorney General issued the following statement:
“Beginning today, medical assistance in dying is permitted in Ontario as a result of a decision by the Supreme Court of Canada.
Patients who wish to access medical assistance in dying should talk with their health care provider. Health care providers should consult their regulatory colleges about any rules, guidelines or practices regarding medical assistance in dying.
Ontario’s health regulatory colleges for physicians, nurses and pharmacists will provide guidance to help health care providers provide appropriate medical assistance in dying to patients who request this option. Ontario will also ensure that drugs required for medical assistance in dying will be available at no cost.
Ontario will establish a referral service to support physicians in making an effective referral for consultation and assessment for possible medical assistance in dying cases. The service will help connect physicians who are unwilling or unable to provide medical assistance in dying with physicians who are willing to complete a patient consultation and assessment.
While not required by the Supreme Court, we encourage patients and health care providers to seek further clarity about how the Supreme Court’s decision applies to their particular circumstances by bringing an application to the Ontario Superior Court of Justice.
Federal government legislation on medical assistance in dying is not currently in place. We urge both the House of Commons and the Senate to continue to work collaboratively to pass legislation so that a national framework for the provision of medical assistance in dying can be established.
Ontario will continue to monitor the proposed federal legislation closely and continue engaging federal officials and other provinces and territories on issues related to this legislation as required. Moving forward, Ontario will also pursue amendments to provincial legislation to further support the implementation of medical assistance in dying.
Medical assistance in dying is a significant matter to all Ontarians. Through our consultations, we heard from thousands of Ontarians, health care providers and stakeholders from across the province about the complex and sensitive issues related to end-of-life decisions and medical assistance in dying. Our ongoing commitment is to ensure that end-of-life care is provided appropriately, safely and with the utmost compassion.”
More information is available on the Ontario government’s website.
Since the federal Liberals missed the deadline, the Supreme Court’s original ruling becomes the law.
That means doctors can’t be prosecuted under the Criminal Code if they help a patient, who meets the criteria, end their life.
The Canadian Medical Protective Association, the organization that provides legal advice to doctors, is recommending they meet with a lawyer if a patient comes to them this week asking for help to die.
The High Court directed that assisted dying should be available to consenting adults with “grievous and irremediable” medical conditions who are enduring intolerable suffering.
However, the government’s legislation is more restrictive and has received plenty of criticism from advocates for doctor-assisted dying.
Bill C-14 sets out considerably more restrictive eligibility criteria, allowing assisted dying only for clearly consenting adults “in an advanced stage of irreversible decline” from a serious and incurable disease, illness or disability and for whom natural death is “reasonably foreseeable.”
Justice Minister Jody Wilson-Raybould argued that the government is not required to stick to the strict wording of the court’s so-called Carter decision, which she said would have meant introducing “one of, if not the broadest assisted dying regimes in the world.”
“Under an approach where any serious medical condition is eligible, the law would be saying that an assisted death could be an acceptable treatment for a soldier with post-traumatic stress disorder, a young person who suffered a spinal cord injury in an accident or a survivor whose mind is haunted by memories of sexual abuse,” she told the House of Commons.
“These are difficult but necessary situations to talk about because cases like these are the unavoidable consequence of an assisted dying law where the only limit on eligibility is an individual’s subjective experience of suffering.”
Officials with the group “Dying with Dignity Canada” believe the bill’s shortcomings are not including those with mental suffering or those suffering from a non-terminal illness.