Euthanasia & Assisted Suicide in Canada

LATEST PROPOSED EUTHANASIA LAW……..

Quebec’s euthanasia bill dead for now
(March 5, 2014)
Bill 52, patterned after Belgium’s euthanasia law, was essentially killed when Quebec Premier Pauline Marois called for a new election in April.  This resulted in dissolution of the National Assembly, killing all pending bills, including bill 52.

Bill 52 (2013), if passed, would legalize euthanasia, calling it “medical aid in dying” and require that doctors administer the fatal drugs.
According to Section 29 of the bill, “if a physician determines …that medical aid in dying may be administered to a patient requesting it, the physician must administer such aid personally and take care of the patient until their death.” (emphasis added)
Update:  Bill 52 has been delayed.  See articles below.

Scroll down for news articles

COURT CASES……….

February 3, 2014
In Bentley v Maplewood, the B.C. Supreme Court has ruled that Margot Bentley’s spoon feeding is to be continued.  Her family had sought to prevent her from eating an drinking.

January 14, 2014
“Canada Supreme Court to revisit decision banning assisted suicide”

(Reuters — January 16, 2014)
The Supreme Court of Canada agreed on Thursday to take another look at a decision it made in 1993 upholding a ban on assisted suicide, setting up a new battle over the right to die.

November 21, 2013
“No ‘Spoon Feeding!’ Case to BC Supremes”
(National Review Online — November 21, 2013)
At stake is whether a nursing home can be forced to starve a patient to death by withholding spoon feeding. The patient is voluntarily swallowing. No one is forcing food or water down her throat. Spoon Feeding!’ Case to BC Supremes”

October 18, 2013:
The Supreme Court of Canada dismissed an appeal that would have permitted doctors to end life support for a severely brain-damaged man without the consent of his family or a substitute decision maker.
Judgment in Cuthberton v. Rasouli

October 10, 2013:
British Columbia’s Court of Appeal reversed a lower court ruling that said Canada’s assisted-suicide ban violated the charter rights of gravely ill Canadians.
Full text of decision in Carter v. Canada (2013 BCCA 435)

June 15, 2012:
British Columbia Supreme Court Judge Lynn Smith ruled against the law forbidding physician-assisted in Canada.  In her decision, she upheld a challenge by three plaintiffs stating that the law’s provisions “unjustifiably infringe the equality rights” of one plaintiff and the “the rights to life, liberty and security” of the other two plaintiffs.
An appeal of the decision is expected.
Full text of decision in Carter v. Canada (2012 BCSC 886)

July 13, 2012:
Justice Minister Rob Nicholson issued a statement, announcing that the federal government will appeal the ruling.  According to Nicholson, “The laws surrounding euthanasia and assisted suicide exist to protect all Canadians, including those who are most vulnerable, such as people who are sick or elderly or people with disabilities. The Supreme Court of Canada acknowledged the state interest in protecting human life and upheld the constitutionality of the existing legislation in Rodriguez (1993).”

ARTICLES…………

“Quebec’s end-of-life bill faces more hurdles”
(Global News — February 23, 2014)
The Philippe Couillard-led Quebec Liberals last week effectively stopped Bill 52 from passing when they decided against staying late to vote on the bill before members of the National Assembly headed out on a two-week break, arguing there was not enough time to afford the bill the amount of debate it warrants.

“Federal Liberals call for de-criminalization of physician-assisted death”
(Montreal Gazette — February 23, 2014)
Federal Liberals have passed a controversial resolution calling for the de-criminalization of medically-assisted suicide during their policy convention here Sunday.
Text of resolution

“Quebec Liberals block passage of end-of-life bill”
(CBC News — February 20, 2014)
The Phillippe Couillard-led Quebec Liberals have blocked the passage of Quebec’s end-of-life legislation, Bill 52, said parliamentary house leader Stephane Bedard…If an election is called, the passage of the end-of-life bill would be paralyzed until an eventual revival by the next government.

“Assisted suicide — what could possibly go wrong?”
(Globe and Mail — Canada — February 20, 2014)
A service launched by a right-to-die group [in the Netherlands] has 30 mobile teams that make house calls to people who want to die but whose family doctors may be unwilling to participate. One of the people its staff put to death was a 63-year-old man who had no friends ot family and couldn’t face the prospect of retirement.  Another was a 54-year-old woman with a pathological fear of germs.

“As Quebec set to legalize euthanasia, doctors already looking to expand who qualifies for lethal injections”
(National Post — Canada — February 13, 2014)
Quebec’s National Assembly is set to begin final adoption next week of a law that will legalize euthanasia in the province.
According to Yyes Robert, secretary of the province’s College of Physicians, “This bill, as it is right now, it’s probably a landmark but surely not the end of the reflection.  It’s only a step.”
[Note: The Quebec proposal, Bill 52, is modeled on Belgium's euthanasia law.]

“Court rules 82-year-old Abbotsford Alzheimer’s patient must be fed in spite of ‘living will’”
(Vancouver Sun — February 3, 2014)
The B.C. Supreme Court ruled Monday that the care and feeding of Margot Bentley must continue.  Central to the ruling was determining that Bentley was capable of making the decision to accept food or drink.
In his ruling, Justice Greyell wrote, “I find it significant that Mrs. Bentley indicates preferences for certain flavours and eats different amounts at different times.”
Her family had insisted that she was not capable and that when the care home staff pressed spoonfuls of food against her lips, she was only acting reflexively when she opened her mouth.
Text of ruling in Bentley v Maplewood

“Martinuk: Suicide prevention plans at odds with right to die”
(Calgary Herald — January 3, 2014)
Prevention is usually a good policy. But I have questions about whether any suicide prevention policy can be successful with Canada’s health-care system and be consistent with other societal messages.

“Belgian rapist’s plea for euthanasia stirs debates on mental health and right to die”
(Globe and Mail — January 1, 2014)
[I]t is also of interest for Canada, where the corrections system struggles similarly with how to best deal with mentally ill inmates.  What’s more, Quebec’s legislature is currently debating a right-to-die bill modeled after the Belgian and Dutch voluntary euthanasia laws.

“No ‘Spoon Feeding!’ Case to BC Supremes”
(National Review Online — November 21, 2013)
At stake is whether a nursing home can be forced to starve a patient to death by withholding spoon feeding. The patient is voluntarily swallowing. No one is forcing food or water down her throat.

“‘Family should decide on life support,’ Canadian Supreme Court rules in Hassan Rasouli case”
(Courier-Mail — October 19, 2013)
Families and not doctors should decide when life support is turned off, says Canada’s Supreme Court.

“Euthanasia puts the elderly at risk”
(Mercatornet — October 28, 2013)
When it comes to euthanasia, the slippery slope aspect of it keeps being swept under the carpet. For me, it is the single most compelling reason not to go forward and here’s why: I have seen the slippery slope played out in the care my mother receives at her nursing home.

“B.C. Court of Appeal upholds ban on assisted suicide”
(CTV News — October 10, 2013)
The British Columbia Court of Appeal has upheld Canada’s ban on physician-assisted suicide in a split 2-1 decision.
Federal Health Minister Rona Ambrose reiterated Ottawa’s stance on euthanasia last week, saying: “We do not support assisted suicide — that is our government’s clear position.”

“B.C.’s Appeal Court says Canada’s ban on assisted-suicide is constitutional”
(Calgary Herald — October 10, 2013)
British Columbia’s Court of Appeal has reversed a lower court ruling that said Canada’s assisted-suicide ban violated the charter rights of gravely ill Canadians.  Two of the three judges in the split decision ruled that while the law banning assisted suicide has certainly evolved in the last two decades, it hasn’t changed enough to undermine the 1993 decision from the Supreme Court of Canada.

“Help to die? Careful what you ask for”
(Globe and Mail — October 9, 2013)
Only one-third of Quebeckers understand (correctly) that “medical help to die” means active euthanasia: a lethal injection performed by a physician on a patient who requested death. Another third of respondents confuse this procedure with palliative care. And 40 percent confuse it with withdrawing the aggressive life-support techniques that can artificially prolong life.

“Family seeks right to die for dad”
(Windsor Star — August 13, 2013)
William Turner, 69, has advanced Alzheimer’s, heart disease, diabetes…His family wants the nursing home where he lives to stop administering his insulin.

“Nursing Home Won’t Starve Mother — Family Sues”
(National Review — August 8, 2013)
In Canada, a family wants a nursing home to stop spoon feeding their mother because she would not want to be kept alive with Alzheimer’s.

“Patient’s family sues B.C. as nursing home keeps her alive against her wishes”
(Vancouver Sun — August 7, 2013)
The actions of Abbotsford nursing home staff who are spoon-feeding an 82-year-old Alzheimer’s patient — contrary to the wishes she expressed in her living will –constitute battery, a lawsuit by her daughter and husband alleges.
Margot Bentley’s daughter, Katherine Hammond, said she doesn’t visit her mom much anymore.

“Family of B.C. woman ravaged by Alzheimer’s fights to fulfill her right to die with dignity”
(National Post — July 10, 2013)
In 1991, Margot Bentley drafted a detailed “living will.” She wrote that health care workers were to dispense “no nourishment or liquids” if it was clear she had no chance of recovery.”
According to her daughter, Bentley’s regular spoon-feeding should stop.

“Quebec is trying to legalize euthanasia by calling it something else”
(Globe and Mail — June 19, 2013)
So, you call your pet duck, which lives with you, a dog, because the law prohibits keeping a duck in your apartment, but allows dogs.  A court will convict you for breaking the law.
Now, you are the Quebec provincial government and you table a bill in which you call euthanasia, which is prohibited as murder, “medical aid in dying” and claim it is medical treatment….

“Quebec Euthanasia: Journalism Malpractice 3″
(National Review — June 13,2013)
Paraplegics could most certainly qualify: It could be deemed an “incurable illness” that has led to “irreversible decline in capability” and which causes “unbearable physical or psychological pain” that cannot be relieved “in a manner the person deems tolerable.”

“Govt Funded Euthanasia Coming to Quebec?”
(National Review — June 12, 2013)
It would require that all “institutions,” e.g., hospitals, nursing homes, and residential care facilities “provide” terminal sedation or euthanasia which are included in the bill’s definition of the term, “end of life care.”

“Whose Life Is It Anyway?”
(National Review — June 3, 2013)
Futile Care Theory is as much about money as it is about benefiting the patient.  It is also about honoring the subjective views of doctors and care givers — even at the expense of rejecting a patient’s specific request for efficacious treatment, that is, treatment that would or could achieve the desire medical result of extending the patient’s life.

“Pro Suicide Advocacy in Globe and Mail
(National review — March 2, 2013)
A woman committed suicide and it is depicted in the press as a positive — “on her own terms.”  And note, she was not terminally ill, the usual excuse for supporting suicide….Suicide is being transformed into a human rights before our very eyes.  But if it’s a “right” that means for any one and any reason:
Death on demand. Reader take warning!

“Some Quebec doctors resisting drive for euthanasia”
(BioEdge — February 22, 2013)
Some Quebec doctors are beginning to fight back against a drive for legalised euthanasia. Earlier this week, Physicians Alliance for the Total Refusal of Euthanasia (PATRE) organised a conference to influence an upcoming debate in the province’s parliament. Most of PATRE’s 317 member doctors hail from Quebec.

“Corbella: Untruths used to push for euthanasia law”
(Calgary Herald — February 15, 2013)
The case of Ruth Goodman is a perfect example of how confused, illogical uniformed and sometimes untruthful many proponents of euthanasia or physician-assisted suicide are.  Goodman killed herself on Feb. 2 with no assistance, at the age of 91 in her Vancouver home, in a bid to change physician assisted suicide laws….[E]veryone already can make “this choice.” It’s not illegal to kill yourself.

“Quebec’s Doctors to Become Killers?”
(National Review — February 7, 2013)
Quebec is about to make a major push to legalize euthanasia based on the recommendations of a commission. The commission’s recommendations include: “We propose that this option take the form of ‘medical aid in dying’. This assistance involves an act performed by a physician in a medical setting following a free and informed request made by the patient himself.”

“A Life Interrupted: Hassan Rasouli’s journey from an earache to a high-stakes battle over end-of-life decisions
(Informer — Toronto, CA — November 27. 2012
….The Rasoulis were stunned. Hassan had been a health, vigorous man.  He had walked into non-emergency surgery under his own volition and caught a bug from the hospital, and now the same hospital was saying they wanted to let him die?

“Family to take end-of-life fight to Supreme Court of Canada”
(CTV TV — November 19, 2012)
The family first began to see signs of improvement in January 2011, saying Rasouli was tracking their movements with his eyes, and even got to the point where he could give a thumbs-up. In their submission to the SCOC, doctors at Sunnybrook said protracted end-of-life care is a massive drain on the entire medical system, arguing that physicians should have the right to decide when life support is halted.

“Death’s midwife helps terminally ill Canadians end their lives”
(The Star – Toronto — October 21, 2012)
Reaching beneath a desk in her home office, Ruth von Fuchs pulls out a white plastic box containing a collection of tubes, valves and microwave turkey roasting bags.
This is her death kit.

“Quebec to legalize doctor-assisted suicide”
(CJAD Radio — October 4, 2012)
Quebec’s new government plans to table legislation legalizing doctor-assisted suicide by this spring. According to social services junior minister Veronique Hivon, patients should only have access to the service if they are adult Quebec residents with a serious and incurable illness, and have given their express written consent.

Quebec has no power over the criminal code, which forbids doctor-assisted suicide.  However, Hivon is arguing that Quebec will be able to pass this law without Ottowa. “Quebec has jurisdiction over health and also over professional qualifications,” she says. “So this gives us the confidence to introduce this medical aid in dying in our bill.”

“Report: Canadian health care spending unsustainable”
(Daily Caller — July 24, 2012)
Single-payer health care, once lauded by President Barack Obama for its ability to keep health care expenditures down by rationing care, has become prohibitively expensive and inefficient in Canada, according to a new study.

“It’s expensive to support the disabled — suicide kits are $39.95″
(Winnepeg Free Press — July 21, 2012)
Arthur Schafer’s portrayal of comments on the merits of physician-assisted suicide need challenging.  Schafer, like many supporters of physician-assisted suicide (also known as “doctor-prescribed death”), does not seem to have considered the wider issues facing Canadians with disabilities, including the ongoing social prejudice and discouraging lack of living supports that we encounter on a daily basis.

“Assisted-suicide ruling to be appealed by Ottawa”
(CBC News — July 13, 2012)
The federal government will appeal last month’s ruling by the British Columbia Supreme Court that partially struck down Canada’s ban on assisted suicide, Justice Minister Bob Nicholson says.
In a statement, Nicholson said, “The Supreme Court of Canada acknowledged the state interest in protecting human life and upheld the constitutionality of the existing legislation in Rodriguez (1993).  In April 2010, a large majority of parliamentarians voted not to change these laws…

“Down a dangerous path”
(The Progress — June 28, 2012)
One person’s right can become another person’s obligation. When patients have the right to choose euthanasia, this sends an implicit message that some lives aren’t worth living. Frail elderly, handicapped, and cancer patients can easily perceive that society doesn’t want them around, when they can instead choose to “die with dignity.” It is a short step from believing that they can choose dying to believing that they should choose dying.

“Is Medically Assisted Death an Individual Right”
(Psych Central — June 27, 2012)
Advocates argue that medically assisted death is a patient’s right. It should therefore be considered as an end-of-life option rather than a criminal act.
“Many physicians and patients will find this a shocking prospect to consider,” write Drs. Ken Flegal and John Fletcher. “Frail, dependent patients often feel a burden to their families or caregivers, and the unspoken possibility of a quick resolution to their predicament may complicate an already stressful situation,” they write.

“Choosing when and how to die: Are we ready to perform therapeutic homicide?”
(Canadian Medical Association Journal — June 25, 2012)
Removing the legal barrier to ending another’s life may ensure the self-dignity of those who wish to die, but may distress and remove the self-dignity of more people who wish to live.

“How do we want our great-great-grandchildren to die?”
(Mercator.net — June 17, 2012)
How do we want our great-great-grandchildren to die? This is probably the most important question of all.  And if we legalize assisted suicide/euthanasia what kind of society will they live in and what will be its shared values?

“Not Dead Yet Responds to Quebec Commission Report on ‘Dying with Dignity’”
(Not Dead Yet blog — March 26, 2012)
The highlight of the report is 24 recommendations that include “medically-assisted death” as an “option for care.”  The report indicates that individuals with such conditions as ALS, Multiple Sclerosis and Muscular Dystrophy, where people can live many satisfying and productive years, even after “advanced deterioration of their capacities” would be eligible for euthanasia.

“Haunting right-to-die case weighs on judges’ minds, 18 years on”
(The Globe and Mail — December 16, 2011)
Jack Major can still see the silent ranks of disabled people, their wheelchairs ringing the Supreme Court of Canada as a courtroom full of lawyers debated the assisted suicide law in 1993….Eighteen years later, the polarizing question is heading back to the top court.

“B.C. right-to-die group launches court challenge”
(CTV BC Canada– August 1, 2011)
Much has changed in the 18 years since Canada’s high court refused Sue Rodriguez the legal right to assisted suicide. For that reason, the Farewell Foundation For The Right to Die will be renewing the court battle around “self-chosen death.”

Canadian government sued over assisted-suicide law
(Courthouse News, Vancouver, BC — April 29, 2011)
For the second time in a month people have sued the Canadian government, seeking to overturn the criminal prohibition on doctor-assisted suicide. A married couple say they fear prosecution for helping the wife’s mother end her life in Switzerland and a doctor says he would be willing to provide the service.

“Assisted Death, Palliative Care and Human Rights”
( Medical News Today – - February 1, 2011 )
The issues of assisted suicide and palliative care in Canada should be discussed in the context of human rights according to a commentary in the Canadian Medical Association Journal…”The equalization of palliative care must occur before legalization of assisted suicide, otherwise there runs the very real risk that a decision to request assisted death is not fully consenting because of the lack of meaningful choices in the ability to alleviate pain and distress.”

Euthanasia & Assisted Suicide in Canada: Chronology 1983 through 2010
(National Library of Canada — October 15, 2011)


In Canada, Francine LaLonde has often introduced assisted suicide bills.  Her 2009-2010 bill, C-384, if passed, would have amended the Criminal Code to permit a doctor to assist a patient’s suicide if the patient was EITHER (A) in severe physical or mental pain, or (B) is terminally ill.  The bill failed.

“Euthanasia is about killing, not the ‘right to die with dignity’”
Examiner - Canada – December 1, 2009 )
Assisted-suicide bill debate is delayed until February 2010.

“Killing without mercy,” (Calgary Herald, 5/8/08)
Canadian lawmaker plans to introduce her euthanasia and assisted-suicide bill again.

“What if we could choose our time to die?” (Montreal Gazette, 1/7/08)
“It seems that no regulation can control euthanasia once the legal ban has been lifted.

2005 Bill to permit assisted suicide fails.
On June 15, 2005, Francine Lalonde, a lawmaker from La Pointe-de-l’Ile, introduced Bill C-407.  The measure would have permitted a medical practitioner or someone assisted by a medical practitioner to aid another person to die if that person has a terminal illness or is experiencing severe physical or mental pain and “appears to be lucid” when he/she requests death.  The measure failed to gain support.
Text of C-407

CANADIAN SUPREME COURT ASSISTED SUICIDE DECISIONS
Rodriguez v. British Columbia
(1993) 
Regina v. Latimer
(Appeal, 1997)
Regina v. Latimer (Appeal decision, 2001)


Justice Minister declares he will not support C-407 (10/13/05)
The following message was sent from Paul Macklin, M.P to Liberal Assistants: – Liberal Members/Députés on October 13, 2005:

Dear Colleagues,

There has been increased reporting by media lately on the subject matter of Euthanasia and Assisted Suicide – due in part to Francine Lalonde’s Private member’s Bill, C-407, and in part to some cases before the courts.

To provide you with the latest information, please find attached our position paper on Bill C-407.  Please be advised that Bill C-407 is tentatively scheduled for its first hour of debate on October 31st.

If you require further information, please do not hesitate to contact the Minister’s office at 992-4621.

Sincerely,

Hon. Paul Macklin, P.C., M.P.
Parliamentary Secretary to the Minister of Justice and Attorney General of Canada

Position Paper
BILL C-407
An Act to amend the Criminal Code (right to die with dignity)
Francine Lalonde (Bloc Québécois)

 

Minister’s Position: The Minister of Justice will not be supporting the bill.

Factual Summary of the Bill:

Bill C-407 proposes to amend the Criminal Code to permit assistance in dying under certain conditions.

Key features of the bill:

 

The bill seeks to permit assisted suicide and euthanasia, in both cases provided the conditions described below are met.

The bill would not only apply to terminally-ill patients, but also to persons who suffer from severe physical or mental pain with no prospect of relief (neither physical nor mental pain is defined).

The aider could be either a medical practitioner or someone who is assisted by a medical practitioner.

The Bill’s prescribed conditions included in the bill somewhat temper its potential scope as the require that the person wishing assistance in dying: must be 18 years of age andor older; over, be either terminally ill or suffering from severe physical or mental pain with no prospect of relief,; make two requests, ast least 10 days apart, while “appearing to be lucid,” to a doctor or aider,; and must also designate someone who will act on his or her behalf vis-à-vis the doctor or aider should he or she become mentally incapacitated. Under the Bill, tThe “aider”: must be either a medical practitioner or someone who is assisted by a medical practitioner,; must have received confirmation of the diagnosis from another doctor, or from two doctors if the aider is not a doctor,; must be a member of, or assisted by, a provincial health services team,; must act in the manner requested by the person wishing to die,; and must provide the coroner with the confirmation of diagnosis.

 

Assessment:

It is expected that this bill will raise considerable public attention and controversy as it touches upon such profound issues as life and death, which for many involves religious beliefs.

The Bill has far-reaching implications in the manner in which it alters the current state of the law and in the way it will impact on medical ethics and practice. The Bill also appears to exceed the parameters of current public views. While many Canadians may not disapprove of permitting those who suffer from severe physical pain with no prospect of relief to access assistance in dying, few would tolerate the idea of allowing those who suffer from severe mental pain with no prospect of relief to have the same access to assisted death. As “mental pain” is not defined in the Bill, such common conditions as chronic depression could potentially qualify as “mental pain”. This particular aspect of the proposal, combined with such vague terms as “while appearing to be lucid” as the requisite criterion for providing consent, raise concerns with respect to s. 7 and s. 15 of the Charter. The recognized medical and legal standard for providing a free and informed consent is not reflected in Bill C-407.

In order to guard against the potential to move towards what is often described as the “slippery slope” in facilitating the unwanted death of elderly, physically or mentally vulnerable persons, a very stringent regime would have to be introduced, and Bill C-407 falls short of accomplishing this. For example, Bill C-407 lacks an appropriate oversight mechanism to guard against abuses. The Bill does not require detailed reporting or establish a committee to review reports as is found in comparable legislation implemented in Oregon, the Netherlands and Belgium, nor does the Bill does address how to deal with cases of abuse, e.g. by creating a specific offence.

The Bill also addresses matters that fall within provincial/territorial responsibilities for the delivery of health care services and the medical profession, and provincial legislation that deals with substitute decision makers. Extensive consultations with interested groups, including the medical profession, and Canadians in general should be undertaken by Parliament before it considers a specific legislative proposal, although Parliament did examine these issues in detail in 1994 and 1995 in the context of the study conducted by the Special Senate Committee on Euthanasia and Assisted Suicide. It should be noted that the majority recommended that theCriminal Code offence of assisted suicide should remain intact.