Physician Assisted Suicide (PAS) in Canada
1992 until 2016-MAR:
Physician Assisted Suicide (a.k.a. Medical
Assistance in Dying [MAID]) in Quebec:
1992 to 2013: Timeline of early PAS activity in Quebec:
A Library of Parliament report states: 1
- 1992-JAN: The Quebec Superior Court ruled in the case of Nancy B., a woman suffering from an incurable disease, that turning off her respirator at her request and letting nature take its course would not be a criminal offence.
- 2007-JUN: "An Ipsos Reid survey of 1,005 Canadians found that 76% of respondents [across Canada] supported the right to die for patients with an incurable disease. That figure had remained [essentially unchanged for the previous 14 years]. The strongest support was in Quebec with 87%. ..."
- 2008-DEC: "The Quebec legislature created a Select Committee on Dying with Dignity to consult the public in that province about PAS and issue a report.
- 2010-MAY: The Select Committee published a consultation document titled "Dying with Dignity." 2
- 2011-NOV: Elsewhere in Canada, in British Columbia, the lawsuit Carter v. Canada is filed. This lawsuit was eventually to reach the Supreme Court of Canada and legalize PAS across the entire country.
- 2012-MAR: "Quebec’s Select Committee tabled its report, recommending legislative reform to facilitate euthanasia."
- 2013-JAN: "Quebec's expert panel recommended amending health care legislation to treat euthanasia as part of end-of-life care."
The main impediment to implementing PAS in Quebec was a section of the Criminal Code of Canada which applies to Quebec and the rest of Canada. The Parliament Library report says in part:
"Under Section 241 of the Criminal Code, it is an offence to counsel or to aid suicide, although suicide itself is no longer an offence:
'241. Everyone who
a. counsels a person to commit suicide, or
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'." 1
That law has placed many individuals in an intolerable situation. They may have some or all of the following problems:
- a terminal disease,
- uncontrollable pain,
- a very short life expectancy,
- no hope that their condition will ever improve,
- a sincere desire to end their lives,
- a lack of physical and/or mental ability to organize their own death.
With Section 241 in place, there was no way that such people could obtain MAID (Medical Aid In Dying) without exposing the helper to the possibility of a very long jail sentence.
2015-FEB-06: The Supreme Court of Canada issued a unanimous ruling in Carter v. Canada. All nine Justices on the High Court agreed that Section 241 of the Criminal Code of Canada violated the Canadian Charter of Rights and Freedoms, Canada's constitution. They stayed their ruling for 12 months to give governments time to produce legislation that would implement MAID while minimizing the risk of hurting vulnerable suicidal people. The federal government was given until 2016-FEB-06 to have laws in place.
In this conflict over PAS, Quebec chose to act independently of the rest of Canada.
2015-DEC-01 to 22: Bill 52, Quebec's assisted dying (MAID) law, overcame a number of hurdles and was implemented:
- Earlier in 2015, the Quebec Legislature had passed a new law to enable Medical Aid In Dying (MAID) for eligible terminally ill individuals. The law allows individual doctors to refuse to help a patient. However, it does require hospitals to implement patients' MAID requests.
The Coalition of Physicians for Social Justice is a group of doctors in Quebec who opposes MAID and challenged the law. The group's lawyer, Domique Talarico, emphasized that a patient’s consent cannot be free and informed if they have not been offered all palliative care options. This is not always the case in the province due to a lack of accessibility to certain treatments, drugs and services.
“The actual state of the health system, disease screening, the state of health care and palliative care in Quebec are possibly more deficient than anywhere else in Canada. The context of care is part of the totality of evidence to be presented to Superior Court.”
"Euthanasia is not medical care or a solution for suffering." 4
- On DEC-01, Justice Michel Pinsonnault of Quebec's Superior Court ruled that Bill 52 conflicts with Section 241 of the Criminal Code of Canada, and thus cannot be implemented.
- The province appealed this decision to a three-judge panel of the Quebec Court of Appeal. This is Quebec's highest court.
Dr. Paul Saba heads the Coalition of Physicians for Social Justice.
He said that his group will ask the Court of Appeal to dismiss the province's appeal and thus prevent the law from going into effect. He said:
"As a doctor, I can’t accept something that is non-medical, non-scientific. It even goes against my code of ethics in Quebec. Under the code of ethics, if we have treatments to offer or an operation, we must always use the least dangerous [path]." 5
- On DEC-10, Quebec's assisted dying law had been scheduled to come into effect on this day.
But it did not become effective because of the decision in the Superior Court.
- On DEC-18, the Quebec Court of Appeal heard arguments about Bill 52.
- On DEC-22: Quebec's top court reversed the Superior Court decision and allowed the MAID law to go into effect. Benjamin Shingler, writing for the CBC, said:
"Quebec's Court of Appeal has maintained the province's right to allow terminally ill patients the choice to die with medical help, the first law of its kind in Canada.
This morning, a three-judge Court of Appeal panel overturned a DEC-01 Quebec Superior Court judgment aimed at suspending implementation of the province's law, Bill 52, until certain provisions of the Criminal Code were changed.
In the ruling, the Court of Appeal said the Quebec law doesn't contravene sections of the Criminal Code related to assisted dying because they were struck down by Canada's Supreme Court last February." 3
2016-JAN & FEB: Bill 52 is enabled. MAID becomes available in Quebec:
- Sometime during January, an anonymous woman from Quebec City was the first known person in Quebec -- and also in Canada -- to have legally committed suicide with the assistance of a physician.
- During January and February about 20 additional people obtained medical aid in dying (MAID).
- Suffering individuals in Canada who live outside of Quebec and who want MAID are not able to obtain it directly from their physician. They will have access when the new federal law becomes effective sometime on or before 2016-JUN-06. However the Supreme Court of Canada has ruled that, as a stopgap measure, they can individually petition a provincial court in their area and request permission to obtain MAID.
The following information sources were used to prepare and update the above
essay. The hyperlinks are not necessarily still active today.
- "Euthanasia and Assisted Suicide in Canada," Library of Parliament, 2013-FEB-15, at: http://www.lop.parl.gc.ca/
- "Dying with Dignity," Select Committee on Dying with Dignity, 2010-MAY, at" http://www.assnat.qc.ca/
- Benjamin Shingler, "Quebec's top court rules assisted dying law can go ahead," CBC News, 2015-DEC-22, at: http://www.cbc.ca/
- "Quebec's assisted dying law debated at Court of Appeal," CBC News, 2015-DEC-18, at: http://www.cbc.ca/
- Alex Schadenberg, "Doctors group to challenge Quebec euthanasia law in the courts," Euthanasia Prevention Coalition, 2015-NOV-06, at: http://alexschadenberg.blogspot.ca/
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Copyright © 2016 by Ontario Consultants on
Original posting: 2016-MAR-04
Latest update : 2016-MAR-04
Author: B.A. Robinson