As of today – June 6, 2016 – physician-assisted dying (also called medical assistance in dying) is legal in Canada. There have been many twists and turns on the path to legalization, and consequently a great deal of confusion about the state of the law. This blog will sort out a few of the myths from the facts.
MYTH: As of June 6 anyone can access physician-assisted dying
FACT: Not just anyone can access physician-assisted dying.
In order to be eligible for physician-assisted dying a person must:
- be a competent adult;
- clearly consent to the termination of life; and
- have a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition
The government has been working on legislation for several months and when it eventually is finalized and comes into force it will likely modify the above criteria. This means that a person in Canada who is eligible today might not be eligible in the future depending on the circumstances of their medical condition.
MYTH: Because the government did not finalize legislation by June 6, there is a “legal limbo” or Canada has no law
FACT: Firstly, June 6 is not a hard “deadline” that has been “missed”. Legislation can still be passed when it is ready. Secondly, although there is no federal legislation yet, there is nonetheless a legal framework.
Between February 6 and June 6 people seeking physician-assisted deaths were required to obtain court orders in order to proceed (called “constitutional exemptions”); now they will be able to proceed as long as they have a physician who says they are eligible, and a physician willing to assist with the death.
Physicians may only provide medical assistance in dying to persons who are eligible based on the criteria above, which was established by the Supreme Court of Canada.
Further, they must comply with a variety of other laws, regulations and policies. There is already legislation, ethical duties and clinical practices that govern informed consent and how to assess capacity to make treatment decisions. There are medical associations and regulatory bodies that have established protocols. For example, the College of Physicians and Surgeons of Ontario released an Interim Guidance document in January 2016.
The provinces are also filling in some of the gaps. Quebec even has its own legislation. However, not every controversial medical service requires freestanding legislation (for example, abortion).
There is certainly room for additional regulation though, including proper safeguards, checks and balances.
MYTH: Health care providers who are morally opposed to assisted dying will be compelled to assist
FACT: There is nothing in the law that forces health care providers to assist with a death. The Supreme Court of Canada stated that nothing in its decision would require physicians to help a person to die. The Court noted that the “Charter rights of patients and physicians will need to be reconciled in any legislative and regulatory response to this judgment.”
Physicians will have to connect with their provincial regulatory bodies in order to determine what is and is not required of them by way of policy.
UPDATE: The Federal government introduced Bill C-14 that subsequently became law. Click here for more information about the new legislation. And click here to read about the legal challenges to the new legislation.
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