physician-assisted dying

After years of debate and lawsuits physician-assisted death is now legal in Canada, following a landmark Supreme Court decision to decriminalize it and the subsequent passage of Bill C-14.

WHAT IS PHYSICIAN-ASSISTED DYING?

Physician assistance in dying (PAD) or medical assistance in dying (MAiD) refers to a practice in which a physician provides a competent, terminally ill patient with a prescription for a lethal dose of medication, upon the patient's request, which the patient intends to use to end his or her own life.

WHO IS ELIGIBLE?

According to the Act*:

A person may receive medical assistance in dying only if they meet all of the following criteria:

(a) they are eligible — or, but for any applicable minimum period of residence or waiting period, would be eligible — for health services funded by a government in Canada;

(b) they are at least 18 years of age and capable of making decisions with respect to their health;

(c) they have a grievous and irremediable medical condition;

(d) they have made a voluntary request for medical assistance in dying that, in particular, was not made as a result of external pressure; and

(e) they give informed consent to receive medical assistance in dying after having been informed of the means that are available to relieve their suffering, including palliative care.

HealthyCanadians.gc.ca

ARE NON-TERMINAL PATIENTS ELIGIBLE?

According to the Justice Ministry, it is not required that the person be suffering from a fatal disease that will cause their death. Rather, the death must be "reasonably foreseeable, taking into account all of their medical circumstances," which could include considerations of age or frailty, and the interaction of several different medical conditions which may cause the person to be in a life-threatening condition.

However, many legal experts contend the law does not comply with the Charter of Rights or the Supreme Court Carter decision, because it is discriminatory and will inflict unwanted, excruciating pain and suffering upon Canadians who are grievously ill but whose deaths are not “reasonably foreseeable.”  The legislation excludes those suffering from severe mental illness or competence-eroding conditions such as dementia.

In June 2016, Julia Lamb, a 25-year old woman from British Columbia, who has Spinal Muscular Atrophy, a degenerative, non-terminal disorder challenged the law. She is petitioning the courts for the right to a physician-assisted death.


Where is physician-assisted dying legal?

In addition to Canada, medical assistance in dying/suicide is legal in the following countries:

Belgium, Colombia, Luxembourg, The Netherlands, Switzerland, The U.S. (California, Montana, Oregon, Vermont, Washington) 


how does canada's new law compare to other jurisdictions?

In every jurisdiction where medical assistance in dying is legal the patient must be competent, well-informed, make a voluntary request, and eligibility must be confirmed by a second doctor.

Assisted-suicide laws in the U.S. allow the practice only for those who are critically ill and have six months or less to live, and the rules require the patient to administer the medication themselves.

European laws on medically assisted death are broader. The eligibility is not restricted to terminal illness, and includes any patient whose suffering is constant and unbearable, resulting from a serious and incurable disorder.  The medication can be self-administered or given by a doctor.

Only the Netherlands and Belgium permit euthanasia for patients under the age of 18.  In the Netherlands it is restricted to age 16 and 17.

The Netherlands is the only country that allows advance directives in the case of dementia.