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Will My Doctor Be Allowed to Kill Me? And Other Questions about Physician-Assisted Suicide in Canada

History is being made. In February 2016 physician-assisted suicide will be legal in Canada. And we need to talk about it.

The Supreme Court of Canada laid the groundwork for the law in Carter v. Canada. It stated that certain sections of the Criminal Code unjustifiably infringe upon certain rights of the Canadian Charter and that those sections “are of no force or effect to the extent that they prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life and (2) has 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.”

But this decision has left many questions. How do we know a person is “competent”? What constitutes “grievous and irremediable medical condition”? Will someone with severe depression fall into this criteria? What about someone with schizophrenia? Can a physician refuse to assist? And if so, must the physician provide a referral? If a physician refuses to assist, what options does the patient have?  Who will provide oversight? Will families be notified that a patient is pursuing assisted suicide? What methods of dying will be available? Will my doctor be allowed to kill me – or only assist with a self-administered suicide? Will OHIP cover the cost? Will a health professional be permitted to raise physician-suicide as an option, or must the patient know to request it? Can a person consent in advance in a power of attorney? Where will the procedures be performed? Will people be allowed to die in their own homes? Could family members be liable for anything? Must there be a witness to the death? Will there be special training provided for those who assist with or administer the deaths? Can I stop my loved one from going through with physician-assisted suicide? How will we prevent a slippery slope? What safeguards will be in place to protect vulnerable people? If I suspect a person is being coerced to request physician-assisted dying, what can I do? Will a patient have to make multiple requests for aid in dying? What will be stated as the cause of death on the death certificate? Will the law differ across the provinces?

As we blogged about here, consultations are underway but legislation will likely not be in place by the time the Carter decision takes effect. This means that physician-assisted suicide will be allowed, but there will be very little law to guide decisions and few answers to the questions above.

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