Physician-assisted dying is no longer illegal in Canada, now that a landmark Supreme Court of Canada ruling has come into effect.
But with no federal legislation yet passed by Parliament to support the court ruling, B.C. moved to create its own regulations on Monday, in an effort to help adults seek a doctor’s assistance to end their lives, and to guide physicians.
The province wants to make medical assistance for dying in B.C. “appropriate, available, and well-monitored,” said a joint statement by B.C. Health Minister Terry Lake and Attorney General Suzanne Anton.
The B.C. College of Physicians and Surgeons upgraded its guidelines Friday on what is expected ethically and professionally from doctors. The government has folded those standards into B.C.’s Health Professions Act, bringing them under provincial law.
“Our ministries are working together, alongside the province’s professional regulatory colleges and other partners, to ensure safeguards are in place to protect vulnerable patients,” the ministers said.
Lake said each health authority has been directed to appoint a co-ordinator for medical assistance in dying.
To meet the college’s criteria, patients must be at least 19 years old and capable of making decisions respecting their health. They must also have a grievous and irremediable medical condition that causes enduring suffering that is intolerable, make a voluntary request in writing witnessed by two independent witnesses, have given free and informed consent to receive such assistance and be eligible for publicly funded health-care services.
Physicians can choose not to assess patients’ eligibility or participate in medically assisted death, based on their values and beliefs, but must provide those patients with enough information and assistance to allow them to make informed choices, and provide effective transfer of care for such patients, the college said.
Only Canadian physicians — not nurses or pharmacists — have the Criminal Code exemption to provide medical assistance in dying, said Dr. Heidi Oetter, registrar of the College of Physicians and Surgeons. Federal legislation — when it comes — will trump the provincial standards, she said.
In a Supreme Court of Canada ruling last year, known as the Carter decision, the ban on assisted dying was struck down as a violation of the charter clause on the right to life, liberty and security of the person.
The federal government was given until June 6 to write legislation, but Bill C-14 is still before the Senate.
The government is urging the Senate to pass the bill quickly, arguing the legislation is urgently needed to ensure strict safeguards to protect the vulnerable.
But that effort might have been threatened Monday when legal scholar Peter Hogg — who literally wrote the book on constitutional law in Canada, a text frequently cited by the Supreme Court — said Bill C-14 is inconsistent with last year’s decision. He argues C-14 would take away constitutional rights granted by the court to an entire group of people outside the terminally ill.
NDP justice critic Murray Rankin called the expert opinion “a real game changer.” If the government is committed to the rule of law, “they have no choice but to amend their bill. It’s no longer supportable,” said Rankin, MP for Victoria.
The College of Physicians and Surgeons’ standards stipulate that someone need not have a terminal illness to seek medical assistance in dying, while the federal government’s legislation says the assistance is only for consenting adults “in an advanced stage of irreversible decline” with an incurable condition and for whom natural death is “reasonably foreseeable.”
— With files from the Canadian Press
B.C. College of Physicians and Surgeons: guidelines for assisted dying and medical assistance in dying FAQs
