“Who owns my life?” Two decades ago, Sue Rodriguez, a Victoria woman diagnosed with ALS, asked that question as she fought all the way to the Supreme Court for the option of medical aid in dying when her suffering became intolerable. In 1993, a divided court split narrowly against her.
In the years since, some European countries and U.S. states legalized medical aid in dying in certain cases. Quebec embarked on a six-year consultation process that produced a comprehensive law on end-of-life care that included, for the first time in Canada, the option of medical aid in dying.
Now, 23 years later, Parliament is poised to consider legislation based on last year’s landmark decision in the case of Kay Carter and others, in which the court ruled unanimously that competent adults, suffering intolerably from grievous and irremediable medical conditions, have the right to seek medical assistance to die on their own terms.
Recently, I was elected vice-chairman of the special parliamentary committee tasked with crafting recommendations for the federal government’s response to this landmark decision.
We began by reviewing the Carter decision and the preceding 400-page judgment in the B.C. Supreme Court. We studied Quebec’s new law, as well as the reports of two major panels on medical aid in dying, which together heard from 13,000 Canadians and more than 100 organizations. Our committee then launched a series of 11 hearings, eventually calling 61 expert witnesses and receiving more than 100 written briefs from groups across Canada.
Surveying this mountain of evidence, I realized that any federal law would have to strike three important balances.
The first was about access, not just a concern in rural and remote communities, but also for patients living in urban institutions. The right of every qualified patient to access this option must be protected, but so must the right of any health-care worker to object for reasons of conscience or faith.
The second was about personal autonomy. The privacy and self-determination of patients must not be violated by arbitrary bureaucracy but, crucially, safeguards must still protect vulnerable individuals.
The last was about jurisdiction. Ottawa must work collaboratively with provinces and regulatory bodies, respecting the boundaries of their jurisdiction. Yet, at the same time, almost every witness warned against allowing a patchwork of rules to emerge. Clearly, leadership was needed to provide clarity and encourage consistency across the country.
Achieving these delicate balances would consume much of the committee’s deliberations.
I was confident that a properly crafted law could balance these considerations. Canada’s response must ensure access to every qualified patient and at the same time protect any doctor who objects from unfair consequences. It must use reasonable and effective safeguards to protect vulnerable individuals and yet still preserve every patient’s privacy and honour their autonomy. It must respect provincial jurisdiction, let regulatory bodies craft rules tailored to their differing needs, while still ensuring consistent access for every patient, regardless of their postal code.
No one can deny that this is a difficult and sensitive issue for Canadians. But it is also an important chance to make progress on something that has long been a priority for the NDP and for all Canadians: improving palliative care.
Under the last government, in a deeply divided parliament, New Democrat MP Charlie Angus earned near-unanimous support for his motion calling for a properly funded national strategy to improve palliative and end-of-life care. Building on that foundation, I introduced to this committee a package of five proposals that would make palliative care a universal right for every Canadian, dedicate new funding for research, training and awareness, and offer better support to all caregivers. These are necessary steps for the government to take as it moves forward with a law on medical aid in dying.
The report just delivered to Parliament reflects the broad range of views expressed to the courts in the Carter case, in the consultations since and in the committee’s hearings. Our task was not to draft a law, but to design a framework — to give the government the tools to build an effective statute. It’s our hope that it will do so in a way that is balanced, that takes real action on palliative care as a priority for Canadians, and that honours the non-partisan and collaborative spirit in which our committee was able to work.
Murray Rankin is the NDP member of Parliament for Victoria. He will host an open town hall meeting on medical aid in dying from 2-4 p.m. on Saturday, March 5 at the Oak Bay United Church.
