The Debate, The Furor, The Decision

"You want to avoid a sort of American Wild, Wild West, angels of medical mercy going around without any kind of accountability. So long as this doesn't look like it's a process run amok ... people are willing to accept it, and the levels of approval increase over time."
"They [his students] wonder what's wrong with all the other states in the United States ... that don't have something like this. It's just become part of the landscape here."
Courtney Campbell, Oregon State University

"If it's not criminal, it's health. If it's health it's provincial, so then it falls to the provinces and territories to regulate it."
Juliet Guichon, bio-ethicist, lawyer, University of Calgary

The Canadian Supreme Court unanimously ruled to legalize physician-assisted suicide on Friday. (Photo: Obert Madondo/flickr/cc)

"It" refers to the Supreme Court of Canada's unanimous decision to strike down Canada's laws outlawing assisted suicide. The agreement by the justices tosses out existing law, giving Parliament a year in which to draft new legislation reflecting the right of consenting adults enduring intolerable suffering to seek out medical help to end their lives of torment and misery through unending pain.

According to the justices, the current ban infringes on all three of life, liberty and security of person provisions in the Charter of Rights and Freedoms. Although it is clear the federal government will have to embark on forging a new law, it may be the provinces for whom health care, including end-of-life issues becomes the source responsible and it will be they who write the definitive legislation.

If that is done under the aegis of an over-arching federal legislation, and the provinces meet to discuss how they may best enact legislation that will reflect universally the need to take advice from the federal legislation, resulting in fairly even provincial sets of rules, there will be less confusion and more fairness in the process. But since the provinces interpret differently regulations, for example in access to abortion, it's anyone's guess what will come out of this vital file.

Experts on the issue are guessing that the federal government, opposed to the very concept of the medical profession aiding in ending a life, may come up with new legislation that respects the court's ruling, but which in its narrow application may limit access to the service as much as can be done. "They might put into place very stringent standards for determining if there is informed consent, there is no coercion", commented Carissima Mathe, constitutional law expert at University of Ottawa.

"The more specificity, the better. How do we evaluate those patients and determine if they qualify or not?" asked Jeff Blackmer, head of the Canadian Medical Association's ethics office. He pointed out that his association's 80,000 members have looked to the kind of regime implemented in Oregon as opposed to the permissive systems in place in Switzerland, Belgium and the Netherlands.

Where the European legislation sparks controversy through extensions of the right beyond terminal, consenting adult patients to permit in some instances, assistance by doctors to end the lives of severely disabled babies or people with psychiatric problems they feel they can no longer live with, the Oregon law specifies someone must be fatally ill, have less than six months to live, and must have voiced the wish to die (written and orally) before aid is given.

Whereupon a doctor signs a prescription for a lethal drug, which the patient then takes on their own, expediting death.