reports from council
Physician-assisted dying
Guest speakers put clinical, legal and ethical issues into context
T
he College invited several experts
to attend Council and speak on
the clinical, legal and ethical issues relating to physician-assisted
death.
Earlier this year, the Supreme Court of
Canada (SCC) handed down a landmark
ruling on physician-assisted death. In Carter
v Canada the Court found that the Criminal
Code provisions that prohibit physicianassisted death are constitutionally invalid, in
circumstances where a competent adult:
(1) C
learly consents to the termination of
life; and
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(2) H
as 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.
The SCC decision in Carter will not
take effect until February 6, 2016 to allow
government, if it so chooses, to develop
an appropriate framework for permitting
physician-assisted death. During this suspension period, the existing Criminal Code provisions that prohibit physician-assisted death
continue to apply. Following the suspension
period, competent adults, who are suffering
intolerably from grievous and irremediable
medical conditions, may legally seek physician assistance in dying.
In making its decision, the SCC stated
that it is feasible for properly qualified and
experienced physicians to reliably assess
patient competence and voluntariness, and
that coercion, undue influence, and ambiva-
lence could be reliably assessed as part of this
process. The SCC noted that this assessment
is a current requirement of informed consent
in other medical decision-making, including
end-of life decision-making.
The presentations at the September Council
meeting provided important context for future Council discussion and decision-making
on this issue.
Sheila Tucker, who represented the plaintiffs
in the Carter v Canada decision, told Council
that the Supreme Court of Canada found that
the Constitution gives Canadians the choice
to seek what they consider to be a good death,
including the option of a physician-assisted
death for seriously and incurably ill, mentally
competent adults.
But she pointed out that “this is not an ondemand option.” Physicians are still entitled
to exercise their medical judgment, and will
have a role in determining whether the paIssue 3, 2015 Dialogue