The issue of euthanasia in Canada is no longer simmering on a back burner. After the Supreme Court of British Columbia found yesterday that Criminal Code provisions which prohibit doctors from helping their patients commit suicide are unconstitutional, it is on a full, rolling boil. In the landmark decision, Justice Lynn Smith set down that if suicide is legal, preventing handicapped persons from taking their lives must be discriminatory.
Judge Smith gave Canada's Parliament a year to draft a law permitting assisted suicide. In the meantime she granted the principal plaintiff in the case, Gloria Taylor, an exemption. This makes Ms Taylor's doctor the only person in the country who may now legally help someone commit suicide. The conditions set down by the judge are very similar to those across the border in the US states of Washington and Oregon for physician-assisted suicide.
Ms Taylor, who has amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease) released a statement which read: “I am deeply grateful to have the comfort of knowing that I’ll have a choice at the end of my life. This is a blessing for me, and other seriously and incurably ill individuals. This decision allows me to approach my death in the same way I have tried to live my life – with dignity, independence and grace.”
The controversial case was initiated by Ms Taylor, four other individuals and the BC Civil Liberties Association. They sought to have the court overturn a 1993 judgement by the Supreme Court of Canada. Sue Rodriguez, who also suffered from ALS, applied for help in committing suicide. The court denied her request but she subsequently committed suicide with the help of an anonymous physician a few months later.
The judge's 395-page decision, which discusses many aspects of the contentious assisted suicide debate, is sure to be challenged. Basically, her argument can be summed up in one sentence: the plaintiffs "succeed because the provisions unjustifiably infringe the equality rights of Gloria Taylor and the rights to life, liberty and security of the person of Gloria Taylor, Lee Carter and Hollis Johnson [the other plaintiffs]." The case is certain to be appealed to the Supreme Court in Ottawa.
In addition to the legal arguments from Canadian law, the document raises a number of interesting ethical issues.
* Suicide, which was removed from Canada's criminal code in 1972, now appears to be regarded as a right. "The claim that the legislation infringes Ms Taylor’s equality rights begins with the fact that the law does not prohibit suicide," the judge wrote. Other people of sound mind can commit suicide if they want, so why not the physically handicapped? "In my opinion, the law creates a distinction that is discriminatory. It perpetuates and worsens a disadvantage experienced by persons with disabilities. The dignity of choice should be afforded to Canadians equally, but the law as it stands does not do so with respect to this ultimately personal and fundamental choice."
* The judge acknowledges that there is no national consensus on assisted suicide. However, in her view, more important than a consensus is the existence of prestigious doctors and ethicists who do believe that it is ethical. "The Canadian physicians who deposed that they would provide assistance with hastened death if it were legal to do so were unchallenged with respect to their standing in the medical community or their understanding of and respect for medical ethics. Their evidence shows that the view that a physician can never ethically participate in terminating life is not universally held by reputable, experienced physicians, despite the position taken by the Canadian Medical Association and similar bodies."
* The judge accepted the idea that assisted suicide can be successfully regulated. "There is a strong consensus that if physician-assisted dying were ever to be ethical, it would be only be with respect to those patients, where clearly consistent with the patient’s wishes and best interests, and in order to relieve suffering."
Opponents of assisted suicide may highlight Justice Smith's decision to admit as evidence two documents which missed the deadline for submitting evidence. The first is a report from the Royal Society of Canada which strongly backed the legalisation of assisted suicide and euthanasia. It was published last November. The second is a March report from a parliamentary committee in Quebec which recommended the legalisation of euthanasia with strict safeguards.