The Supreme Court of Canada has unanimously struck down Canada's assisted suicide laws to call for new legislation to allow mentally competent but suffering patients to seek a doctor-assisted death.
At a glance, here's a look at the key points in the high court decision:
Why did the court strike down the current law?
The Supreme Court decided that, by not allowing suffering patients to end their lives with the help of others at the time of their choosing, the current law violated their constitutional rights.
The current law effectively forces very ill patients to take their own lives prematurely rather than risk being incapable of doing so when their suffering actually becomes intolerable, the court said.
It also said the current law denies dying people the right to make decisions concerning their own medical care and thus violates their Charter rights. It wasn't fair, the court decided, that patients can request pain relief and sedation, refuse nutrition, or request to remove life support equipment, but were not allowed to request a doctor's assistance to die.
Does this mean that anyone can coerce anyone else to kill themselves?
No. The original law was designed to protect vulnerable people from being coerced into committing suicide, and the court says that protection should remain.
This decision does open the door, however, for those with incurable or intolerable illnesses to choose a doctor-assisted death.
The court was very specific in its wording, noting the patient should be "a competent adult" who "clearly consents" to end their life, and who has a "grievous and irremediable medical condition." That could include a disease, but it could also include a disability that causes "enduring suffering" and that is intolerable to the individual.
What changed since the last time the Supreme Court looked at this issue?
In some ways, the court hasn't made a great shift in its thinking.
In 1993, when the Supreme Court ruled on the case of dying ALS patient Sue Rodriguez, the justices agreed that the existing law infringed a person's rights to make decisions about their life and their death. But it noted larger concerns that vulnerable people would not be adequately protected if physician-assisted suicide were legalized.
This time, the courts could look to the example of other jurisdictions that allow doctor-assisted death. The Supreme Court said the original trial judge in this case correctly looked at the experience of those jurisdictions and found "no compelling evidence" that allowing doctor-assisted death in Canada would lead down a slippery slope of widespread abuse.
What next?
For now, nothing. The court has declared the current law invalid, but also suspended its decision for 12 months to allow Parliament time to draft new legislation.
During those 12 months, the law will stand, and no court will be allowed to grant exemptions to those seeking to end their lives during the suspension period. That means for now, it is still illegal for a doctor or family member to aid terminally ill patients from ending their lives.
The pressure is now on parliamentarians to draft new legislation. But it's an issue that the current government is likely reticent to wade into, particularly since it's an election year. It's possible Parliament could take the tack it took with abortion legislation and allow the law to be struck down while not drafting a new law. That may leave the issue in the hands of the provinces, or perhaps leave it to doctors' groups to come up with their own regulations in the absence of a law.
Does this mean doctors will have to help patients die on request?
By declaring the current law invalid, the court said it is not compelling doctors to help patients die. It also said any new laws or regulations will have to take note of the Charter rights of physicians, too.
The Canadian Medical Association's own polling has found that only 27 per cent of doctors think they would likely participatean assisted death. The groups says that since it will likely be doctors who will have the task of determining whether particular patients should be eligible for medical aid in dying, they hope to work with Parliament in drafting any new laws on the issue to ensure that "the physician perspective" is reflected.
What does this mean for Quebec's assisted suicide legislation?
Quebec adopted right-to-die legislation last year, deciding that end-of-life care is a health care issue and thus a provincial matter.
The Supreme Court appeared to offer its approval of the province's right to forge ahead with its own legislation. It said in its ruling that health care is shared between the federal and provincial governments, and that the issue of physician assisted death should be the subject of legislation by both levels of government.
Quebec's health minister says the Supreme Court's decision shows that Quebec is on the right path with its own legislation.
