Canadian Prime Minister Backs Physician-Assisted Suicide Bill

Dying with dignity and autonomy is on Canada's agenda today with proposed legislation to legalize physician-assisted suicide.

Dying with dignity and autonomy is on Canada's agenda today with proposed legislation to legalize physician-assisted suicide.

Only Albania, Belgium, Columbia, Germany, Japan, Luxemburg, Netherlands, and Switzerland allow any form of assisted suicide through national legislation, and their laws vary.

Introduced by Prime Minister Justin Trudeau's government, the odds are the legislation will pass. Canada's House of Commons has a strong Liberal Party majority. Approximately 70% of Canadians are in favor.

Under Canada’s proposed law, people who have serious medical conditions and prefer death to suffering will have two options: they can commit suicide alone or with help from family members with medication prescribed by their doctors, or their doctors can administer medication that will hasten death.

The proposed legislation applies to adults only. It has no allowance for advance directives – patients would be able to decide to take advantage of the law only when diagnosed with serious or terminal medical conditions, not before.

Patients will also need to be assessed by two independent physicians.

The proposed legislation also excludes patients with serious psychiatric illness.

Members of the Canadian Medical Association (CMS) were opposed to such action until 2014, when it changed its position slightly.

They announced CMA “supports the right of all physicians, within the bounds of existing legislation, to follow their conscience when deciding whether to provide medical aid in dying.” A primary factor in their change of position was Canada's poor palliative care system.

A 2014 poll found that 44.8% of Canadian physicians supported legalizing assisted suicide, and 13.5% were undecided. The remaining 41% were opposed.

With this proposal, doctors who object to assisted suicide need not help people die.  Instead, they would need to refer patients to a willing physician, however.

Assisted suicide has been legal in Canada since February 2015 when its Supreme Court overturned a criminal ban against assisted suicide. That law had been on the books since 1993 and imposed a maximum prison sentence of 14 years.  

However, at the time, Canada’s Conservative Party government strongly opposed legalizing assisted suicide. The Supreme Court gave them one year to draft legislation, a deadline they largely ignored. With the landslide election of Liberal Party representatives in the autumn of 2015, sentiments changed. The Supreme Court extended the deadline for legislation to June 2016. The hope is that this court-ordered legislation will pass before the deadline.

All involved agree this is an ambitious goal.

Canada's current Prime Minister Trudeau is the son of former Prime Minister Pierre Trudeau. The elder Trudeau struggled with prostate cancer and Parkinson’s disease at end of life, and died in 2000. Current Prime Minister Trudeau credits his experience with his father with changing his position on the matter – now supporting physician-aided deaths.

Members of the Liberal Party will be allowed to vote their consciences and will not be required to support the party position.

Americans won't be flocking across the border any time soon. "Medical tourism" – the practice of traveling abroad to receive healthcare that is unaffordable or unavailable at home – has been a major concern for Canada. This law has language that will prevent an influx of tourists seeking relief unavailable in their own countries.

Only Canadians and residents who are eligible to participate in Canada's national health care may collaborate with physicians for life-ending medication.

Americans are following this issue with interest. For now, the only states in the US that allow physician-assisted suicide are California, Oregon, Vermont, and Washington. Canada's proposed law has clearly-defined limits. A full 70% of Americans support “death with dignity” laws when the language doesn’t use the word “suicide” explicitly.

The Canadian government will monitor and assess assisted suicide and public sentiment if the legislation passes. It will use its findings to fine-tune the legislation.