On February 12, 1994, Sue Rodriguez ended her life with the help of an anonymous physician. A 44-year old British Columbia resident, Ms. Rodriguez had been suffering from the devastating effects of Amyotrophic Lateral Sclerosis (ALS) for many years and her campaign for the legal right to assisted suicide made her a figurehead for the right-to-die movement in Canada. After a gripping court battle that dominated headlines across Canada, the Supreme Court of Canada ruled against her in 1993 in the landmark Rodriguez v British Columbia decision . Despite losing the case, she later terminated her own life with the assistance of then-MPP Svend Robinson. Neither Mr. Robinson or the anonymous physician were ever charged for their involvement.
Although assisted suicide remains a controversial issue worldwide, the passage of Oregon's Death With Dignity Act in 1994 made it the first U.S. state and one of the first jurisdictions in the world to allow medically-assisted suicide under specific conditions. Since then, Washington and Montana have also moved to allow physicans to assist patients commit suicide under controlled conditions. In Europe, the Netherlands passed the Termination of Life on Request and Assisted Suicide (Review Procedures) Act in 2002 which has since been followed by similar legislation in Luxembourg and France. More controversially, assisted-suicide legislation in Switzerland has enabled the establishment of medical clinics operated by Dignitas, a Swiss assisted-dying organization. Despite attempts to block foreign visitors from using the Dignitas clinics, a new form of "suicide tourism" has led to Dignitas being involved in more than eight hundred suicides as of March 2008 (60 per cent of these suicides are from nearby Germany).
Since the Rodriguez decision, assisted suicide continues to be a criminal offense under Canadian law with a potential penalty of fourteen years in prison. Despite several high-profile cases, including the prosecution of Robert Latimer for killing his physically disabled daughter in 1993 and opinion polls which consistently show widespread support for medically assisted suicide by Canadians, the right-to-die debate in Canada has only recently been reignited by two high-profile cases from British Columbia.
The first of these cases involved Kathleen (Kay) Carter who, in 2010, became the tenth Canadian to die by assisted suicide at the Dignitas clinic in Switzerland. An 89-year old resident of a Vancouver nursing home who was nearly paralyzed with spinal stenosis, Ms. Carter was horrified at her increasing debilition and made the decision to end her life in 2009. After researching different options, she informed her seven children of her intention to die and enlisted their support. Due to concerns over possible arrest for seeking an assisted suicide, she traveled to Switzerland in secret accompanied by family members (the other residents of her nursing home were only told that she was being taken ouot of province to "visit her sister"). After meeting with Dignitas physicians, Kay Carter drank a lethal drug combination supplied by her physicans on January 15, 2010 and died peacefully. After their return to Canada, Kay Carter's daughter Lee and her husband Hollis Johnson have become part of a legal challenge directed at the British Columbia Supreme Court to allow physician-assisted suicide in Canada. Working with them and the British Columbia Civlil Liberties Association (BCCLA) was the second high-profile case to test current assisted suicide legislation in Canada.
A long-time resident of British Columbia, Gloria Taylor has become a familiar figure sitting in her wheelchair while waiting to address the British Columbia Supreme Court during the current round of hearings. The 64-year old grandmother is suffering from the debilitating effects of ALS, much as Sue Rodriguez had. After hearing about the legal challenge launched by Lee Carter, Hollis Johnson, and the BCCLA, Ms. Taylor added her name to the Carter Challenge and became a co-plaintant. In the affadavit that she has presented to the court, Ms. Taylor described her own horror at her progressively worsening condition. "I must make this clear: I do not want to die" she added. "I want to live every day that I can to the fullest, one day at a time. What I do not want is to die an agonizing, slow, difficult, unpleasant, undignified death." She also described the suffering of several of her friends, including a fellow ALS sufferer who also provided an affidavit although he died before the trial began.
As the court challenge continues in British Columbia, the fight for medically assisted suicide is progressing in Quebec. On March 22 of this year, a Quebec commission on Dying With Dignity released a report after two years of public hearings on the contentious issue. The commssion heard from thirty-two experts in diverse fields such as law, philosophy, ethics, medicine, and psychology. They also conducted public hearings and heard evidence from hundreds of individuals and groups and held meetings in Belgium, the Netherlands, and France to examine palliative care systems in other countries. Finally, the commission received more than 16,000 comments by mail, fax, and email and examined online questionnaire responses from more than 6558 respondents.
In the final report released by the commission, they made the following recommendations:
- Quebec should improve access to palliative care to all terminally ill people and increase traing of medical staff in palliative care;
- A centralized registry for advance care directives should be created and hospitals should be routinely audited to ensure they follow the directions in these documents;
- The law should be changed to allow medically assisted dying. Doctors who provide medical assistance to help a person die should not be subject to criinal prosecution if the patient:
- Is a resident of Quebec
- Is an adul and mentally competent to make decisions
- Is in constant and unbearable suffering from a disease which has no prospect for improvement
- Makes two written requests for medically assisted dying, which are in turn assessed by two doctors
While Canada's federal government has the final jurisdiction for changing legislation relating to euthanasia and assisted suicide, the commision's report represents an important step in changing current laws. As well, the responsibility for charging and prosecuting medical doctors and family members for participating in assisted suicides are left up to the discretion of the Attorney General for each individual province. Since healthcare is also a provincial responsibility, the growing support for assisted suicide legislation, as well as the latest court challenges, may well force provinces to demand changes at the federal level.
As the various court challenges work their way through the system, groups such as Dying With Dignity Canada are seeking to raise grassroots support with a series of debates across the country. Many of these debates involve DWD Executive Director, Wanda Morris facing active opposition from religious groups, including the BC Euthanasia Prevention Coalition and the Canadian Catholic Bioethics Institute. "We must look to the rights of those who suffer needlessly," Ms. Morris pointed out in a debate held in Toronto recently. "As Canadians we have a number of rights. Now it's time that we have one more. If a time comes when I am suffering and want to end my life, I hope I can choose my time, gather my loved ones around me and gently go into the good night."
In the meantime, Gloria Taylor and others like her are still waiting for a final legal decision from the B.C. Supreme Court (and the Federal Supreme Court as well, most likely) but the fight for assisted suicide in Canada is likely only just beginning.