Euthanasia in Canada

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Euthanasia in Canada in its legal voluntary form is called Medical Assistance in Dying (MAiD, also spelled MAID) and it first became legal along with assisted suicide in June 2016 for those whose death was reasonably foreseeable. [1] Before this time, it was illegal as a form of culpable homicide. In March 2021, the law was further amended by Bill C-7 to include those suffering from a grievous and irremediable condition whose death was not reasonably foreseeable. [2] The planned inclusion of people with mental illnesses is controversial and has been repeatedly delayed. The legality of this postponement to 2027 is being challenged in court. [3]

Contents

The intensity and breadth of Canada's MAID program has led to condemnation of its program by UN human rights experts and disability rights groups in Canada. [4] It has also been the subject of substantial international attention and criticism. [5] [6] [7] Human rights advocates have criticized Canada's euthanasia laws for lacking safeguards, devaluing the lives of disabled people, prompting health workers and doctors to suggest euthanasia to people who would not otherwise consider it, and killing people who were not receiving adequate government support to continue living. [4] According to the Fifth Annual Report on MAID, there were 15,343 MAID provisions reported in Canada, accounting for 4.7% of all deaths in Canada. [8] There have been 60,301 MAID deaths reported in Canada since the introduction of legislation in 2016. [8]

Background

Euthanasia was previously prohibited under the Criminal Code as a form of culpable homicide. [9] [10] The prohibition was overturned in a February 2015 decision by the Supreme Court of Canada in Carter v. Canada (Attorney General) , which ruled that the Criminal Code provisions that make it a crime to help a person end their life violate the Canadian Charter of Rights and Freedoms and that eligible adults with grievous and irremediable medical conditions are entitled to an assisted death. The Court delayed its suspension of invalidity for a period of 12 months, to allow Parliament the opportunity to amend its laws if it so chose. [11] In January 2016, the Court granted an additional four-month extension to the suspension to allow for further time. As an interim measure, it ruled that provincial courts can now begin approving applications for euthanasia pursuant to the criteria in the Carter decision. On 6 June 2016, the suspension of invalidity expired and the law was struck down. On 17 June 2016, a bill to legalize and regulate euthanasia passed in Canada's Parliament. [12] Canada's current law makes euthanasia available only to residents eligible for Canadian healthcare coverage. [13]

The previous law's requirement that a natural death must be reasonably foreseeable and that the medical condition be grievous and irremediable medical condition had been controversial for how it limited the original Supreme Court of Canada ruling, mandating that euthanasia be made available to all adults with grievous and irremediable medical conditions. The British Columbia Civil Liberties Association (BCCLA) challenged the constitutionality of the previous law because it excluded people with long-term disabilities and those with "curable" medical conditions whose only treatment options people may find unacceptable. [14] The BCCLA argued these medical conditions should qualify under the court's definition of grievous and irremediable. [15] The BC Supreme Court and the Quebec Supreme court in Truchon ruled in 2019 that the law could not limit euthanasia only to individuals whose death was reasonably foreseeable. [16]

The current law prohibits mental illnesses as being considered as a grievous and irremediable condition, but this prohibition was initially set to expire on 17 March 2024. On 2 February 2023, the Canadian government introduced legislation to extend the temporary exclusion of eligibility in circumstances where a person's sole underlying medical condition is a mental illness for a period of one-year, until 17 March 2024. [17] In 2024, this was further delayed until 2027. [18] After this date, persons with a severe refractory mental illness will be eligible for medical assistance in dying, subject to any further amendments to the law or any new regulations. [19]

Canada's euthanasia law includes some legal safeguards aimed at preventing abuse and ensuring informed consent. Neither the legal witness nor the physicians involved can have any legal or financial interest in the outcomes of the patient. Consent must be repeatedly expressed, not implied, including in the moment right before death. Consent can be revoked at any time, in any manner. There are no consequences for backing out and there are no limits to how often it can be requested. Doctors are permitted to suggest euthanasia to patients, regardless of whether the patient has already said that they do not want it. To receive euthanasia, patients experiencing disease, disability or terminal illness must sign a written request expressing their wish to end their life in front of one independent witness who can confirm it was done willingly free of coercion. Next, two physicians and/or nurse practitioners must independently confirm their written agreement that the patient has an incurablegrievous and irremediable medical condition that is in an advanced state of irreversible decline, and that the patient is capable of receiving and willing to receive euthanasia. If their death is not reasonably foreseeable, a medical expert in the underlying medical condition must sign off on the request, their assessment must take at least 90 days, and they must be informed about and decline all other forms of treatment, including palliative care. [20]

Canada's law is consistent with many other nations that allow euthanasia in requiring at least two physicians to confirm the details of a diagnosis. [21] Canada's law no longer requires the presence of a terminal illness, unlike many other countries where euthanasia is only legal in those circumstances. [21] Canada's law is more restrictive than those of Belgium and the Netherlands in that it does not permit minors access to euthanasia. Canada does not yet allow it on the grounds of mental illness, a practice allowed in the Netherlands, Belgium, and Switzerland, until at least 17 March 2027. [22] Canada's law is less restrictive in that it does not require a patient to have exhausted all other treatment options, unlike Belgium and the Netherlands. [4] While Belgium allows advanced directives in all circumstances, such advance directives in Canada may only be used if the patient's death is reasonably foreseeable. [23] Canada is the only country that allows nurses to administer the drugs used for euthanasia. [4]

Carter v. Canada (Attorney General) decision

On 15 June 2012, in a case filed by Gloria Taylor, the Supreme Court of British Columbia ruled that provisions in the Criminal Code prohibiting euthanasia were unconstitutional as they apply to severely disabled patients capable of giving consent. The lower court ruled that the Criminal Code provisions "infringe s. 7 [and s. 15 ] of the Charter, and are of no force and effect to the extent that they prohibit physician-assisted suicide by a medical practitioner in the context of a physician-patient relationship". Moreover, the court found that the relevant sections were legislatively overbroad, had a disproportionate effect on people with disabilities, and was "grossly disproportionate to the objectives it is meant to accomplish." [24] The case reached the Supreme Court of Canada in Carter v. Canada (Attorney General). The court ruled that the law banning euthanasia of terminally-ill patients (based on the Rodriguez v British Columbia (Attorney General) decision) was unconstitutional, and violated Section 7 of the Canadian Charter of Rights and Freedoms. [25] The Supreme Court issued a 12-month suspended declaration of invalidity. [11] [26] As a result of the decision, euthanasia was expected to be made legal for "a competent adult person who (1) clearly consents to the termination of life and (2) has 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". [27] The court decision includes a requirement that there must be stringent limits that are "scrupulously monitored". This will require the death certificate to be completed by an independent medical examiner, not the treating physician, to ensure the accuracy of reporting the cause of death. [28]

Bill C-14

Parliament of Canada
  • An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)
CitationS.C. 2016, c. 3
Enacted by Parliament of Canada
Royal assent 17 June 2016
Legislative history
Bill citationC-14, 42nd Parliament, 1st Session
Introduced by Jody Wilson-Raybould
First reading 14 April 2016
Second reading 4 May 2016
Third reading 31 May 2016
First reading31 May 2016
Second reading3 June 2016
Third reading15 June 2016

As required by the 2015 Supreme Court decision, Justice Minister Jody Wilson-Raybould tabled a bill in parliament in April 2016 to amend the Criminal Code to allow euthanasia. [29] Bill C-14 "create[s] exemptions from the offences of culpable homicide, of aiding suicide and of administering a noxious thing, in order to permit medical practitioners and nurse practitioners to provide medical assistance in dying and to permit pharmacists and other persons to assist in the process". [30] The bill restricted euthanasia only to mentally competent adults with "enduring and intolerable suffering" and in cases where death is reasonably foreseeable. It also mandated a 10-day reflection period. [29]

After the House of Commons passed Bill C-14 that would allow for euthanasia, it was debated in the Senate in mid-June 2016. Initially, that chamber amended the bill, expanding eligibility for euthanasia. However, when it became apparent that the elected House of Commons would not accept the amendment, a final vote was held on 18 June. At that time, a majority agreed with the restrictive wording provided by the House of Commons indicating that "only patients suffering from an incurable illness whose natural death is 'reasonably foreseeable' are eligible for a medically assisted death", as summarized by the Toronto Star . Some opponents to the law indicate that the Carter v. Canada (Attorney General) decision was broader, including desperately ill individuals and not only those who are terminally ill or near death. The House of Commons did accept a few Senate amendments, such as requiring that patients be counseled about alternatives including palliative care and barring beneficiaries from acting in the euthanasia. Senators such as Serge Joyal who disagree with the restrictive wording believe that the provinces should refer the issue to the Supreme Court of Canada for an opinion in order to preclude the need for individuals to proceed with such an Appeal and incur the significant expense of doing so. [31] There was also a debate on the issue of suicide in Indigenous communities with MP Robert-Falcon Ouellette (Liberal) voting against the government on C-14. This was the first instance of a government backbencher voting against their party. Ouellette believes that large-scale changes to social norms like euthanasia should move very slowly because the impacts will be felt differently across Canada and societies. [32]

Truchon v. Attorney General of Canada

On 11 September 2019, the Superior Court of Quebec declared that restricting euthanasia to those whose death is reasonably foreseeable violated the Charter's guarantee to "life, liberty, and security of the person" as well as the Charter's guarantee of "equal protection" under the law. [33] [34] The ruling declared the reasonably foreseeable clause in the federal euthanasia legislation to be unconstitutional. Neither the Attorney General of Canada or the Attorney General of Quebec appealed the decision. [16] [33]

Bill C-7

The federal government passed Bill C-7 on 17 March 2021. [2] The new legislation relaxed or eliminated some of the safeguards for patients whose deaths were reasonably foreseeable, notably removing the 10-day waiting period, requiring only a single independent witness, and removing the requirement to offer palliative care. The legislation also introduced a new avenue for those whose death was not reasonably foreseeable to access euthanasia, conditional on the approval of medical practitioner who specialized in the underlying condition, a 90-day assessment period, and discussion on all other available treatment methods. The legislation also included a sunset clause that would allow people with severe refractory mental illnesses that have exhausted all treatment options to be eligible for euthanasia two years after the legislation passed. This clause has been particularly controversial due to the perceived difficulty of receiving informed consent from individuals suffering from a mental illness, particularly when the mental illness is already associated with suicide ideation. [35] However, multiple studies show that the majority of people with mental illnesses do not lack the mental competence or the capacity to make treatment-related decisions. [36] [37] [38] [39] This expansion in access to medical assistance in dying was originally planned for March 2023 before being postponed by one year to 17 March 2024. [40] It was further postponed to 2027. [41]

A panel was established by the government to study potential issues and safeguards with implementing medical assistance in dying for people whose sole medical condition was a mental illness. [42] A report of this process was given to parliament on 6 May 2022. The panel had nineteen recommendations that could be implemented without amending the Criminal Code. Some arguments addressed to the panel suggested that there was no evidence that safeguards and protocols could be adequate and thus the panel's mandate could not be fulfilled. The panel concluded that despite these uncertainties, people could still voluntarily wish to request medical assistance in dying and thus its mandate could be fulfilled. [43] One member of the panel, Ellen Cohen, resigned for ethical reasons. Cohen believes that the issues faced by those in poverty or seeking housing was not adequately considered by the rest of the panel. [44] A person can simultaneously seek medical assistance in dying while waiting for other treatments. [45] Proponents of including mentally ill patients regard the delays as discriminatory. Opponents are sceptical that mental illness is irremediable or concerned about endangering vulnerable individuals. [46]

In 2024, a lawsuit about the legality of delaying expansion of euthanasia to those with a mental disorder was filed due to the belief that denying it on these grounds is discriminatory and violates the Charter of Rights and Freedoms. [3] A separate charter challenge was also filed in 2024, on the grounds that the track 2 criteria causes premature deaths of disabled people and euthanasia should be limited to those with reasonably foreseeable deaths. [47]

Statistics

There have been 60,301 MAID deaths reported in Canada since the introduction of legislation in 2016. [8] In 2023, 15,343 MAID provisions were reported in Canada, accounting for 4.7% of all deaths in Canada. [8] This represents a growth rate of 15.8% over 2022. The average age of individuals at the time MAID was provided in 2023 was 77.6 years. In 2022, the underlying medical conditions included cancer (63%), cardiovascular (18.8%), other at 14.9% (can be frailty, diabetes, chronic pain, autoimmune), respiratory (13.2%), and neurological conditions (12.6%). [48] 75% of MAID recipients received palliative care and of the MAID recipients who required, but did not receive, palliative care 80.5% had access, a level similar to the three previous years. [8] [49]

NLPENSNBQCONMBSKABBCYTNTNUCanada
2016––249494191241163194–––1,018 [48]
2017––62498538396357205677–––2,838 [48]
2018238126921,2491,5001388530795112––4,493 [48]
201920201471411,6041,788177973771,28013––5,665 [48]
202049371901602,2782,3782141605551,57213––7,611 [48]
202165412452053,2993,1022452475942,03015––10,092 [48]
202290442742474,8013,9342232578362,51516––13,241 [48]
202372443592995,6014,6442273449772,759x––19,660 [49]
Total 2016–20233392001,4271,20220,17918,3761,3111,2583,91411,978–––60,301 [49]


Reception

Before euthanasia was made legal in Quebec in June 2014, [50] the Quebec College of Physicians had declared that it was prepared to cross the line on the debate over euthanasia and proposed that it be included as part of the appropriate care in certain particular circumstances. [51] The Canadian Medical Association (CMA) describes euthanasia as "one of the most complex and ethically challenging issues facing Canadian physicians". [52] Before the legalization of euthanasia, the organization stated that it is not up to them to decide on the issue of euthanasia, but the responsibility of society. The organization also reported that not all doctors were willing to help a terminally-ill patient die. [53]

A 2015 survey indicated that 29% of Canadian doctors surveyed would consider providing euthanasia while 63% would refuse. [54] However, the belief in late 2015 was that no physician would be forced to do so. [55] The extent of conscientious objection to providing euthanasia continues to be debated on issues such as whether objecting physicians must refer patients to a doctor who is willing to provide euthanasia and whether institutions have a right to refuse to provide euthanasia services; at present doctors are required to make effective referrals. [56] [57] Catholic hospitals often refuse to provide healthcare that goes against the institution's tenets, such as abortion or euthanasia. [58]

A 2023 survey by the Angus Reid Institute showed 61% of Canadians supported the current version of the legislation, while 31% supported extending euthanasia to mental disorders. [59] A poll conducted by Leger in the summer of 2022 regarding further liberalization of Canada's euthanasia laws found that 51% of Canadians supported expanding euthanasia to mature minors, with 23% opposed and 26% being unsure. 65% supported advanced directives in the face of a worsening cognitive condition, with 14% opposed and 22% being unsure. 45% supported expanding eligibility for euthanasia to include individuals with serious mental health illnesses, with 23% opposed and 32% being unsure of their position. [60]

Criticism

In 2021, the United Nations Human Rights Council's special rapporteur on the rights of persons with disabilities criticized Bill C-7 and assisted death in general, for undermining both disabled people's equal right to live and their ability to autonomously access support to continue living. [5] An estimated 25% of disabled Canadian adults live in poverty. Money available through social programs differs across provinces but is often below the poverty threshold: New Brunswick offers the least at $705 per month and Alberta offers the most at $1,685 per month. [61] In an August 2023 paper, Medical Assistance in Dying, Palliative Care, Safety, and Structural Vulnerability, the authors argued that while socioeconomic deprivation drives mortality to a large degree, it does not drive medical assistance in dying to any substantial degree. [62] Another 2023 paper, The Realities of Medical Assistance in Dying in Canada, concluded that "The Canadian MAiD regime is lacking the safeguards, data collection, and oversight necessary to protect Canadians against premature death." [63]

In certain cases, family members are not informed that their relative has died through MAID, as individuals have a right to medical privacy. While standard reviews of MAID cases may be conducted, [64] Canada's process has been criticized for lacking regional panels and oversight processes that other countries with legal euthanasia provide. [65]

Impact on the impoverished

After the repeal of the reasonably foreseeable requirement in Bill C-7, there have been claims from writers for The Spectator, Jacobin, and Global News that many might opt into euthanasia because of poverty, with accusations of Canada "euthanizing its poor". [66] [67] [68] Critics believe that a lack of social spending structurally places these people in poverty, and then introduces MAID as a way out, citing issues like insufficient welfare for disabled people and unconstitutionally long waiting times for healthcare as evidence that those who are disabled and impoverished do not have enough support to survive. [68] [69] An analysis piece from The Spectator, their most popular article in 2022, stated that the Canadian government sees MAID as a more economical alternative to investments in social programs and welfare. [66] The Canadian Parliamentary Budget Officer released a report claiming the old MAID policies will save Canada $86.9 million per year and that Bill C-7 will save an additional $62 million per year. [70] There have also been intersectional issues raised with MAID relating to higher rates of poverty in marginalized communities, lack of social support, and ableism and racism in the medical community. [71]

Ableism and equality concerns

Bill C-7 has been criticized as discriminatory towards disabled people. A letter from the United Nations Human Rights Council's Special Rapporteur on the rights of persons with disabilities, the Independent Expert on the enjoyment of all human rights by older persons, and the Special Rapporteur on extreme poverty on human rights raised concerns that the bill would not adhere to "international human rights standards". [72] They believe that the bill potentially violates the right to life of disabled people, that provisions of the bill are not consistent with Canada's obligation to equality and non-discrimination, and that the bill perpetuates negative stereotypes about disabilities. [72] In a paper from August 2023 authored by a member of the law faculty at the University of British Columbia, Legislated Ableism: Bill C-7 and the Rapid Expansion of MAiD in Canada, the author argues that the expansion of MAID through Bill C-7 conflicts with the Canadian constitution, violating s.7 and s.15, which pertain to equal protection under law and anti-discrimination. [73]

Handling of specific cases

In addition to broader criticism of MAID, the handling of certain cases have been subject to media coverage. These include:

See also

Related Research Articles

Euthanasia is the practice of intentionally ending life to eliminate pain and suffering.

<span class="mw-page-title-main">Assisted suicide</span> Suicide undertaken with aid from another person

Assisted suicide, also known as physician-assisted suicide (PAS), describes the process by which a person, with the help of others, takes drugs to end their life.

The right to die is a concept rooted in the belief that individuals have the autonomy to make fundamental decisions about their own lives, including the choice to end them or undergo voluntary euthanasia, central to the broader notion of health freedom. This right is often associated with cases involving terminal illnesses or incurable pain, where assisted suicide provides an option for individuals to exercise control over their suffering and dignity.

Voluntary euthanasia is the purposeful ending of another person's life at their request, in order to relieve them of suffering. Voluntary euthanasia and physician-assisted suicide (PAS) have been the focus of intense debate in the 21st century, surrounding the idea of a right to die. Some forms of voluntary euthanasia are legal in Australia, Belgium, Canada, Colombia, Luxembourg, the Netherlands, New Zealand, and Spain.

<span class="mw-page-title-main">Suicide legislation</span> Laws concerning suicide around the world

Suicide is a crime in some parts of the world. However, while suicide has been decriminalized in many countries, the act is almost universally stigmatized and discouraged. In some contexts, suicide could be utilized as an extreme expression of liberty, as is exemplified by its usage as an expression of devout dissent towards perceived tyranny or injustice which occurred occasionally in cultures such as ancient Rome, medieval Japan, or today's Tibet Autonomous Region.

Euthanasia in the Netherlands is regulated by the "Termination of Life on Request and Assisted Suicide Act" which was passed in 2001 and took effect in 2002. It states that euthanasia and physician-assisted suicide are not punishable if the attending physician acts in accordance with criteria of due care. These criteria concern the patient's request, the patient's suffering, the information provided to the patient, the absence of reasonable alternatives, consultation of another physician and the applied method of ending life. To demonstrate their compliance, the Act requires physicians to consult another, independant colleague before the euthanasia and to send a report after the euthanasia to a review committee.

Involuntary euthanasia is illegal in all 50 states of the United States. Assisted suicide is legal in ten jurisdictions in the US: Washington, D.C. and the states of California, Colorado, Oregon, Vermont, New Mexico, Maine, New Jersey, Hawaii, and Washington. The status of assisted suicide is disputed in Montana, though currently authorized per the Montana Supreme Court's ruling in Baxter v. Montana that "nothing in Montana Supreme Court precedent or Montana statutes [indicates] that physician aid in dying is against public policy."

<span class="mw-page-title-main">Dignity in Dying</span> UK pro-euthanasia organisation

Dignity in Dying is a United Kingdom nationwide campaigning organisation. It is funded by voluntary contributions from members of the public, and as of December 2010, it claimed to have 25,000 actively subscribing supporters. The organisation declares it is independent of any political, religious or other affiliations, and has the stated primary aim of campaigning for individuals to have greater choice and more control over end-of-life decisions, so as to alleviate any suffering they may be undergoing as they near the end of their life.

<span class="mw-page-title-main">Dignitas (non-profit organisation)</span> Swiss organisation offering assisted suicide to members

Dignitas is a Swiss non-profit organization providing physician-assisted suicide to members with terminal illness or severe physical or mental illness, supported by independent Swiss doctors. By the end of 2020, they had assisted 3,248 people with suicide at home within Switzerland and at Dignitas' house/flat near Zürich. They provide advisory work on palliative care, health care advance directives, suicide attempt prevention, and legislation for right-to-die laws around the world.

<span class="mw-page-title-main">Legality of euthanasia</span>

The legality of euthanasia varies between countries and territories. Efforts to change government policies on euthanasia of humans in the 20th and 21st centuries have met with limited success in Western countries. Human euthanasia policies have also been developed by a variety of NGOs, most advocacy organisations although medical associations express a range of perspectives, and supporters of palliative care broadly oppose euthanasia.

Euthanasia became legal in New Zealand when the End of Life Choice Act 2019 took full effect on 7 November 2021. It is illegal to "aid and abet suicide" under Section 179 of the New Zealand Crimes Act 1961. The clauses of this act make it an offence to "incite, procure or counsel" and "aid and abet" someone else to commit suicide, regardless of whether a suicide attempt is made or not. Section 179 covers both coercion to undertake assisted suicide and true suicide, such as that caused by bullying. This will not change under the End of Life Choices Act 2019, which has provisions on coercion of terminally ill people.

<span class="mw-page-title-main">Assisted suicide in Australia</span> Legal history of euthanasia in Australia

Laws regarding euthanasia or assisted suicide in Australia are matters for state and territory governments. As of June 2024 all states and the Australian Capital Territory have passed legislation creating an assisted suicide and euthanasia scheme for eligible individuals. These laws typically refer to the practices as "voluntary assisted dying".

<span class="mw-page-title-main">Assisted suicide in the United States</span> Medically-induced suicide with help from another person

State laws regarding Medical Aid in Dying in the United States

Both euthanasia and assisted suicide are illegal in the United Kingdom and could be prosecuted as murder or manslaughter.

My Death, My Decision (MDMD) is an organisation that campaigns for the legalisation of assisted dying in England and Wales. The group was founded in 2009, in order to campaign for a change in the law and advocate on behalf of adults of sound mind, who are either terminally ill or incurably suffering.

<i>Carter v Canada (AG)</i> Decision of the Supreme Court of Canada

Carter v Canada (AG), 2015 SCC 5 is a landmark Supreme Court of Canada decision where the prohibition of assisted suicide was challenged as contrary to the Canadian Charter of Rights and Freedoms ("Charter") by several parties, including the family of Kay Carter, a woman suffering from degenerative spinal stenosis, and Gloria Taylor, a woman suffering from amyotrophic lateral sclerosis ("ALS"). In a unanimous decision on February 6, 2015, the Court struck down the provision in the Criminal Code, thereby giving Canadian adults who are mentally competent and suffering intolerably and enduringly the right to a doctor's assistance in dying. This ruling overturned the Supreme Court's 1993 ruling in Rodriguez v British Columbia (AG), which had denied a right to assisted suicide.

California End of Life Option Act is a law enacted in June 2016 by the California State Legislature which allows terminally ill adult residents in the state of California to access medical aid in dying by self-administering lethal drugs, provided specific circumstances are met. The law was signed in by California governor Jerry Brown in October 2015, making California the fifth state to allow physicians to prescribe drugs to end the life of a terminally ill patient, often referred to as physician-assisted suicide.

<span class="mw-page-title-main">End of Life Choice Act 2019</span> Act of Parliament in New Zealand

The End of Life Choice Act 2019 is an Act of Parliament in New Zealand that gives people with a terminal illness the option of receiving assisted suicide or euthanasia. The act came into force on 7 November 2021, twelve months after the 2020 euthanasia referendum was declared in favour of the legislation.

Assisted suicide is the ending of one's own life with the assistance of another. It is currently illegal under the law of the United Kingdom. In England and Wales, the Suicide Act 1961 prohibits "aiding, abetting, counselling or procuring the suicide of another" with a penalty of up to 14 years' imprisonment. Approximately 46 Britons a year travel abroad for physician-assisted suicide, usually to Dignitas in Switzerland. Following legal challenges, public prosecutorial guidance was issued in 2010 indicating scenarios where prosecution for assisted suicide may not be in the public interest. The phrase "assisted dying" is often used instead of physician-assisted suicide by proponents of legalisation and the media when used in the context of a medically assisted suicide for the purpose of relieving suffering. Bills to legalise assisted dying have been introduced multiple times in Parliament since the 1930s, but none have passed. The devolved governments of Scotland and Northern Ireland have not legalised assisted dying either, although there is some political support for changing the law in Scotland. Polling shows a majority of the British public and doctors support legalising assisted dying. The British Medical Association adopted a neutral position in 2021 after previously opposing any changes to the law.

Euthanasia for mental illness involves a physician intentionally ending the life of a patient who has requested euthanasia due to a psychiatric condition. The practice is legal in Belgium, the Netherlands, Luxembourg, Spain and Colombia. In Canada, legislation authorizing the procedure was passed, but has since been repeatedly postponed.

References

  1. ↑ "Medical assistance in dying: Legislation in Canada". Government of Canada. 28 October 2024. Retrieved 8 January 2025.
  2. 1 2 "Government Bill (House of Commons) C-7 (43-2) - Royal Assent - An Act to amend the Criminal Code (medical assistance in dying) - Parliament of Canada". parl.ca. Retrieved 15 July 2022.
  3. 1 2 "Canada's assisted-dying law faces constitutional fight for excluding mental disorder". CTV News. 19 August 2024. Retrieved 20 August 2024.
  4. 1 2 3 4 5 Cheng, Maria (11 August 2022). "'Disturbing': Experts troubled by Canada's euthanasia laws". Associated Press . Retrieved 14 August 2022.
  5. 1 2 "As Bill C-7 reaches Senate, UN watchdog raises concerns about MAiD for persons with disabilities". Canadian Broadcasting Corporation. 2 February 2021.
  6. ↑ Zhu, Yuan Yi (31 December 2022). "Most-read 2022: Why is Canada euthanising the poor?". The Spectator. Retrieved 8 March 2023.
  7. ↑ "As assisted dying broadens, countries wrestle with new ethical lines". Christian Science Monitor. ISSN   0882-7729 . Retrieved 8 March 2023.
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  11. 1 2 Carter v. Canada (Attorney General) , 2015 SCC 5 at para 128
  12. ↑ BBC News, Canada's parliament passed assisted suicide bill 18 June 2016.
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  14. ↑ "Archived copy" (PDF). Archived from the original (PDF) on 16 January 2017. Retrieved 14 January 2017.{{cite web}}: CS1 maint: archived copy as title (link)
  15. ↑ "Assisted-dying legislation faces new legal challenge in B.C. - British Columbia - CBC News". Archived from the original on 15 January 2017. Retrieved 14 January 2017.
  16. 1 2 Tiedemann, Marlissa. "Medical Assistance in Dying in Canada After Carter v. Canada". Library of Parliament. Retrieved 18 May 2024.
  17. ↑ "Delay of eligibility for medical assistance in dying for persons suffering solely from mental illness proposed by Ministers of Justice and Health". 2 February 2023.
  18. ↑ Taylor, Stephanie; Osman, Laura (February 2024). "Liberals delay expansion of assisted dying eligibility until 2027". City News Calgary. The Canadian Press. Retrieved 1 February 2024.
  19. ↑ "Final Report of the Expert Panel on MAiD and Mental Illness". 13 May 2022.
  20. ↑ Canada, Health (2022). "Medical assistance in dying". www.canada.ca. Retrieved 14 July 2022.
  21. 1 2 Lewis, Penney (6 October 2015). "What different countries say about assisted dying". BBC News.
  22. ↑ Navarre, Brianna (5 March 2024). "Canada Backtracks on Allowing Euthanasia for the Mentally Ill". U.S. News & World Report. Retrieved 7 May 2024.
  23. ↑ Herremans, J (2008). "[Advance directives: the legal situation in Belgium]". Bull Soc Sci Med Grand Duche Luxemb (3): 305–310. PMID   19069729.
  24. ↑ Greer, Darryl (18 June 2012). "B.C. Supreme Court Kills Assisted-Suicide Ban". Courthouse News Service. Retrieved 6 July 2012.
  25. ↑ "Supreme Court Judgments". Supreme Court of Canada. SCC/CSC. 6 February 2015. Retrieved 2 January 2016.
  26. ↑ Chappell, Bill (6 February 2015). "Canadians Have A Right To Assisted Suicide, High Court Says". NPR.org.
  27. ↑ End-of-life law and policy in Canada. University of Dalhousie
  28. ↑ Guichon; Alakija; Doig; Mitchell & Thibeault (28 December 2015). "Assisted dying: Four problems, one simple solution". Glove and Mail. Toronto, Canada. Retrieved 2 January 2016.
  29. 1 2 "Doctor-assisted dying bill restricted to adults facing 'foreseeable' death". CBC. 14 April 2016. Retrieved 28 April 2016.
  30. ↑ "Bill C-14: An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)". openparliament.ca. Retrieved 28 April 2016.
  31. ↑ McCharles, Tonda (17 July 2016). "Assisted dying to become law after Senate backs Liberals' bill". Toronto Star. Toronto, Canada. Retrieved 18 July 2016.
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  33. 1 2 Truchon c. Procureur général du Canada, 2019 QCCS 3792
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  66. 1 2 Zhu, Yuan Yi (31 December 2022). "Most-read 2022: Why is Canada euthanising the poor?". The Spectator. Retrieved 26 July 2024.
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  72. 1 2 "Mandates of the Special Rapporteur on the rights of persons with disabilities; the Independent Expert on the enjoyment of all human rights by older persons; and the Special Rapporteur on extreme poverty and human rights". spcommreports.ohchr.org. 3 February 2021. Retrieved 26 July 2024.
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