Canada’s new assisted dying law faces legal challenge

BMJ 2016; 354 doi: (Published 01 July 2016) Cite this as: BMJ 2016;354:i3688
  1. Owen Dyer
  1. Montreal

After just 11 days Canada’s controversial new law on physician assisted dying has been challenged on constitutional grounds by a young woman with a degenerative wasting disease who is ineligible for assistance.

Julia Lamb, 25, the new face of the right-to-die movement in Canada, does not qualify for physician assistance in dying under the new legislation but would be eligible under the Supreme Court ruling that forced the government to draw up the legislation.

Canada’s top court ruled a longstanding criminal ban on physician assisted death as unconstitutional in the landmark Carter v Canada decision of February 2015, and gave the government 12 months to draw up a regulatory system, a deadline later extended by four months.1

But while the court stipulated that anyone with a “grievous and irremediable” condition causing “enduring and intolerable suffering” might seek assistance in dying, this proved a step too far for conservative legislators. Instead, the Medical Assistance in Dying Act 2016, passed just before the Canadian Parliament’s summer recess, required that a patient’s death be “reasonably foreseeable.”

Outside the Supreme Court of British Columbia, Lamb said, “I am terrified by the idea that I could become trapped in a state of physical and mental suffering that could go on for months, years, or even decades.” She continued, “If my symptoms develop in a way that causes me misery, but I remain far from death, the government’s new law will force me to suffer.”

The debate in Canada is no longer about whether patients should have the right to assisted dying, a position overwhelmingly supported by the public, but whether the new legislation went far enough in granting that right. Right-to-die groups had already warned that the gap between the law and the court’s directions would swiftly be exposed by patients who met one set of criteria but not the other.

Just three weeks before the law passed, Alberta’s Court of Appeal granted the right to seek medical assistance in dying to a woman with a grievous but not terminal condition. In its decision, the court warned that the government’s argument requiring that a patient be near death “was not supported by the words of the [Carter] decision as a whole, nor by the principles articulated in the decision.”2


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