The Supreme Court of Canada's historic ruling: approving doctors to assist euthanasia

Source: Vancouver lohas.com on February 6, 2015, the chief justice of the Supreme Court of Canada unanimously made an important historical ruling: those who have been proved to have incurable diseases have the right to ask medical students to assist them in their death if they do not want to continue to suffer from severe illness The high court's ruling said that the current provision in the law that anyone helping others commit suicide should be changed to allow doctors to provide such help in special circumstances But this only applies to qualified adults, who are well aware of the meaning of their decision to end their lives The Supreme Court gave the federal and provincial governments 12 months to revise the current law in accordance with the ruling, while doctors were still prohibited from assisting in death until the new law was enacted This provision is undoubtedly a major event in the history of medicine It is important to know that when someone challenged this Law 21 years ago, the Supreme Court of Canada made a completely different decision Canada's law banning suicide with the help of doctors has been one of the biggest issues in legal and medical circles In some countries and regions in the world, suicide with the help of doctors is legal, including Belgium, the Netherlands and Switzerland The Supreme Court judges agreed that the current law banning euthanasia violates all the definitions of life, freedom and personal safety in part VII of the Charter of rights and freedoms The Supreme Court also explicitly instructed members of Congress that the current law violates the relevant elements of the Charter, because it prohibits adults who are able to make decisions with the help of doctors from committing suicide, although these people: 1) explicitly agree to terminate their lives; 2) they have diseases or disabilities that are quite serious or can not be cured, resulting in lasting and intolerable suffering The court's ruling is based on a lawsuit filed a few years ago by two incurable patients in British Columbia for euthanasia Catherine Carter, 89, suffered from degenerative spinal stenosis She said in an affidavit that she didn't want to live "like an ironing board." Because her back must be straight and flat, and she can't even read newspapers But the provincial court's ruling did not allow doctors to assist her in her wish to die Finally, her daughter had to take her to Switzerland to "euthanasia" in 2010 Another client who has died is Gloria Taylor, 64 She has the same illness as Ms Rodriguez 22 years ago She said in an affidavit that she was worried that she would not be able to breathe when her condition worsened, "eventually suffocating and struggling, like a fish leaving the water." She died of infection at the end of 2012 They can't get the help of doctors and get rid of the disease completely in Canada, because the current law of Canada stipulates that "anyone who tutors a person to commit suicide, assists or abets a person to commit suicide, whether or not the suicide actually occurs, is a criminal act and will be sentenced to a term of not more than 14 years" The federal attorney general's explanation for this is: "the information that the law absolutely prohibits assisted suicide is that all lives are precious, worthy of protection, and should be protected No one can implicitly encourage vulnerable groups to terminate their lives." Euthanasia: there is a long way to go, said Zheng Min, a family doctor The Supreme Court of Canada only said that the existing ban on doctors' assisted suicide has been lifted, but it does not mean that euthanasia is legal Because the court is not the legislature, legislation is to be done by Parliament The Supreme Court gave Parliament a year to discuss legislation, and the outcome of the legislation is still unknown That is to say, before the new law came into being, there was no doctor who could help the patient to be euthanized, and the court's decision stressed that there was no exception According to reports, in the previous survey of Canadian doctors, only a dozen doctors are willing to help patients with euthanasia Zheng Min said that this is because some patients choose euthanasia, which may be related to the mental and emotional factors at that time, so it is easy to cause some wrong choices If some cancer patients are just diagnosed, they may feel that life has come to an end and they don't want to live again But some people who didn't want to live at that time, after active treatment, have lived well for many years Therefore, in the issue of euthanasia, it is very important to protect those who are mentally and physically vulnerable and to prevent misjudged death Under the existing legal framework, it is illegal for doctors to assist suicide, but it is legal for patients to commit suicide Some patients with advanced cancer can choose to refuse treatment In this case, what doctors can do is to use drugs to minimize the pain of patients, such as pain relief, Zheng Min said For a long time, the opposition has changed its position The Canadian Medical Association has been unanimously opposed to euthanasia, but recently its position has also been loosened It has agreed that in rare cases, if the patient is suffering from the cruel torture of the disease, the doctor assisted death can be implemented if the law allows The president of the association, Dr Chris Simpson, said that if the Supreme Court ruled that the current law on medical assisted suicide and euthanasia was unconstitutional, it would need to be revised, "we strongly hope to participate", help draft the new law and give guidance to doctors and patients "We need to know how to apply the rules," he said Is it only for patients with certain diseases? What is the definition of end-stage disease? How many doctors are required to approve it? Is it necessary to have a calm period to ensure everyone's determination? "Are we only allowed to make decisions for the patients who have the ability to make decisions for themselves? Or, for patients with dementia, we are allowed to make decisions for alternative decision makers such as family members?" Why do the justices of the Supreme Court agree to legalize euthanasia? First of all, the time is ripe Some countries and regions in the world have legalized euthanasia, allowing doctors to assist in death Since 1993, there have been Luxembourg, Belgium, the Netherlands, Washington state and Oregon in the United States A study by Lynn Smith, a judge at the British Columbia High Court, found that the "risk of forced death" faced by vulnerable groups in these jurisdictions has been significantly reduced If the law continues to prohibit assisted death, it will not only prolong the suffering of the ultimate patient, but also lead some people to end their lives earlier Secondly, the presiding judge followed the principle of "fact finding" in the judgment of this case Carissima mathen, a law professor at the University of Ottawa, said that when it comes to assisted suicide, "laws that were previously absolutely prohibited not only have a serious impact on individual autonomy, but also cause great personal suffering The evidence the presiding judge now sees does not support this absolute prohibition The specific importance of "fact finding" here lies in that it depicts a vivid picture of the suffering of the ultimate patients who have no capacity to act when they cannot choose their own time of death 14 months ago, another decision of the Canadian High Court overturned the federal government's original law on prostitution, which was also based on the determination of "social and judicial facts" The presiding judge thus believes that the effect of the legal provisions on prostitution is to bring more life risks to vulnerable groups (sex workers) Therefore, if we want to minimize this risk, we can only conclude that the past laws need to be modified The last reason is that most of the current Supreme Court justices are appointed by Prime Minister Harper, which helps them to make a series of far-reaching decisions boldly in the past year, including labor rights, indigenous rights, the rights of sex workers, and the failure to agree with the Conservative Party's laws that attempt to increase the punishment of criminals Note: This article is based on CNCA, Jixin law firm and CBC