Carter v. Canada and the road to choice

The Supreme Court's ruling in Carter v. Canada was a game-changer for the movement to afford Canadians the right to die with dignity.

On Feb. 6, 2015, the Supreme Court of Canada sent a powerful message heard around the world. In a unanimous decision, the justices of the high court struck down the federal prohibition on physician-assisted dying (PAD), arguing the old law violates the Canadian Charter of Rights and Freedoms. Channeling the cherished Canadian values of compassion and individual freedom, the decision promises to reshape how we think about death and dying in the years to come.

The Carter v. Canada ruling established strict, but fair, guidelines for determining who can access PAD and how it can be safely administered. It also gave decision-makers until February 2016 to prepare for the decriminalization of assisted dying, but this was later extended to June 6, 2016.

With the help of some sharp legal minds, DWD Canada has prepared an easy-to-digest summary of the Carter decision and what it means for individuals seeking an assisted death. Use it to better understand your rights and what must be done to make sure they’re respected.

Is physician assisted dying legal now?

Yes! On June 6, 2016, the legal ban on physician-assisted dying expired. While the federal government has yet to pass legislation, Canadians may now legally access assisted dying under the guidelines put forth by the Supreme Court's Carter decision.

Who is eligible for a physician’s assistance to die?

Until a national framework is passed, eligibility for PAD will be determined based on the Supreme Court's guidelines. In its Feb. 6 decision, the Supreme Court decriminalized physician-assisted death for Canadians with a “grievous and irremediable” medical condition (an illness, disease or disability) that causes enduring suffering that is intolerable to the individual. The court did not define “grievous and irremediable,” but it is clearly not limited to terminal illness.

Only competent, consenting adults will be allowed to access PAD.

Does a person with dementia (for example, Alzheimer’s disease) qualify for physician-assisted death?

Someone who has dementia but is still competent to provide informed consent may qualify, provided their suffering is intolerable to them at the time of the request.

The court is silent on whether someone should be allowed to consent to physician-assisted death through an advance care plan. This may be addressed through legislation.

How can the physician help?

Physicians are able to assist either by providing the knowledge or the means for a person to end their own life. Doctors are allowed to prescribe or administer life-ending medication (for example, by injection or through an IV) to eligible adults who request assistance to die.

Are doctors able to refuse a request?

The SCC decision does not compel physicians to assist a patient in dying. It does not address whether doctors must provide information about PAD or refer requests for assistance to another physician.

Are hospices, hospitals and other institutions able to refuse to allow physician-assisted dying on their premises?

The SCC decision also leaves it up to lawmakers and healthcare regulators to decide whether institutions must provide PAD. If the duty to provide physician-assisted death by hospitals, hospices and other institutions is not addressed in legislation, physician-assisted death will remain a right, but it might not be accessible for all Canadians.