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things to know about a constitutional right to die in the Carter case:
7 of the Canadian Charter of Rights and
Freedoms protects the rights to “life, liberty, and security of the
person”. In Carter v
Canada, a unanimous Supreme Court of Canada ruled s. 7, in some
circumstances, also protects the right to die.
law has a long and complicated relationship with suicide. Traditionally, the
common law viewed suicide as an offence against both God and the Crown. Until
1823, English law commanded that the body of a person who has committed suicide
be driven by a stake and placed at the intersection of two highways. In Canada,
attempting suicide and assisting someone to commit suicide were both among the
crimes listed in Canada’s first Criminal Code in 1892. Although Canada repealed the criminalization
on attempted suicide in 1972, the prohibition on aiding or abetting a person to
commit suicide – s. 241 of the Criminal Code – remained in force.
Taylor argued that the criminal prohibition on assisted suicide violated her constitutional
rights to life, liberty, and security of the person. Ms. Taylor suffered from
ALS, a fatal neurodegenerative disorder which causes sufferers to lose control
of their bodies, culminating in the inability to speak, swallow, and breathe.
“I do not want to end my life violently,” Ms. Taylor argued in her evidence. “I
do not want to die slowly, piece by piece.” “I want the legal right to die
peacefully, at the time of my own choosing, in the embrace of my family and
friends.” Ms. Taylor’s compelling evidence played a large role in convincing In
large part, it was the compelling evidence of Ms. Taylor, that convinced the
Court of the law’s unconstitutionality.
Three myths about the Carter case and a constitutional right to die:
Myth #1: The Carter case should have been decided on the basis of the previous
decision in Rodriguez.
Reality: Carter was not the first time the Supreme Court has confronted the
delicate and difficult matters of constitutional rights to life and death. In
1993, the Court upheld the prohibition on assisted suicide in Sue
Rodriquez’s unsuccessful constitutional challenge. But life and law has
changed a good deal since 1993, the Court ruled in Carter. For example, expert and public opinion (including within
the medical profession) has increasingly titled towards the need for legal
reform in the law concerning end of life care. As well, although most countries
continue to ban assisted suicide, eight jurisdictions outside of Canada
(several American states and a number of countries in Europe) now permit some
form of assisted dying. Perhaps most importantly, the Court agreed that a
number of recent cases – involving hospital waiting times, safe injection
sites, and sex workers, among others – had altered and expanded the meaning of
the right to life, liberty, and security of the person in Canadian
constitutional law. Accordingly, the legal, social, and political context that
existed in Rodriquez no longer bound
Myth #2: Carteris likely to result in a deluge
of assisted suicides in Canada.
Reality: “The sanctity of life is one of our most
fundamental societal values,” the Court held. “Section 7 is rooted in a
profound respect for the value of human life. But s. 7 also encompasses life,
liberty and security of the person during the passage to death.” Overruling its
previous decision in Rodriguez, the
Court held that the prohibition on assisted suicide violated Ms. Taylor’s s. 7
rights because it forced upon her, and others like her, the “cruel” choice of
ending her life prematurely or suffering until she dies from natural causes.
Those grave consequences, the Court ruled, were not in keeping with the
“principles of fundamental justice,” or a “reasonable limit” since they went
far beyond the law’s objective of preventing vulnerable persons from being induced
to commit suicide in moments of weakness.
The Court rejected arguments that the law
recognized that life must be preserved at all costs, or that the decision would
open the floodgates to masses of depressed people demanding physicians assist
them to die. There is no medical duty on any physician to assist someone to die,
the Court noted. In addition, the right exists only for those adults freely
consenting to death, and suffering from a “grevious and irremediable medical
condition.” Medical professionals will continue to determine true consent and real
vulnerability as they do in countless other medical care decision-making
Myth #3: Carter
marks the end of the assisted suicide debate.
Reality: As Robert
Leckey suggests in his analysis of Quebec’s assisted suicide legislation,
the decision in Carter is just one
further step in the on-going societal debate on assisted suicide. Although the
Supreme Court struck down the prohibition on aiding and abetting suicide as
unconstitutional, it suspended that result for one year to allow time for
Parliament to fashion an appropriate constitutional solution. There will be
ample room for Parliament to continue to protect individuals from undue
influence to end their lives, so long as individuals like Ms. Taylor have their
autonomy and dignity to end their lives exempted from criminal punishment.
The Supreme Court of Canada peered deep
into the right to life, liberty, and security of the person and found that
sometimes, to give those rights full and true meaning, an individual must have
the right to die. Finding the balance between those rights and the needs of
vulnerable persons in practice is a task that now lies with Parliament. In that
sense, the constitutional right to die may have begun with the courts, but it
ends in the democratic debates in which we all play a role.
Today the Supreme Court of Canada unanimously ruled that Canada’s
blanket prohibition on assisted suicide violates section 7 of the Charter. To the extent that the law
prohibits a competent and consenting adult who seeks to end his / her life in
circumstances of a “grievous and irremediable medical condition” that is
causing intolerable suffering, it is of no force and effect. The Court suspended
its declaration of invalidity to give Parliament 12 months to enact legislation
that is consistent with its reasoning.
important facts about Carter and medical
care at the end of life:
1. Competent adult patients are entitled to
refuse medical care – even where that care is necessary to save the person’s
2. The focus of the claim, and the Court’s
decision, in Carter is on competent
adult patients who have expressed a clear wish to end their life in order to
avoid continued intolerable suffering.
3. The shape the law will ultimately take
is up to Parliament. The Court has provided guidance as to the constitutional
imperatives that the law must meet, but has left the details to elected
Three myths about Carter and medical care at the end of life:
Myth #1: The Court’s ruling will require physicians who object for moral or religious
reasons to assist their patients to die.
Reality: The Court explicitly addressed this
question, noting that nothing in its reasons would “compel physicians to
provide assistance in dying”. The Court explained that the resolution of this
issue is now for regulators and elected representatives.
Myth #2: The
Court’s decision reflects its sense that some lives have less value than others.
Reality: The Court focused on the intimate and intensely
personal nature of end of life decision-making, noting that “s. 7 recognizes the value of life, but it
also honours the role that autonomy and dignity play at the end of that life.”
Myth #3: A
law that permits physician-assisted suicide (PAS) will result a reduced focus
on improving the reach and the effectiveness of palliative care.
Reality The Court notes that one of the trial judge’s
findings was that in some jurisdictions with a permissive regime, the provision
of palliative care actually improved after PAS was legalized. Read more on this topic, from Dr. Eric Adams.
Dr. Erin Nelson is a
professor in the Faculty of Law at the University of Alberta. She teaches
Torts, Health Care Ethics & the Law and Law & Medicine. Her research
interests focus on health law and policy.