Québec’s Bill-52 (Euthanasia) & SCC Implications

Conflict at the end-of-life, particularly between families and healthcare providers, involves many complex factors: differing opinions surrounding a patient’s prognosis, cultural differences, moral values and religious beliefs, associated costs, internal family dynamics, and of course, legal ramifications.
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Recently, Véronique Hivon, Minister for Social Services and Youth Protection for the governing Parti Québécois in Québec, introduced Bill 52: An Act Respecting End-of-Life Care.
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PURPOSE OF THE ACT
The purpose of this Act is to ensure that end-of-life patients are provided care that is respectful of their dignity and their autonomy. The Act establishes the rights of such patients as well as the organization of and a framework for end-of-life care so that everyone may have access, throughout the continuum of care, to quality care that is appropriate to their needs, including prevention and relief of suffering.
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Bill-52 has sparked immense debate throughout Québec and across Canada. National Assembly legislators and Québec civil society continues to engage in a polarizing debate as Québec aims to become the first province to legalize euthanasia. The bill, expected to pass as early as this week, will have far-reaching implications for healthcare decision-making for families, healthcare providers, religious groups, and others.
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Currently, the U.S. states of Washington, Oregon and Vermont allow physician-assisted suicide, but not euthanasia, when patients are within months of dying; other countries, such as Belgium, Luxembourg, and the Netherlands, have similar laws. In fact, Belgium recently became the first country to expand euthanasia laws to children (Feb. 13, 2014.)
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If Bill 52 passes, it is likely to make its way to the Supreme Court of Canada. Other cases have been reviewed in the past. One of the most seminal decisions involved Ms. Sue Rodriguez, a woman who suffered from amyotrophic lateral sclerosis (ALS) and, in 1992-93, challenged the validity of Section 241(b) of the Criminal Code. At both the British Columbia Court of Appeal and British Columbia Supreme Court Rodriguez claimed this provision violated Sections 7 (the right to “life, liberty and security of the person”), 12 (protection from “cruel and unusual punishment”) and 15 (equality rights) of the Charter. The case made its way to the Supreme Court of Canada. The Supreme Court rendered a 5-4 decision on September 30, 1993, dismissing Rodriguez’s appeal, and upheld the status quo — prohibiting rights to physician-assisted suicide. In 1994, Ms. Rodriguez ended her own life with the assistance of an unknown physician.
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On April 21, 2010, the Bloc Québécois-proposed Bill C-384: An Act to amend the Criminal Code (Right to Die with Dignity) was defeated at second reading by a vote of 228-59, after introduction by MP Francine Lalonde. There was a free vote, which received support across party lines.
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The high-profile case raised many ethical and constitutional dilemmas, which are not unique to Ms. Rodriguez’s case or Bill 52 before the Québec National Assembly today, but the issue has certainly received renewed national attention. On January 16, 2014, the Supreme Court of Canada agreed to hear a British Columbia couple’s appeal, from a lawsuit originally filed in 2011 with the assistance of the BC Civil Liberties Association (BCCLA). The original plaintiffs, Lee Carter and Hollis Johnson, were members of Kay Carter’s family, who sued the government on behalf of their relative who travelled to a Switzerland clinic in 2010 to die by choice, after Kay Carter was denied physician-assisted suicide in Canada. Gloria Taylor, a woman with ALS who later joined the plaintiffs, died in 2012. The British Columbia Supreme Court overturned the assisted-suicide law, which was later challenged by the Canadian government and reinstated, in a 2-1 decision, by the British Columbia Court of Appeal. The BCCLA has now been granted leave from the country’s top court. Grace Pastine, litigation director with the BCCLA stated:
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“There are few rights more fundamental, or more deeply personal, than the right to determine how much suffering to endure and whether to seek a doctor’s assistance to hasten death if living becomes unbearable.”
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Clearly much remains to monitor at the Supreme Court. This entry has been adapted from a recent academic paper written by Matthew Ponsford, which can be accessed via www.uottawa.academia.edu/Matthew Ponsford.