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EUTHANASIA / MEDICAL ASSISTANCE IN DYING (MAID) – RODRIGUEZ V. ATTORNEY GENERAL OF BRITISH COLUMBIA AND/ OR CARTER V. CANADA
EUTHANASIA / MEDICAL ASSISTANCE IN DYING (MAID) – RODRIGUEZ V. ATTORNEY GENERAL OF BRITISH COLUMBIA AND/ OR CARTER V. CANADA
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Euthanasia or Medical Assistance in Dying
Euthanasia refers to the intentional practice of ending someone’s life to alleviate suffering and pain. It falls into three categories, namely: involuntary, non-voluntary, and voluntary euthanasia (Brazier, 2018). Canada legally permits voluntary euthanasia, commonly known as medical assistance in dying, together with assisted suicide to terminate the distress of terminal patients. The Canadian law prohibits assisted suicide and euthanasia to minors, curable conditions, prolonged disability, and mental illness. Only citizens with Canadian healthcare insurance are eligible to avoid suicide tourism. Canadian legislation on assisted death encompasses legal defenses to prevent abuse and ensure informed consent. Physicians and legal witnesses involved must not have any financial or legal interest in the results of the patient. Therefore, patients must express consent repeatedly in writing rather than imply.
Earlier, the Canadian criminal code classified euthanasia as a type of censurable homicide until the Supreme Court overturned the prohibition in the monumental case, Carter v. Canada that came into effect in 2016. The court ruled that terminally ill persons are eligible to physician-aided suicide. Therefore, this paper focuses on euthanasia with reference to Carter v. Canada and Rodriguez v. Attorney General of British Columbia. It describes the major philosophical issues in the above Canadian legal cases. It also outlines the principles applicable in these cases and specific reasoning of the judges, including litigation arguments in connection to each individual case.
The current Canadian law stipulates that natural death must be incurable or reasonably foreseeable, which creates a controversy on how it immensely undermines the initial Supreme Court ruling allowing medical assisted suicide to grownups with irremediable and grievous clinical issues. Patients with curable medical conditions, permanent disabilities and mental disorders should feature in the irremediable and grievous category as per the court’s definition.
Rodriguez v British Columbia (Attorney General)
Rodriguez v. Attorney General of British Columbia, [1993] 3 SCR 519 counts as a milestone ruling made by the Canadian Supreme Court. Sue Rodriquez, a terminal patient contested the interdiction of assisted suicide, citing constitutional violation of the “Charter” Canadian Charter of Freedoms and Rights. The Supreme Court affirmed the Criminal Code provision that prohibits euthanasia in a 5-4 split ruling. At the time, she was 42 years old with terminal Lou Gehrig’s disorder, also known as amyotrophic lateral sclerosis, diagnosed 12 months before her landmark case. Sue Rodriquez discovered that she had less than one year to live, thus she embarked in a spirited campaign demanding the invalidation of section 241(b) under the Criminal Code that disallows physician-assisted suicide for terminally ill patients.
Rodriguez moved the British Columbia Supreme Court to annul section 241(b) in the Criminal Code alleging that it infringed her civil right provided in the Canadian Charter of Freedoms and Rights. She argued that section 241(b) would compel her to commit suicide several months sooner than required, due to anxiety of being unable to do it herself when her condition deteriorates. Section 7 establishes that each individual has a right to security, liberty, and life, as well as the right to be eligible, unless otherwise stipulated by the doctrines of fundamental justice.
Section 12 guarantees protection against bizarre and cruel punishment or treatment, while section 15(1) provides for equality stating that each person equal before the law and so enjoy equal benefits of the laws and protection without discrimination due to physical disabilities. Eike Kluge Henner served as her ethics adviser throughout the case. The Supreme Court gave a 5-4 split decision with the majority ruling against Rodriguez, indicating that section 241(b) violated the civil rights of Rodriguez.
Nonetheless, citing section 1 of the Charter, the majority decision termed it a justifiable limitation considering the innate risk of unlawful death of the elderly and ill individuals, if the Court was to annul section 241(b). The majority ruling found no encroachment of section seven. To justify their decision, the five judges examined whether the ban on physician-assisted suicide involved the right to security of person and the quality of life aspect. They discovered significant correlation between the justice system and the interdiction due to its effects on a person’s freedom and right to life resulting to psychological and physical suffering.
The majority ruled that the Criminal Code did not infringe any tenets of fundamental justice. They evaluated the historical background of suicide ban and concluded that it reflected crucial components of societal values, hence not a breach of fundamental justice. The five judges dismissed the claim that section 241(b) of the Criminal Code breaches section twelve that protects everyone from bizarre and cruel punishment or treatment, stating that the provision was a sheer ban that did not fall under the definition of treatment. Concerning the section 15 dispute that focuses on equality, the majority decision stated that the issue did not fall under this section, but in the assumption that the provision did not infringe the equality right, indicating that it falls under section 1. They ruled that the goal was rational, substantial and pressing, and no lesser means was available to accomplish the objective.
The minority ruling was in favor of Rodriguez, declaring that section 1 of the Charter protected her civil rights against violation. Lamer CJ, one of the dissenting judges found that section 241(b) of the Criminal Code had breached section 15; however, he failed to examine section 12 and 7. Cory J held that the section 7 of the Charter protects autonomy, all components of life, and right to die. McLachlin J ruled that section 241(b) infringed the right to security of an individual under Charter section 7, and that the infringement did not fall under section 1.
Carter v. Canada (AG)
Primarily, the ruling rendered in the Carter v. Canada case, overturned the verdict of the Supreme Court in the Rodriguez v British Columbia (Attorney General) case made 22 years earlier. It declared that prohibiting assisted suicide violates section 7 of the Charter (Hutchinson, 2016). Carter v. Canada, [2015] 1 SCR 331 featured Gloria Taylor, British Columbia Civil Liberties Association, William Shoichet, Hollis Johnson, and Lee Carter as the plaintiff. The British Colombia and Canada Attorney General featured as defendants, while several other interested parties appeared before the Court as intervenors and amicus curiae.
Gloria Taylor, the appellant was a 64-year-old woman diagnosed with terminal ALS, a severe neurodegenerative disorder also known as Lou Gehrig’s disease. Gloria was worried that with her deteriorated health condition, she would not be able to commit suicide by herself. Hollis Johnson and Lee Carter joined the case since they had to take their mother to undergo euthanasia in Switzerland due to the faced fear of prosecution by the Canadian authorities. Lee Carter’s mother was terminally ill; hence, her primary objective for seeking euthanasia was to die in a dignified manner without enduring suffering and pain. The BCCLA joined the case as an advocacy and civil rights group because the section 241(b) of the Criminal Code also affects patients with curable disease, mental disorders, and permanent disabilities.
Much like Rodriguez, Gloria contested the constitutionality of various provisions in the Criminal Code that prohibits assisted suicide. She purported that these provisions violated her civil rights provided under section 7 and 15 of the Charter. She further claimed that the infringements were not legally justifiable according to section 1 of the Charter. Specifically, Gloria Taylor challenged section 241(b), 222, 22, 21, and 14 of the Criminal Code. Justice Lynn Smit was the presiding judge in the case.
Similar to the minority ruling in the Rodriguez case, the trial judge found that section 241(b) violated the plaintiff’s right to equal protection, security, freedom, and life. Justice Smith ruled that the breach is not justifiable under section 1 of the Charter, therefore declaring the ban unconstitutional. The critical difference between the two verdicts is contingent on three major principles of fundamental, namely: gross disproportionality, overbreadth, and arbitrary. The latter stipulates that no legislation should infringe a person’s rights where it has no correlation to the goal behind it. The presiding judge stated that the plaintiff’s rights were not limited arbitrarily, given that the goal of the ban is to protect the disadvantaged, hence absolute prohibition aids to accomplish that goal.
Concerning overbreadth, the tenant that evaluates if a legislation violates rights and curtails the rights of particular groups without connection to the objective. Justice Smith ruled that the total ban unlawfully applied to people not classified as vulnerable population, therefore establishing unjustifiable limitations to the plaintiff’s civil rights. Gross disproportionality happens when the legislation’s goal is unbalanced with comparison to enduring impacts on the rights of people. She ruled that that the resulting effects of the assisted suicide ban were severe, hence grossly disproportionate to its legal purpose.
Moreover, Justice Smith declared limitations set out under section 1 as unconstitutional, deeming two of the three core tenets of fundamental justice insufficient. Ultimately, Justice Smith annulled section 241(b) of the Criminal Code, although she gave the parliament one year to repeal the legislation. This ruling became a milestone case by breaking the obstacle of stare decisis, a constitutional tenet that obliges provisional courts to uphold the precedents set by the Canadian Supreme Court. Stare decisis refused lower courts to accept new cases related to euthanasia. The ruling attracted an appeal in the Supreme Court for review.
The appeal presented several issues before the Canadian Supreme Court for deliberation. Foremost is to ascertain whether section 241(b) of the Criminal Code violated section 7 of the Charter. Secondly, the Court was to determine if the violation is justifiable under the Charter section 1. The Supreme Court upheld Justice Smith’s ruling, stating no grounds to refute the decision because it demonstrated that the ban denies dignified death. The Court also concurred with Smith in relation to the right to security, and liberty. It declared that complete ban meddles with decision making about healthcare and body integrity, hence trenching liberty. Depending on presented evidence and arguments, the Supreme Court ruled that section 241(b) of the Criminal Code infringes section 7.
Moreover, the Court considered if the limitations set out in section 1 of the Charter, violated the tenets of minimal impairment and overbreadth. It concurred with Justice Smith indicating that the effect of the ban was illegal because it causes unwarranted pain and suffering to people, depriving them the right to choose how to engage the body and treat it. On the other hand, the minimal impairment doctrine determine the presence of reasonable and safer methods of accomplishing the legal objective. Based on the evidence, the Supreme Court agreed with the ruling accredited physicians can conducted assisted suicide to consented patients.
Overall, concluding that all legislations that violate section 7 of the Chapter and are not justifiable under section 1, thus they are unconstitutional. The sanctity of life is a crucial value of the society, and human life value informs section 7, including an individual’s right to security, liberty, and life. Hence, the sanctity does not require protection of human life at all times, but embraces the quality of life. The ruling of Gloria’s case reflects Canadian values by allowing assisted suicide.
References
Brazier, Y. (2018, December 17). What are euthanasia and assisted suicide? Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/182951.php
Carter v. Canada (Attorney General), 2012 BCSC 886 – Decision Summary.
Carter v. Canada (Attorney General), 2015 SCC 5 – Decision Summary.
Hutchinson, B. (2016, June 18). It’s not suicide’: B.C. judge grants ALS sufferer the right to ‘assisted dying’. National Post. Retrieved from https://nationalpost.com/news/canada/its-not-suicide-b-c-judge-grants-als-sufferer-the-right-to-assisted-dying