Rare Disease Report

In Canada, Tensions Rise in Debate over Physician Assisted Suicide Bill

MAY 20, 2016
Ruth J Hickman, MD and James Radke, PhD
In Canada, tensions are running high as members of Parliament debate a bill making legal some forms of physician-assisted suicide. The government is pressing heavily to get the bill passed quickly, so the country will not be exposed to a “legal loophole” of legal physician suicide without enough regulation. But others say the measure shouldn’t be rushed, whatever the results.
And in the process of rushing the bill through, members of Parliament had a bit of an ‘altercation’ that is being labeled #elbowgate.

Bill C-14

In February 2015, the Supreme Court of Canada overturned the criminal ban on physician-assisted suicide. The court suspended implementation of the ruling until June 6 of this year, giving time for the legislature to provide supporting laws. But Canada’s ruling Conservative party opposed the ruling, and did not move to enact supporting legislation.
The Liberal party came to power last fall, headed by Prime Minister Justin Trudeau. Trudeau has supported doctor-aided death partly because of his personal experience with his father, former Prime Minister Pierre Elliot Trudeau, who died in 2000.
Trudeau introduced Bill C-14 to the House of Commons. The bill defines the criteria by which people may legally request assistance in dying. It also amends the current criminal code to protect medical professionals, prohibits assisted suicide in persons traveling to Canada, and includes other safeguards such as a mandatory waiting period.
Many supporters of physician-assisted death are encouraged by the bill, but others think it is too restrictive. For example, it will not apply to people with certain long-term chronic illnesses. It also does not provide for minors, or for people in the early stage of an illness like dementia. Other critics of the bill, including some religious leaders, have long opposed any kind of physician-assisted death for moral reasons.
The bill is expected to eventually pass, given the Liberal party’s large majority in the House of Commons. The question is when. The Trudeau government would like to measure to go through before the June 6 deadline.
Justice Minister Jody Wilson-Raybould argued that such a delay beyond June 6 would create a “dangerous legal vacuum.” She told members of the Committee for Justice and Human Rights, “There would be no safeguards in place. Medical practitioners would have uncertainty around how the [Supreme Court ruling on assisted suicide] would be applied.” She added, “Patients who want to access medical assistance and dying would be limited in doing so, given the uncertainty that would exist.”
But some legislators have not wanted the process rushed. Some outright oppose the bill for ethical reasons. Others think the bill should be amended, for example, to allow the possibility of advance directives, include terminal illness in the eligibility criteria, or add a judicial review process. Certain senators think that Parliament is unlikely to meet the June 6 deadline.


To help propel the legislation forward by the deadline, the Trudeau government has exerted more control over the House of Commons schedule. On Wednesday, members gathered to vote on a motion to limit debate on the bill. When opposing members set up tactics to delay the voting (for reasons related to both the bill and the nature of the way the voting procedure for the bill was rushed through), the Prime Minister charged through the crowd to escort the Minority Whip to his seat. On the way he strongly elbowed New Democratic Member of Parliament Ruth Ellen Brosseau in the chest, causing her to need to leave the chamber.
The Prime Minister claimed that move was inadvertent, and he apologized a few minutes later.


But members of the opposition expressed outrage, seeing the incident as a sign of poor respect for Parliament. In the end the government withdrew the controversial motion, so debate on the bill continues. The incident seems to exemplify the strong feelings held by proponents of both sides of the debate. When enacted, Canada would become only a handful of countries to permit legal physician assisted death.

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