Monday, February 9, 2015

Supreme Court of Canada ruled this morning in favour of allowing physician-assisted death

Special Notice from Hospice Palliative Care Ontario
Friday, February 6, 2015



The Supreme Court of Canada ruled this morning in favour of allowing physician-assisted death.

In the judgment, available here,  the court ruled that:

Section 241 (b) and s. 14  of the Criminal Code  unjustifiably infringe s. 7  of the Charter  and are of no force or effect to the extent that they prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.

The Court's also ruled that:

 
The appropriate remedy is therefore "a declaration that s. 241 (b) and s. 14  of the Criminal Code  are void insofar as they prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life; and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.  "Irremediable," it should be added, does not require the patient to undertake treatments that are not acceptable to the individual.  The scope of this declaration is intended to respond to the factual circumstances in this case.  We make no pronouncement on other situations where physician-assisted dying may be sought. 

The ruling was suspended for 12 months to allow Parliament and provincial legislatures to respond by enacting legislation consistent with ruling. 

The Court declined to create a mechanism for exemptions allowing physician-assisted death during the 12 month suspension period.

The Court also expressed the view that nothing in the judgment would compel physician to provide assistance in dying. 

What Happens Now?

Parliament has 12 months to introduce legislation that is consistent with the Court's ruling. Various healthcare associations and interested parties have offered to will work with government to craft regulations to address the issue. HPCO will support such work with the The Canadian Hospice Palliative Care Association .

As stated in our February 5, 2015 advisory, access to hospice palliative care is our main focus. While the legislation and other details regarding physician-assisted death are worked out over the next 12 month, HPCO will maintain our focus on promoting awareness of hospice palliative care and the need for better access to high quality hospice palliative care in any setting where someone may be expected to die. 

HPCO will also distributed all materials developed by CHPCA for marketing National Hospice Palliative Care Week in May 2015. The materials will be available at end of March.
HPCO's Key Messages 

We have updated our key messages to include that hospice palliative care providers and healthcare professionals must have the option to not participate in assisted suicide.

  • Most Canadians are not being referred to hospice palliative care in a timely fashion - the support for living well until dying can be greatly increased.
  • The decision will have complex and confounding implications for end-of-life care in Canada and we cannot lose focus on the need to improve access to hospice palliative care.
  • As a hospice palliative care organization we know that the health care system continues to underutilize and under-deliver palliative services, the first option for patients with terminal or life-threatening conditions. 
  • Improving access to hospice palliative care in any setting where someone may die must remain a public policy priority.

  • Hospice palliative care providers and healthcare professionals must have the option to not participate in assisted suicide.
  • The decision on assisted suicide is no excuse to stop or slow important progress required in improving access to palliative care across Canada.
The Quality End of Life Care Coalition of Canada's Blueprint for Action makes four recommendations to improve hospice palliative care:
  1. Better access to tertiary care, hospice palliative care and a palliative approach in primary care.
  2. Caregiver support, including grief and bereavement.
  3. Education, training and research to support all healthcare providers to provide palliative care to patients with life-limiting illnesses.
  4. Advance care planning for all Canadians and tools to help healthcare providers initiate conversations about wishes, hopes, and goals of care.
Further resources:
 

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