What the Supreme Court of Canada decision on physician-assisted dying means for physicians

Statement from the Canadian Medical Protective Association (CMPA) concerning the Supreme Court - Carter assisted dying decision.

"This means that at this time it remains illegal for anyone, including physicians, to counsel, aid, or abet a person to commit suicide."

In a landmark decision, the Supreme Court of Canada unanimously declared the criminal prohibition against physician-assisted dying unconstitutional. While the February 6, 2015 decision is important, the Canadian Medical Protective Association (CMPA) wants physicians to keep in mind several important facts.

The most important is that the Court suspended the decision for 12 months to give Parliament and the provincial legislatures time to enact legislation, and medical regulatory authorities (Colleges) and medical associations time to develop policies and guidelines. This means that at this time it remains illegal for anyone, including physicians, to counsel, aid, or abet a person to commit suicide.

The Court’s decision is also limited to situations in which the patient is a competent adult person who clearly consents to the termination of life. In addition, the patient must be suffering from “…a grievous and irremediable medical condition […] that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.”¹

In an attempt to clarify what might be considered a “grievous and irremediable medical condition,” the Court stated that it includes an illness, disease, or disability. Moreover, the term “irremediable” is not intended to require the patient to attempt treatments that the patient considers unacceptable.²

The Court expressly recognized a physician’s right to refuse to assist a patient to die based on freedom of conscience. The Court deferred to Parliament, provincial legislatures, and Colleges to establish appropriate frameworks that reconcile the Charter rights of patients and physicians.

In 2014, the Québec government passed An Act respecting end-of-life care that, once enacted, will permit physician-assisted dying in more restrictive circumstances than those set out by the Supreme Court of Canada. More information and guidance is expected from the Collège des médecins du Québec in advance of the new Act coming into force in Québec on December 10, 2015. In the meantime, the CMPA’s advice to Québec members is the same as to members in the rest of the country — the law currently continues to prohibit anyone from counselling, aiding, or abetting a person to commit suicide.

In the coming months, it is expected that Colleges and medical associations across the country will develop policies and guidance on physician-assisted dying. The CMPA will continue to work with stakeholders to ensure that physicians’ medico-legal interests are protected, and that physicians are aware of their responsibilities and rights in this area.

In the meantime, members are encouraged to contact the CMPA for case-specific medico-legal advice on such issues, including when there is disagreement with a patient, family member, or substitute decision-maker on the recommended treatment plan.

1. Carter v Canada (Attorney General), 2015, SCC 5.
2. Ibid.