Key players in the right-to-die decision and debate
Legislation limited to 'mentally competent' people over 18 years old
The debate about physician-assisted death continues in Canada, even as the federal government tabled a bill Thursday saying it would be restricted to mentally competent adults with serious and incurable illness.
The bill is an attempt to bring balance to a highly contentious issue, but neither side is likely to be completely appeased.
- Doctor-assisted dying bill restricted to adults facing 'foreseeable' death
- Read the text of bill C-14 on medical-assisted dying
- Assisted death bill won't allow 'suicide tourism'
This isn't the first time the issue of assisted dying has played out in the public and the courts, and the list of all those who have lobbied for or against is extensive. But here's a list of some the key players — from parliamentarians to advocates — who have played a part in shaping the current bill.
In the courts
1. Kay Carter, Gloria Taylor and the B.C. Civil Liberties Association
The assisted-dying case that sparked change in this case was brought by the B.C. Civil Liberties Association on behalf of Kay Carter and Gloria Taylor, who suffered from degenerative diseases.
Both women died before the case made it to Canada's top court — Carter chose to go to Switzerland to end her life and Taylor died of an infection.
2. Supreme Court of Canada
The nine justices who make up Canada's highest court issued a unanimous decision in February 2015 to strike down the criminal code prohibitions against assisted dying.
The court ruled that in some circumstances, Canadians have the right to ask a doctor to help them to die. The court gave the government until Feb. 6 to come up with a new law, but later extended the deadline to June.
1. Special joint committee on physician-assisted dying
Following the Supreme Court decision, the government formed a committee of members of Parliament and the Senate to put recommendations forward.
The committee was led by Conservative Senator Kelvin Ogilvie and Liberal MP Robert Oliphant. Other MPs and senators from all three major parties make up the rest of the committee.
The committee recommended people diagnosed with competence-impairing conditions like dementia be able to make advance requests for medical help to die. They also said mature minors should have the right to choose assisted death within three years of the initial legislation. And perhaps most controversially, it said people with psychological conditions that cause intolerable suffering should also have the right to request medical help to die.
2. Justice Minister Jody Wilson-Raybould
Wilson-Raybould has the task of balancing the Canadian Charter of Rights and Freedoms with the Criminal Code. She introduced the bill, which placed limits on who was eligible, on Thursday.
"We believe this legislation is the best approach to ensure that dying patients who are suffering unbearable pain have the choice for a peaceful death and the vulnerable are protected," she said.
3. Health Minister Jane Philpott
As this issue touches as much on health as it does on justice, Philpott has been a key player in the discussion around physician-assisted death. She tabled the bill along with Wilson-Raybould.
She said in a statement that the federal government would work with the territories and provinces "to support consistency in the delivery of medical assistance in dying, as well as to develop a pan-Canadian monitoring system to collect and analyze data, monitor trends and publicly report on the new regime."
4. MP Dominic LeBlanc, Liberal House Leader
LeBlanc, as house leader, could have forced the back-bench Liberal MPs to vote to support the bill. He had initially said he would whip the vote, but later decided that individual MPs can choose whether or not to support it.
5. Conservative MP Michael Cooper
Cooper, vice-chair of the joint committee on physician-assisted dying, said he disagreed with many of the recommendations that came out of the committee. His disagreements centered on allowing mentally ill people to ask for assisted dying. He was also opposed to minors being included in the bill.
6. Provincial-territorial advisory group
This Ontario-led group is comprised of doctors, health-care workers, ethicists and patient safety groups from across the country. The group spent three months working on a report about assisted dying, which it released in November 2015.
The group supports access to physician-assisted dying, but wanted to make sure that there were many safeguards in place to protect patients and doctors.
Maureen Taylor, co-chair of the advisory group, is a former medical journalist with CBC News and physician assistant in infectious disease. Taylor's husband, Donald Low, a famed microbiologist in Toronto, advocated for physician-assisted suicide before his death.
- Deciding on assisted death in context of mental illness highly complex, experts say
- Right to die: Should 'mature minors' have access to doctor-assisted death?
There are a host of national, provincial and territorial advocates on either side of the debate.
Advocates in support
1. Canadian Medical Association
Earlier this year, the association released recommendations after two years of consultation on the issue. It said that physician-assisted death should be allowed if the patient is a competent adult capable of making an informed decision. They also said physicians should be able to decline to do it on moral grounds.
2. Dying with Dignity Canada
This group, which has been at the forefront of the push for assisted-dying legislation, is disappointed with this bill. The group's CEO Shanaaz Gokool calling it harsh and discriminatory because it does not go far enough to support those with what it describes as catastrophic degenerative conditions to give advance requests for assisted dying once their pre-stated conditions are met.
1. Council of Canadians with Disabilities
This organization has come out against physician-assisted dying, saying that it promotes negative stereotypes of people with disabilities. It says any government action to decriminalize assisted dying has too much potential for abuse to people with disabilities.
2. Euthanasia prevention coalition
This is one of the many groups that have expressed concern about the legislation, saying that no number of safeguards will be able to prevent abuse.
Many groups call for safeguards
Some groups, such as the Canadian Psychological Association, the Canadian Nurses Association and the Canadian Association for Community Living (CACL) have also weighed in.
However, the groups have voiced concerns about how people with mental illnesses could suffer from abuse without proper safeguards. The nurse's association said it will respect the court's decision, but called for many specific safeguards, such as the creation of a national oversight body.
CACL executive vice president Michael Bach said minors should not be eligible. He said this is not to deny the suffering of young people with terminal conditions, but said palliative care is the appropriate response.