Note: A previous version of this story incorrectly stated that a growing number of Canadians were travelling to Switzerland for help to end their own lives. This story has been updated with the correct numbers.
A small number of Canadians travelled to Switzerland to end their own lives last year, as Parliament passed a new law permitting doctor-assisted death that was widely criticized as too restrictive.
According to figures from Dignitas, a Swiss organization that assists patients with chronic or terminal illness to die, 131 Canadians became members in 2016, but only five travelled to Switzerland to end their lives, down slightly from seven the previous year and 11 in 2014.
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One of the Canadian patients who turned to Dignitas was Monique Hamel, who did not qualify for doctor-assisted death under the new Canadian law because her death was not imminent. After suffering for 20 years with a chronic neurological disorder, she left behind a two-page letter criticizing the politicians who enacted the restrictive law.
Forced to die 'with strangers'
"I will die with strangers who are more courageous and humane than our doctors and our decision makers," she wrote in the letter, written in French and released by Dignitas. "I leave you hoping that our elected officials finally have enough courage and empathy to permit people who are suffering to decide the moment of their death, here in Quebec and in Canada. As a matter of fact, when you read this text, I will probably be dead. It's sad! Indescribably sad...."
In the letter, Hamel accused politicians of putting electoral interests ahead of patient care, and also lashed out at doctors who oppose more liberal assisted death, saying they want to preserve a "monopoly" over life and death decisions.
She said the current law forced her to die far from home and loved ones, and that she spent more than $20,000 in fees for medical verification and travel costs.
In 2016, there were 7,764 people from 98 countries who became members of "Dignitas, To live with dignity – To die with dignity," up from 6,595 five years ago. Last year, a total of 201 people travelled to Switzerland to end their own lives.
Canada's new law, which came into effect on June 17, 2016, limits assisted death to mentally competent adults who have serious and incurable illness, disease or disability, where death is "reasonably foreseeable."
Restrictions on minors, mentally ill
It excluded some of the most contentious recommendations from a parliamentary committee that studied the issue, including extending the right to die to "mature minors" and the mentally ill, and allowing advance consent for patients with degenerative disorders.
Shanaaz Gokool, the CEO of Canadian advocacy group Dying with Dignity Canada, said that excludes large swaths of people who should have been covered under the Supreme Court of Canada decision in the landmark Carter case which struck down the sections in the Criminal Code that prohibited assisted death. That's forcing people to travel abroad to die, she said.
"We would hope that with the Supreme Court decision on Carter that people wouldn't have to resort to these measures, and it's very unfortunate that people have to be separated from their friends, families, communities at their most vulnerable time in their lives, when they are having an assisted death," she said.
Julia Lamb, a B.C. woman with spinal muscular atrophy, and the British Columbia Civil Liberties Association launched a legal challenge of the new law, arguing it is too narrow.
Spurred by Supreme Court
The government was forced to draft new legislation after a unanimous landmark ruling on Feb. 6, 2015, by the Supreme Court of Canada, which found the ban on physician-assisted violated Canadians' Charter rights.
The case involved two B.C. women who wanted end their lives with medical help. Both died before the court ruled,
Gloria Taylor, who had a neurodegenerative disease, eventually died of an infection. Kay Carter, then 89, travelled to Switzerland.
Justices gave the federal and provincial governments 12 months to prepare for the decision to come into effect.
After taking office, the Liberal government asked for a six-month extension, but the high court granted an extra four months, to June 6, 2016, leading to a compressed law-making process.
David Taylor, a spokesman for Justice Minister Jody Wilson-Raybould, said independent reviews of three issues identified in Bill C-14 as requiring further study is now underway, with a report due by December 2018.
Liberal MP Rob Oliphant, who chaired the special parliamentary committee that studied the issue, said he's disappointed by the pace of the review and called it "very concerning" that Canadians are forced to travel abroad to die.
Law needs more clarity
"I think Canadians need to understand that this is affecting real people and that we have to have better clarity in the Act to ensure it meets the Supreme Court expectations," he said. "To me, the Supreme Court was clear that an illness did not need to be terminal to be eligible."
Oliphant said he has received a number of emails, phone calls and letters from Canadians and family members who can't get the medical assistance they need and are either forced to travel to Switzerland or endure tremendous pain.
He said the recurring message is that Canadians should have a continuum of medical care that allows them full dignity.
"That's what the legislation needs to guarantee, that people are able to entrust their lives and their deaths in the hands of the physicians who will understand whether they have the right to end their own lives when a certain set of criteria have been met."
The special committee's 70-page report said Canadians should have the right to make an "advance request" for medical aid in dying after being diagnosed with certain debilitating but not necessarily terminal conditions.
It also said assisted death should not be limited to those with physical conditions, and that Canadians with psychiatric conditions should not be excluded from doctor assistance to end suffering.
This story has been edited from a previous version that incorrectly stated 131 Canadians travelled to Switzerland last year for medical assistance in ending their own lives. In fact, 131 is the number of Canadians who are members in an organization there that provides medical assistance in dying; only five Canadians travelled to the country last year to end their own lives.Feb 06, 2017 12:37 PM ET