Manitobans seeking medically assisted death may still need court approval

Medically assisted death becomes legal in Canada Tuesday for patients who meet the criteria but Manitobans seeking doctor-assisted death will likely still need to get approval from a judge.

Winnipeg lawyer disagrees with court approval, says applications require 'significant work'

Manitobans seeking doctor-assisted death need a judge to sign off on the procedure. (CBC News)

Medically assisted death is officially legal in Canada for patients who meet the criteria but Manitobans seeking doctor-assisted death will likely still need approval from a judge.

The federal government had until June 6 to draft new assisted dying legislation, but Bill C-14 — the Liberals' proposed bill on assistance in dying — is still under Senate review. As of Tuesday, the Supreme Court's original ruling becomes the law of land in the interim. That means doctors can't be prosecuted under the Criminal Code if they help a patient suffering from a "grievous and irremediable" illness die.

The head of the College of Physicians and Surgeons in Manitoba said Monday that in the absence of new federal legislation, realistically patients will still need court approval. The main reason is the Supreme Court ruling only protects doctors from prosecution, not the entire medical team, college registrar Dr. Anna Ziomek said.

"The Supreme Court decision applies only to physicians, therefore there would be no ability for nurses, social [workers]  and pharmacists to participate in the process," Dr. Anna Ziomek, the college's registrar said. 

"There is no real way to deliver this service as a lone physician, you need to be part of a team which has at least a physician and a nurse and a pharmacist and some support through social work."

Ziomek said if an application is made through the courts, all regulated health professionals receive an exemption under the Criminal Code.

3 doctors performing medically assisted death in Manitoba

Right now in Manitoba, three doctors, two nurses, two pharmacists and three social workers make up the "implementation team" assisting patients who are granted the right to die, Ziomek said. 

The team is based out of the Winnipeg Regional Health Authority, and Ziomek said they have drafted protocol and are organizing education for physicians who wish to be involved.

So far, three patients have won the right to medically aided dying in Manitoba and Ziomek added "a number of patients" are in the application process. 

Lawyer questions mandated court-approval

John Myers is a Winnipeg lawyer who has represented all three Manitobans who have been granted the right to a medically assisted death. He disagrees with the college's opinion that court approval will be needed to protect the team. 

"I think it's already there," said Myers. "In my view the Supreme Court of Canada [and] by implication its decision also protects that team, the nurses, the pharmacists — anybody who would be involved to provide the support to the physician providing the service."

Myers said the court process is onerous on a family already dealing with a loved one who is gravely ill. 

"Court applications require a significant amount of work. You need to spend time with families, you need to gather evidence gathered for affidavits for court, you need to co-ordinate to some extent with the physicians ... draft orders and applications, you need to appear in court."

Myers said he believes families would be better off spending time with the loved they're losing than a court application.

Personal victory for MLA Steven Fletcher

Medically-assisted death is officially legal in Canada for patients who meet the criteria but Manitobans seeking doctor-assisted death will still be required to get approval from a judge. 1:55
For Manitoba MLA Steven Fletcher, the ruling is a long-time coming. Fletcher says needing court-approval seems like unecessary red tape but he expects that will change as people become more familiar with the criteria.

On a personal note, the ruling is a big victory for Fletcher.

The former Member of Parliament, who was paralyzed from the neck down in a 1996 car crash, introduced two private member's bills which allow assisted-death in some cases. The ruling even used some of his exact wording, he said before quickly adding it's not about him nor is it about the physicians: it's about Canadians.
    
"The Supreme Court has provided peace of mind for a lot of people," Fletcher told CBC News.

"Most people are not going to take advantage of medically assisted death, but they will know they will not be forced to suffer a horrific end. And this actually saves lives and prolongs lives. There are many instances where people end their lives in anticipation of what might happen if they have a degenerative disease, a neurological disease."

"Now we can err on the side of life and if it is the worst case scenario we can help end the suffering in a open and transparent manner."

Fletcher said he believes the Supreme Court ruling will make Canada a leader in the western world when it comes to assisted death.

"I think it will push society to be more empathetic, more thoughtful, philosophical, ethical and merciful."

Clarifications

  • The College of Physicians and Surgeons of Manitoba does not require court approval for medically assisted death, as stated in an earlier version of this story. It does say that court approval would be necessary to protect other members of the medical team.
    Jun 07, 2016 10:44 AM CT

About the Author

Jill Coubrough

Reporter, CBC News

Jill Coubrough is a video journalist with CBC News based in Winnipeg. Before joining CBC Manitoba, she worked as a reporter for CBC News in Halifax and an associate producer for CBC's documentary series Land and Sea. She holds a degree in political studies from the University of Manitoba and a degree in journalism from the University of King's College in Halifax. Email: jillian.coubrough@cbc.ca.