Physician Assisted Patient Death in Canada: Impact on Law and Society

The case of Carter vs Canada legalized physician assisted patient death in Canada. This ruling has had a significant impact on Canadian law and society. Patients, medical practitioners, and families have all been affected. The decision has given patients the right to dictate their medical care and end their suffering caused by an irremediable medical condition. Medical practitioners can now carry out this procedure without fear of being held liable. The law has also prevented unnecessary medical bills and improved the quality of life for patients and their families. The bill was signed by the royal assent in 2016 and includes several exemptions for medical practitioners and nurse practitioners to assist in dying to avoid unnecessary suffering.

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Laws regarding physician assisted patient dying.
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Carter vs Canada.
In the case of Carter against Canada, through the attorney general, regarding the issue of
physician-assisted death, the supreme court overturned the 1993 ruling of Rodriguez vs Canada
(Murphy,2016). The earlier ruling had upheld a prohibition of anyone from aiding or abetting in
committing a suicide. It was an indictable offense. In this ruling, the court had denied this right
to assisted death. In the 2015 supreme court ruling, the charter on human rights enshrined in the
Canadian constitution was the point of reference (Butler & Tiedemann, 2015) . It provides for
the right to life, liberty, and security. A decision, to prohibit an individual from making a
decision concerning their medical care when they have an irremediable medical condition would
be considered an act of infringing on their human rights. The state prohibition was overturned.
This decision gives patients the right to dictate the way they would want to be treated to end the
alienable suffering caused by a disease.
Impacts on Canadian.
The decision by the supreme court has had a great impact on the lives of Canadians
undergoing terminal illnesses. This ruling set a platform through which the physician-assisted
suicide could be done within the precincts of the law. In this respect, physicians cannot be held
liable under the penal code (Steele, 2018). There was an exemption of medical practitioners
allowed to participate in euthanasia. The Canadian medical professionals can carry out this
procedure without the fear of being made liable for the death if it is done with due regards to the
law. This a major milestone in patient care. The role of physicians in terminal illness is ensuring
the best quality of life before death. They can properly inform the patients and their families and
the interventions that are possible. The option of euthanasia is a viable option and can now be
suggested to the patients and the families (Landry, Valiani, Foreman & Patel, 2016) The sole

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purpose of medicine is to alleviate patient suffering and this as one of the interventions makes
the physicians perform their roles effectively
Medical practitioners have had a sigh of relief in dealing with patients with irremediable
conditions. The whole process of physicians having to experience an interaction with terminally
ill patients has been found to have some impact on their mental health. A high number of
practitioners working in palliative care clinics have developed psychological and psychological
problems (Welie, Sullivan & Heng, 2016). Depression has been the most common issue and this
has an effect on the productivity and quality of services. However, most of these medical
professionals do not seek medical attention. this particular issue has also been on the rise in
Canada.
To the Canadian population, this has been relieving solution to the high cost of medical
care. health care is one of the most expensive services despite it being a basic needs and right.
Every citizen has a right to the highest level of attainable health care. This right is not fully
enjoyed owing to the high cost of healthcare provision (Grandin, 2015). Patients have been
reduced to beggars in the search for healthcare in some conditions that have been termed as
irremediable. Before the ruling, most patients would practically spend their entire life in
hospitals at the expense of their savings and their families’ contribution. This is devastating
especially when disease history cannot be altered to improve their quality of life. There have
been cases of patients being put under life support for years even after being declared brain dead.
A recovery from such a condition is very rare and this may economically cripple the patient and
their caregivers.
The law has made it possible to make a decision before the situation becomes worse.
Initially, the move to authorize euthanasia would be punishable by law. Right now the patient’s

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family members are not burdened with unnecessary bills to foot. The patients can consent to
euthanasia and prevent appropriation of a fund that would otherwise be drained in the medical
intervention. This has prevented suffering among the bereaved.
The patient’s quality of life is substantially improved. Excess suffering from illness can
be halted. Suffering may be physical or emotional. In terminally ill patients, life is usually a very
critical journey. They go through the stages of grief before the can come to a consensus with
their condition. These stages need support and at the moment they reach the acceptance stage
they are ready to face death. When they reach the stage, it's more enabling if the option of
euthanasia is on the table. They can make plans and arrangements for their loved ones with a
clearer mind and certainty that when they are not able to estimate the time they have. This also
empowers the patient and makes them feel in control of what happens to their lives. The patient
is the center of interest in healthcare, their decision is made a priority. They are made to
participate in the provision of care. According to research in palliative care (Trachtenberg &
Manns, 2017), one of the methods of preparing patients for death is honoring their request. In the
event that a patient requests a certain method of euthanasia, this can be provided to them within
the provisions of the law. Death is very depressing to the patient especially in the face of
uncertainty. Their quality of life is improved when some of the uncertainties are cleared.
The family members are an essential support structure in the wellbeing of the patient.
Their emotional health is critical to the whole process. Family members need psychological
support to accept the fate of their loved one. Families had initially been exposed to mental torture
as they watched their members fight with some irremediable conditions (Murphy, 2016). It is
depressing and devastating. Members have had to go through counseling because of the effects
of the suffering. Euthanasia has prevented such circumstances in Canada. Family members don’t

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have to watch them suffer. This is good for their mental health. It helps them go through a
healthy grieving process.
Impact of the case on Canadian law
In June 2016 the House of Commons passed the bill well known as Bill C14. This states
that there were several exemptions for medical practitioners and nurse practitioners to assist in
dying to aid avoidable suffering according to the Rights (2012). The Act includes the parliament
of Canada recognizes the autonomy of individuals suffering from terminal illness with
unnecessary suffering. The Act recognizes the need to prevent medical errors and abuse of
medically assisted dying. The vulnerable who might be unable to make decisions during these
moments should be protected. The Canadian parliament respects the jurisdiction of provinces
regarding regulation of healthcare workers and insurance. The Act includes the aspect of all who
are eligible for euthanasia should weigh the legal adverse consequences it would cause to their
families. The government of Canada upholds public administration, universality in regards to
medical assistance in dying.
According to Statutes of Canada (2016) section, 14 was amended to allow the medical
and nurse practitioners to practice medical assistance in dying. This refers to the act where a
substance is administered to a person to cause death. The eligibility for medical assistance to
dying includes a person above eighteen years able to make decisions, have an irremediable
medical condition, they are able to give consent, they are not coerced to make the decision rather
it is their own free will and they give consent on being informed on available options.
An irremediable condition according to this act refers to a serious incurable illness, the
state of the medical condition is irreversible, illness is causing emotional and physical suffering

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that can’t be relieved and their natural death can be foreseen. The person must meet the above
criteria, request the medical assistance in dying in writing, can withdraw and are able to
communicate their needs. The nurse and medical practitioners should comply with the standards
and failure risk imprisonment of not more than five years. The conviction also applies to anyone
who forges documents and destruction of documents regarding medical assistance to die. The
patients should be informed of other alternatives regarding their palliative care. When the person
who is requesting medical assistance to dying is unable to sign, another person who is above
eighteen years and understands the procedure can sign on their behalf (Ponsford, 2017). There
can be an independent witness on signing who understands medical assistance to die.
The medical and nurse practitioner should have medical knowledge regarding provincial
laws, rules, and regulations. The pharmacist should be informed on the aim of the substance
before dispensing the substance. The death certificate should include the medical assistance to
dying, the substance used and the medical illness or disability prompting the medical assistance.
The bill was signed by the royal assent on the same day after the debate in the house of
commons.
Conclusion
The case in which assisted medical dying was legalized in Canada is a steering
wheel in the medical practice in Canada (Martinez, 2015). It also challenges other countries
regarding this contentious issue. This practice eases the unavoidable suffering regarding terminal
illnesses which cause pain that cannot be managed. The family is also granted the chance of
financial freedom regarding long hospitalization stays for a relative who’s been diagnosed with a
terminal illness. According to Chan and Somerville (2016) the law is restrictive since it
addresses illness with poor prognosis without addressing chronic degenerative illness such as

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multiple sclerosis. However, the bill should be reviewed after five years since assent to address
upcoming issues and this is among the issues to be addressed in the future. This bill brings light
to families that have been hit by the blow of terminal illness.

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REFERENCES
Butler, M., & Tiedemann, M. (2015). Carter V. Canada: The Supreme Court of Canada's
Decision on Assisted Dying. Library of Parliament= Bibliothèque du Parlement.
Chan, B., & Somerville, M. (2016). Converting The ‘right To Life’To The ‘right To Physician-
assisted Suicide And Euthanasia’: An Analysis Of carter V Canada (attorney General),
Supreme Court Of Canada. Medical law review, 24(2), 143-175.
Grandin, T. (Ed.). (2015). Improving animal welfare: a practical approach. Cabi.
http://www.parl.gc.ca/HousePublications/Publication.aspx?
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education curriculum for critical care trainees in Canada: from knowledge synthesis to
bedside application. International Journal of Ethics Education, 1(1), 57-68.
Martinez, F. R. (2015). ASSISTED SUICIDE AS A FUNDAMENTAL RIGHT.
COMMENTARY TO THE DECISION OF THE CANADIAN SUPREME COURT IN
CARTER V. CANADA (6 FEBRUARY 2015).
Murphy, S. (2016). 'A Uniquely Canadian Approach'to Freedom of Conscience Experts
Recommend Coercion to Ensure Delivery of Euthanasia and Assisted Suicide.
Murphy, S. (2016). Supreme Court of Canada Orders Legalization of Physician Assisted Suicide
and Euthanasia Carter v. Canada (Attorney General) 2015 SCC 5.
Ponsford, M. (2017). Chronic, Irremediable Depression Constituting Mental Disability:
Expanding Legal Rights to Euthanasia in Canada.

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Rights, E. (2012). Canadian charter of rights and freedoms. Toronto: Carswell, 183-229.
Statutes of Canada 2016, chapter 3. Bill C-14 (Royal Assent).
Steele, C. (2018). Carter v. Canada: Nonreligion in the Context of Physician-Assisted
Dying (Doctoral dissertation, Université d'Ottawa/University of Ottawa).
Trachtenberg, A. J., & Manns, B. (2017). Cost analysis of medical assistance in dying in
Canada. Canadian Medical Association Journal, 189(3), E101-E105.
Welie, J. V., Sullivan, W. F., & Heng, J. (2016). The Value of Palliative Care: IACB Guidelines
for Health Care Facilities and Individual Providers Facing Permissive Laws on Physician
Assistance in Suicide and Euthanasia. The National Catholic Bioethics Quarterly, 16(4),
657-662.