Physician Assisted Dying Case Summary

The concept of autonomy supports capable patients to make their own decisions regarding their care (8). Patient have the “right to decide how one is to live one’s life, in particular how to make critical life-decisions (9)” and one can argue that this right also extends to choosing the manner death (10). This right is also supported by Section 7 of the Canadian Charter of Rights and Freedoms, which states that “everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice (11).” The Trial Judge in the Carter v. Canada (Attorney General) 2015 case ruled that prohibiting MAID would interfere with a patient’s life and infringe on the liberty and security of that patient (5). The prohibition of MAID interferes with a patient’s life because it may lead some patients to end their life early they are still capable of doing so. Furthermore, prohibiting MAID would interfere with the patient’s ability to “make decisions concerning their bodily integrity and medical care” and prevent the patient from having control over his or her bodily integrity that is free from state interference (5). Therefore, the respect for patient autonomy strongly supports Bill

1. (problem – PAS): In today’s society, Physician Assisted Suicide is one of the most questionable and debatable issues. Many people feel that it is wrong for people to ask their doctor to help them end their life; while others feel it is their right to choose between the right to life and the right to death. “Suffering has always been a part of human existence.” (PAS) “Physicians have no similar duty to provide actions, such as assistance in suicide, simply because they have been requested by patients. In deciding how to respond to patients ' requests, physicians should use their judgment about the medical appropriateness of the request.” (Bernat, JL) Physician Assisted Suicide differs from withholding or discontinuing medical treatment, it consists of doctors providing a competent patient with a prescription for medication to aid in the use to end their life.

In a more recent court decision, Carter v. Canada was a game-changer for the movement to grant Canadians the right to die with dignity. In a unanimous decision, the justices of the high court struck down on the federal prohibition on doctor-assisted dying. It was argued that the law violated the Canadian Charter of Rights and Freedoms. Since the law regarding doctor assisted dying was created because of Carter v. Canada, the immediate and known risks associated with doctor assisted dying are being addressed and managed by establishing a strict but fair criteria for determining who can access doctor assisted dying and the safeguards that are in place to safely administer it. To meet the criteria, he/she must be a competent adult, clearly consent to the termination of life, have a grievous and irremediable medical condition, and experience enduring suffering that is intolerable in the circumstances of his or her condition. Doctors are required to use their knowledge, skill and judgement to assess an individual’s aptness for doctor assisted death, in conjunction with the above-mentioned criteria. We must recognize that within these criteria are sub-criteria’s and there are many steps to this procedure.

Sylvia Law, a published author in the University of Maryland Law Review, in her essay, “Physician-Assisted Death: An Essay on Constitutional Rights and Remedies,” addresses the issues in constitutional law surrounding the controversy of a person’s right to die. In the three parts to her essay, Law contends and considers whether “statutes that criminalize medically assisted suicides violate the liberty and privacy rights of terminally ill” and whether “assisted suicide should be considered a constitutionally protected right and also the ways in which these issues come before the courts”. Her purpose is to analyze and inform on the laws and challenges relating to this issue in order to make readers aware of the problems that are created by the

The court has agreed that the social and legislative facts did not prevent Smith from departing from the decision. This case was then taken to the Supreme Court of Canada in which they took a look at the main issue of whether the prohibitions in s.241 of the Criminal Code violates s.7 and s.15 of the Canadian Charter of Rights and Freedoms, while also at two other preliminary issues: 1) whether the decision within the Rodriguez case can be revisited and 2) whether prohibition interferes with the provincial jurisdiction of health. Firstly in terms of the preliminary issues, the court finds that the trial judge had the right to reconsider the decision as new legal issues were raised and that there were a change in circumstances, and the court believes that he federal government still has power over the provincial government in regards to physician-assisted deaths. In regards to the Charter, the courts agrees that the prohibition interferes with s.7 and that it recognizes that a person’s choice about how to end their lives deserves

In the Carter of Rights and Freedoms section 7 states that everyone has the right to life, liberty and security of the person and the right to not be deprived thereof except in accordance to the principles of fundamental justice (Canadian Charter of Rights and Freedoms,1982). In the cases of Rodrigues vs. Carter, Sue Rodrigues was a woman who was suffering from Lou Gehrig’s disease. She was denied of her request for assisted suicide despite the fact that she was terminally ill and fully competent to make the decision for herself. The main premise for rejecting Rodriguez’s claim is derived from section 7 of the charter of rights and freedoms which is later counter argued by claims that the prohibition interfered with Rodriguez’s right to personal

To begin, patients can die with dignity. Dying with dignity is the philosophical concept that a terminally ill individual should be allowed to die naturally and comfortably instead of experiencing a life of deep unconsciousness prolonged by mechanical support systems. (Death with Dignity) In 1993, Sue Rodriguez, a sufferer of ALS, believed that the time and manner of her death should not be determined by her illness or by the law. She expressed that it should be legal for a physician to end her life for her at a time she has chosen. (Fenton) Rodriguez took her case to the Supreme Court of British Columbia, she argued that Section 241(b) of the Criminal Code, everyone who aids or abets a person in committing suicide commits an indictable offence, violates her rights in the Charter under Section 7, that everyone has the right to life, liberty, and security, 12, that everyone has the right not to be subjected to any

“[t]he court ruled that laws making physician-assisted death illegal violated Canadians’ constitutional rights in cases where an adult clearly consents to the termination of life and has a grievous and irremediable medical condition." (Larson)

Firstly, a man's father had not received doctor assisted suicide because he did not reach requirements even though he had prostate cancer. He needed a approval from 2 healthcare providers. One of them had approved and the other denied because the healthcare worker assumed that he wasn't in distress. As time passed, 2 weeks later the man's father died in a home that cared for the sick. Furthermore, even though the man had prostate cancer and he was going to die, he could not get doctor assisted suicide because it was assumed that he was not in distress. Secondly, a person with a grievous and irremediable medical condition can only be granted to get doctor assisted suicide. A doctor in Toronto said that just because of this law only 1 out of 10 requests for medically assisted dying are granted. Additionally, the doctor had also stated that there are many reasons why a patient can not be granted doctor assisted suicide and the most common one is that their condition might not be too severe and their death may not be foreseeable. Many kill themselves because they can not bear the pain that others can not see. Thirdly, the mentally ill are not being included for doctor assisted suicide. There are many organizations that fight for this right but the main one is "Dying with Dignity". This organization argues that the bill passed by Canada called C-14 discludes the mentally ill. Additionally, this is a violation to charter of rights. People have the right to make decisions about treatment according to Ontario's Health Care Consent Act. Although, they can only make these decisions if they are capable which means if they understand the information about the treatments and the consequences of refusing the treatment. Moreover, research states that the general public and health workers do not wish that the law includes these

At the heart of the debate of doctor assisted suicide is the supreme court trial of Carter v Canada. This was the catalyst which lead to the national legalization of assisted suicide. One of the major arguments against this law was that of the safeguards and regulations needed to protect Canadians from harm. Proponents against physician assisted suicide believe that any bill that are created for such a cause will have “inadequacy of safeguards and the potential to devalue human life” (Carter v Canada, 344). Thus, leaving those who are pro-assisted suicide require to create guidelines and protections for all parties involved with process. Allowing for there to be proper and adequate safeguards for assisted suicide is of vital importance to this law as it is these safeguards are the foundation of the assisted suicide law.

Whether the Criminal Code provisions prohibiting physician-assisted dying found in s. 241 (b) violates the claimants’ rights to life, liberty and security (s.7) and rights to equal treatment (s. 15) of the Charter (Carter, para.29, 40).

The investigators used a trained research nurse to be the interviewer that did not directly treat any of the patients previously. The approach was to interview terminally ill cancer patients versus most research studies that only considered a physician’s insight and perspective. This is a unique and interesting twist on one what undoubtedly has to be one of the most difficult situations anyone could encounter. The participants ranged across various cancer diagnosis’s, however, all were terminal. Having a personal interview versus completing only a survey going to create a better opportunity to truly feel the patient’s perspective or attitude towards euthanasia.

Physician assisted suicide (PAS) is a situation in which a physician gives a patient medications that the patient can then self-administer in order to bring about death. The patient is a competent adult in these situations and has requested this service of the physician. The doctor does not cause the death of the patient; he/she only supplies the means. (American Nurses Association [ANA], 2013; Pasterfield, Lewis, Carter, Hodgson & Wilkinson, 2013). Nurses are not allowed to participate in PAS according to the position statement released by the American Nurses Association (ANA, 2013). This is the case even though studies, such as the one carried out by Smith, Goy, Harvath, and Ganzini (2011), show that the quality of death for patients receiving PAS are no worse than those who do not participate in PAS and family members actually rate the physician assisted deaths as better. According to Walker (2011), six ethical principles guide health care. Two of these principles, autonomy and beneficence, are particularly interesting when discussing PAS.

S. Constitution. In regards to the Constitution, the eighth amendment is particularly significant when considering whether or not Physician Assisted Suicide should be legalized. To disallow patients the right to choose their fate, even in the most desperate stage of their life, is undeniably a form of cruel and unusual punishment which the constitution explicitly grants us the freedom from. Current policy allows patients to request that if extraordinary measures are necessary to keep them alive, then they are not to be resuscitated. Current policy also allows patients to refuse care altogether and to die naturally. Finally, current policy allows patients to participate in treatments that will lengthen their lifespan but will be physically damaging to their health as the price. Each of these options hasten the process of death in some way or dictate the way in which the patient requests to die. As of now it is ethically acceptable to request that doctors sit at your bedside and allow you to die when they have the means to save you but it is seen as inappropriate to want to die when your life is nearing the end of the road in a manner that causes pain and suffering.

Respect for one’s individual autonomy is a hallmark of Canadian liberal democracy, as Downie (2004) notes that countries operating under the common law system have recognized a person’s physical integrity as a fundamental principle for centuries (p. 50). This concern over personal autonomy was a major aspect of the Carter v. Canada case, as one of the plaintiff’s, Gloria Taylor, issued a written statement to the court that read: “What I want is to be able to die in a manner that is consistent with the way that I lived my life. I want to be able to exercise control and die with dignity and with my sense of self and personal integrity intact” (2012, p. 1).