Canada legalizes physician-assisted suicide

1. On Friday, Canada's Supreme Court legalized physician-assisted suicide.
2. This makes Canada one of a small handful of countries — the others are Belgium, the Netherlands, Luxembourg and Switzerland — that allow doctors to hasten the deaths of terminally-ill patients.
3. Canada's law will take effect in one year, after the country's provinces have had time to set up rules and regulations of how new aid-in-dying laws will work.

A huge decision for advocates of physician-assisted suicide

In a landmark decision, Canada's Supreme Court ruled that physicians should be allowed to aid a patient in dying so long as "the person affected clearly consents to the termination of life" and is suffering from ""grievous and irremediable medical condition."

The ruling centered on the case of 89-year-old Gloria Taylor, a resident of British Columbia who suffered from late-stage Amyotrophic Lateral Sclerosis, or ALS, which causes progressive muscle weakness.

"I do not want to waste away," the plaintiff in the case wrote

"What I fear is a death that negates, as opposed to concludes, my life," Taylor wrote of her wish for physician-assisted suicide in documents the Supreme Court quoted. "I do not want to die slowly, piece by piece. I do not want to waste away unconscious in a hospital bed. I do not want to die wracked with pain."

Canada's law will take effect in one year, after the country's provinces have had time to set up rules and regulations of how new aid-in-dying laws will work.

Canada joins a handful of European countries with legal physician-assisted suicide

An assisted suicide clinic in Switzerland run by Zurich-based group Dignitias (AFP via Getty News Images)Three countries have passed legislation that allows doctors to hasten the deaths of terminally-ill patients: Belgium, the Netherlands, and Luxembourg. Switzerland has an even more liberal aid-in-dying policy, which allows non-doctors to assist suicide, that stems from the country's criminal code.

The Netherlands was the first country to legalize physician-assisted suicide with a 2002 law, although the country has informally permitted such activities for approximately three decades. The Dutch law also legalized euthanasia, which the country defines as death from a medication administered by a physician to hasten death (whereas physician-assisted suicide includes cases where the patient gets a prescription for a deadly dosage, but administers it him or herself).

1.8 percent of all deaths in the netherlands are the result of physician aid-in-dying

A 2007 study found that, in 2005, 1.8 percent of all deaths in the country were the result of euthanasia or physician-assisted suicide.

Belgium also passed its aid-in-dying law in 2002, and it also permits both euthanasia and physician-assisted suicide. In 2014, Belgium extended its law to apply to children of any age living with terminal illness (the Netherlands' law is not available to children under 12 and, for teens using it, requires parental consent). Luxembourg was the third country to legalize euthanasia in 2009.

In Switzerland, physician-assisted suicide is legal so long as the doctor is not motivated by "selfish" interests. Euthanasia, however, is not allowed. Switzerland is unique in that it allows non-doctors to assist in suicides as well and does not limit access to life-ending drugs to patients with terminal illness.

The ruling from the Canadian Supreme Court says that provinces there cannot "prohibit physician-assisted death." Whether this means they will allow physician-assisted suicide (where doctors prescribe fatal drugs for patients to take) or euthanasia (where the doctor himself administers the deadly medication).

Five states in America have right-to-die laws

Protesters rally at the Supreme Court before arguments in Gonzalez v. Oregon, a 2005 decision that allowed Oregon's aid-in-dying law to continue (The Washington Post via Getty News Images)

No states in America allow for euthanasia. The five states with right-to-die laws — Oregon, Washington, New Mexico, Montana, and Vermont — all require the patient to administer their own deadly medications.

In Oregon, which passed its Death with Dignity law in 1997, patients must make their request for a lethal medication in writing and then, 15 days later, make an oral request. Another 15 days must pass before the patient can fill the prescription — and they could decide never to fill it at all.

"If a doctor is allowed to give a patient a lethal injection, the doctor is the last actor," says Alan Meisel, a bioethicist at the University of Pittsburgh who has written extensively on right-to-die laws. "In Oregon and Washington, the patient is the last actor. And that lets them reserve the right not to act at all."

Will Canada's new law lead to suicide tourism in North America?

Switzerland's law is best known for attracting suicide tourism: those who travel from abroad to end their own lives, because they cannot do where they live.

Brittany Maynard ended her life on November 1 (Courtesy of Compassion and Choices)

Suicide tourism to Switzerland, particularly among those who are not terminally-ill, appears to have increased in recent years. One study found that 611 non-Swiss citizens from 31 countries used the country's aid-in-dying laws between 2008 and 2012.

There are two reasons to think Canada will not have nearly as much suicide tourism as Switzerland. First, Canada's law is much more restrictive than Switzerland's. While Switzerland allows those who are not terminally ill to end their lives, Canada's laws will restrict access to those who have an "irremediable" condition that causes "enduring and intolerable suffering."

Second, aid-in-dying has been available in the United States since 1997, when Oregon passed its death with dignity law. The Oregon law does require those wishing to end their lives to be residents of the state. This is certainly an obstacle, but not an impossible one: 29-year-old Brittany Maynard famously moved to Oregon in 2014 to end her life after being diagnosed with terminal brain cancer.

It's unclear, at this point, whether the Canadian law will have residency requirements — that's up to the provinces there as they interpret the new court ruling. If it does, that will likely be a significant deterrent to Americans traveling there seeking to end their lives.

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