Canadian bill that would legalize assisted suicide panned by opponents

A government bill that would legalize euthanasia and physician-assisted suicide was met with strong opposition from Catholic leaders and groups who have long contested such practices.

Designated as Bill C-14, the legislation introduced April 14 spells out conditions under which seriously ill or dying competent adult Canadians may seek medical help to end their lives. The bill does not allow "medically assisted dying" for minors, people with mental illness or those diagnosed with dementia. Instead, the federal government has committed those matters to further study.

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The Canadian Conference of Catholic Bishops and other groups opposed to physician-assisted suicide called on members of Parliament to vote against the measure.

The bill comes in response to a unanimous Supreme Court of Canada decision in February 2015 to overturn a 1993 ban on physician-assisted suicide. The court had given government a June 6 deadline to pass legislation.

The bishops said the bill was "an affront to human dignity, an erosion of human solidarity and a danger to all vulnerable persons," especially the elderly, infirm, disabled and sick who are often isolated and marginalized.

"Moreover, it is a violation of the sacrosanct duty of health care providers to heal and the responsibility of legislators and citizens to assure and provide protection for all, especially those persons most at risk," the bishops said in a statement released soon after the bill was introduced.

The bishops also urged elected officials to "consistently defend and protect the lives of all" support efforts to guarantee accessible home care and palliative care and to protect conscience rights of health care providers and institutions that refuse to participate in euthanasia and physician-assisted suicide.

In a separate statement, Archbishop J. Michael Miller of Vancouver, British Columbia, said the bill "sets Canada on the tragic course of offering death as the solution to pain and suffering."

He called the legislation problematic because it is unclear about who qualifies for physician-assisted suicide, lacks conscience protection for institutions opposed to the practice, and offers no financial support for palliative care alternatives for the seriously ill.

Other voices opposing the measure include Canadian Physicians for Life, Euthanasia Prevention Coalition and Campaign Life Coalition.

The bill requires two independent physicians or nurse practitioners to approve euthanasia or an assisted suicide procedure. 

Justice Minister Jody Wilson-Raybould said the bill tried to balance the rights of those seeking a medically assisted death with the protection of vulnerable persons through "robust" safeguards. The measure includes a mandatory review after five years.

Those eligible for either voluntary euthanasia or assisted suicide must be 18 years old or older; have a "grievous and irremediable medical condition" that makes "natural death reasonably foreseeable;" must make a voluntary request with informed consent and be eligible for publicly funded health care services in Canada.

Health Minister Jane Philpott said "medical aid in dying" will be considered health care so it will be subject to the rules of the Canada health act to ensure universality and accessibility, so Canadians can have "autonomy" in their end-of-life decisions, she said.

Health care workers who follow the criteria for a medically assisted death "no longer need to fear criminal prosecution," Philpott added.

The bill would restore the sections of the Criminal Code prohibiting assisted suicide and counseling and abetting suicide, but carves out exemptions for physicians, nurse-practitioners, pharmacists and others who help carry out a medically assisted death according to specified rules. For example, that means a family member could help put a lethal drug cocktail to the lips of a person who has had the drug prescribed by a physician without risking being charged.

The safeguards include a requirement of two independent medical opinions from a physician or a nurse practitioner indicating the person meets the eligibility criteria; a request in writing or by a proxy if the person cannot write; the right to withdraw the request at any time; a 15-day waiting period "unless death or loss of capacity is imminent;" and a confirmation of informed consent immediately before the assisted-death is provided.

Though the bill mentions conscience rights of health care professionals in its preamble, it does not protect them. Philpott said the provinces and territories and health professionals' regulatory bodies would determine whether health care professionals will be required to refer patients if they refuse to participate.

Assisted suicide is legal in Albania, Colombia, Germany, Japan and Switzerland, and doctors are allowed to perform euthanasia in Belgium, Netherlands and Luxembourg under severe circumstances. In the United States, terminally ill people can legally take their own lives only in Washington, Oregon, Vermont and Montana.

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