Bill C-14: An Act To Amend The Criminal Code
Bill C-14 is an act that was created in order to make changes to other acts in order for physician-assisted suicide to be implemented. The bill was created as a result to the Carter v Canada (2015) case, that set the precedent of physician assisted suicide not being illegal. However, before this case, there was the case of Rodriguez v British Columbia (1993), where the Supreme Court of Canada did not allow Sue Rodriguez to have the right to end her life as she was dealing with Lou Gehrig’s disease. Rodriguez appealed to the Supreme Court because she thought that section 241 (b) of the criminal code violated section 7, 12 and 15 (1) of the Canadian Charter of Rights and Freedom. Though the court at that time prohibited physician assisted suicide, the Carter v Canada decision, made it possible for amendments to be made to the criminal code. Furthermore, as a causation of this case, physician assisted suicide is not considered a criminal offence. This bill looks at the requirements and standard for an individual to qualify for physician assisted suicide and the medical practitioners that are allowed to assist in the act.
Opposition Bill C-14 was presented by the Minister of Justice from the Liberal Party and at the official opposition of the House of Commons is the Conservative Party of Canada. The opposition did support the bill in relation to the Carter case, however, there were certain areas that the opposition thought was not mentioned about. They agreed with the parameters that only those who are suffering from an illness or disease that is incurable and in which the loss of life is probably can physician assisted suicide be allowed. On the contrary the opposition did not believe that the legislation protects those persons who are vulnerable, specifically those with mental health issues. Mr. Michael Cooper from the Conservative Party states: the legislation falls short is that it does not take into account persons who have a physical illness on the one hand, but on the other hand, suffer from an underlying mental health challenge. The issue is ensuring their capacity to consent. The legislation fails to address the issue of how a medical practitioner can determine consent for a person who faces mental health challenges. For the reason, Mr. Michael Cooper suggests the need for someone with particular training such as a psychiatrist to determine the person’s capacity and consent. Another shortcoming of the legislation was that the legislation did not contain stipulations that would safeguard the moral and ethical rights of the health care professionals that would perform these procedures. By adding a provision for healthcare professionals, it allows for not only the patients to have rights, but also the medical practitioners; in relation to objecting to assist the patient with the procedure. Additionally, for the Conservative Party, there is also the issue of palliative care. Though it is mentioned that physician assisted suicide is not an option until all options are explore – with palliative care being one of them – about only 15 to 30 percent of Canadians have access to palliative care. For the opposition “the option of palliative care without access to palliative care is no option at all” and for that reason they want to recommend that there be new funding for palliative care.
Overall, the official opposition does support the bill, however it suggests other provisions that go further than just the Carter case. Interest Groups and Testimonies The groups of interest in bill c-14 were the Canadian Association of Social Workers, Canadian Association of Advanced Practice Nurses, Euthanasia Prevention Coalition and the Evangelical Fellowship of Canada. Though the Canadian Association of Social Workers (CASW) supported the bill, their main was the fact that social workers should also get the same amount protection that healthcare professionals would get for assisted in medical termination. The point made by the association was that social workers might “be the first point of contact”. By this they mean that many social workers take care of those patients with terminal illnesses, the patient might question and want guidance in regard to physician assisted suicide; therefore, the social worker should be able to give references to services relating to medical assistance in dying without worrying about criminal consequences. They want to change the language in section 241(a) of the Criminal Code to persuade or encourage than counsel, which is very often what social workers help these patients with. Furthermore “that no social worker who aids a practitioner or patient by engaging with the person on the topic of MAID would be party to an offence”.
As a result of this testimony, the change was made in section 241 where it states that social workers are not committing an offence by counselling the terminally ill. The Canadian Association of Advanced Practice Nurses (NPAC) brought up the issue of age restriction and how it is discriminatory. The requirement for medical assistance in dying is to be an adult, however, NPAC states that a 16-year-old person with brain tumor will suffer just as much as a 36-year-old signifying that pain has no age and that both would be in the same amount of pain. Furthermore, that terms such as serious and incurable do not “provide the practitioner with no descriptive value”. The concern here is that, how does a medical professional measure seriousness or incurableness when they are words that describe a situation rather than showing if it is serious or incurable. The Euthanasia Prevention Coalition’s main concern was with palliative care. Though the bill mentions that MAID will only be available to those after every other option is suggested, it does not provide suitable access to those who might want palliative care. Only about 30 percent of Canadians have access to palliative care – meaning that many of them are dying needlessly. For the coalition, they want Parliament to give new funding for palliative care, so that everyone can have access to it, not just the 30 percent.
The final interest group is the Evangelical Fellowship of Canada, who completely oppose the decriminalization of euthanasia and physician assisted suicide. However, because legislation is already proceeding, they have amendments that they want to be made. The first being that of freedom of conscience and religion. Though the legislation does not force medical healthcare professionals to participate in MAID, it is considered ‘medically necessary’. The Evangelical Fellowship wants provisions that allows a person and or institutions to the right to refuse without the “risk of coercion to aide with MAID”. That medical practitioners can choose not to help with MAID directly or indirectly, including the right to not make referrals to the terminally ill patient. Assessment and Analysis After reading the government documents relating to bill c-14 and looking at the Supreme Court decisions surrounding physician assisted suicide, my opinion still stays the same, which is supporting this bill for physician assisted suicide. There are many factors for my opinion, the first being that not being able to choose to end your life goes against the Charter of Rights and Freedoms. Section 7, 12 and 15 are the rights that are being infringed by not allowing medically assistance in dying (MAID). Section 7 of the Charter states that “everyone has the right to life, liberty and security of the person”; which can also be translated to the right to life or not to life. It is the person’s choice whether or not they want to continue living and suffering with the terminal illness they have – what type of life would they be living when all they can do is feel pain. Additionally, section 12 says “Everyone has the right not to be subjected to any cruel and unusual treatment or punishment”; by denying someone the right to terminate their life, they are being subjected to cruel treatment and punishment. A survey with participants who are terminally ill found that “73% believed that euthanasia or physician-assisted suicide should be legalized, citing pain and the individual's right to choose as their major reasons”. This only supports the idea that those who are terminally ill rather be at peace by ending their life than going through the pain and anguish of their illness.
Moreover, the pain is not the only thing that makes them want to choose the option of physician assisted suicide, but also the fact that they feel despair and have a loss of pleasure and interest in activities. During the study they also found that over 58 percent of the participants would choose to “personally make a future request for a hastened death, particularly if pain or physical symptoms became intolerable” if it is legal – survey was done form 1996-1998 before legalization of medically assisted death. Another study done in 2007 in Palliative Cancer Care found interesting results. Of the terminally ill patients in palliative care, 238 (62. 8%) participants that believed physician assisted suicide and/or euthanasia should be legalized with “151 (39. 8%) who would consider making a future request for a physician-hastened death”. To have to keep living every day in pain and not being able to do what you want is not living at all. When a patient is terminally ill, and their state cannot be brought back, medical assistance in dying is needed; because in my opinion at that point one is simply breathing, not living.
Furthermore, section 15 of the charter states that “equal protection and equal benefit of the law without discrimination”. This means that all the parties who play a part in medical assistance in dying should be held criminally responsible. From the patients to healthcare professionals to counselling staff, none of them should be held liable for assisting the patient is dying. Section 241 of the Criminal Code of Canada stated that “Everyone who (a) counsels a person to commit suicide, or (b) aids or abets a person to commit suicide, whether suicide ensues or not, is guilty of an indictable offence and liable to imprisonment for a term not exceeding fourteen years”.
However, because of bill c-14, section 241 was amended, making those involved with physician assisted suicide, to be able to help those who need it without worrying about committing an offence. The amended section of the criminal code is the same as the above with added subsection for exemption for medical assistance in dying, for person aiding practitioner, for pharmacist and for person aiding patient. This means that “no social worker, psychologist, psychiatrist, therapist, medical practitioner, nurse practitioner or other health care professional” is committing an illegal act when assisting with medical assistance in dying. A study done in 2016 where the participants where Canadian psychiatrists found that 72 percent of the psychiatrists supported the legalisation of medical assistance in dying. Since the section 241 of the criminal code has been amended, it allows those doctors who want to help the terminally ill in MAID to do so without worrying about it being prohibited.
