Canadian court decisions have been instrumental in prompting lawmakers to open assisted suicide to more Canadians—including to those who are not terminally ill, and soon to those whose sole condition is mental illness.
Supreme Court’s 1993 Decision
In the case Rodriguez v. British Columbia, a 42-year-old mother named Sue Rodriguez sought assisted suicide after being diagnosed with the terminal disease amyotrophic lateral sclerosis (ALS).She brought her case through to British Columbia’s top court, and ultimately appealed to the Supreme Court of Canada. She argued that a prohibition on assisted suicide violates Section 7 of the of Rights and Freedoms, “the right to life, liberty and security of the person.”
Then-Justice John Sopinka, writing for the majority, said the prohibition did indeed infringe on her section 7 right, but that infringement was justified. Its purpose was to protect the vulnerable and safeguard human life.
Justice Sopinka commented on how society’s prevailing values influence what the court considers to be the “fundamental principles of justice” used to justify infringing on the charter rights of individuals.
Justice Sopinka noted that it is the norm in Western democracies to prohibit assisted suicide, and that other nations had not found this unconstitutional or contrary to human rights.
In the B.C. Court of Appeal, Justice H.A. Hollinrake made similar comments on the fundamental principles of justice when evaluating Ms. Rodriguez’s case.
Supreme Court justices who dissented brought up various arguments as to why Ms. Rodriguez should be allowed assisted suicide.
One argument was that Parliament had decriminalized attempted suicide, showing it no longer believed the preservation of human life overrides the right to self-determination. Another argument was that able-bodied people can take their own lives, but physically disabled people may be unable to, so in the name of equality, they should be allowed assistance.
Supreme Court’s 2015 Decision
In Carter v. Canada, a B.C. woman named Lee Carter was subject to criminal charges in Canada for arranging her mother’s assisted suicide in Switzerland. She was joined by other plaintiffs, including Gloria Taylor who suffered from ALS and wanted assisted suicide, and Dr. William Shoichet, a doctor who supported legalizing it.It issued a “declaration of invalidity” regarding the prohibition, but suspended it for one year, giving Parliament time to legislate accordingly.
“The Charter rights of patients and physicians will need to be reconciled in any legislative and regulatory response to this judgment,” it said.
The court said assisted suicide should be permitted to “a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.”
It introduced Bill C-14, legalizing assisted suicide, or MAID, and that became law in 2016 amid much debate. Critics have argued that the safeguards in the legislation do not effectively protect the vulnerable as the court said they should.
Bill C-14 limited MAID eligibility to people whose natural death is “reasonably foreseeable.” This limitation and others were debated in a subsequent legal challenge.
Quebec Superior Court’s 2019 Decision
In Truchon v. Canada, two plaintiffs challenged Quebec’s and Canada’s MAID legislation. Jean Truchon suffered from cerebral palsy and Nichole Gladu from post-polio syndrome, and they argued that these “grievous and irremediable” conditions should qualify them for MAID without the requirement that their deaths be “reasonably foreseeable.”On Sept. 12, 2019, Justice Christine Baudouin of the Quebec Superior Court ruled that this limitation on eligibility was unconstitutional. She gave governments six months to legislate accordingly, though that deadline was extended multiple times due to various circumstances.
Neither the Quebec government nor the federal government chose to appeal, and federal legislation passed in 2021 opening MAID to those who are not terminally ill.
Mental Illness and MAID: What the Courts Say
The Centre for Addiction and Mental Health (CAMH) has summarized the debate on mental illness eligibility that followed the Supreme Court’s 2015 decision.“Others note that during the trial process the Court commented that international cases related to MAID for mental illness were not relevant to the current case...implying that mental illness is not within the scope of the Court’s decision, or at least making the Court’s intentions on the matter unclear.”
Nonetheless, the federal government decided to extend MAID to those with mental illness as the sole condition, effective March 17, 2024.
Mr. Lemmens is among 32 law professors who signed an open letter to the prime minister and multiple cabinet ministers, including Mr. Lametti, on Feb. 1. They took issue with the idea that the courts mandated the move to extend MAID to include mental illness.
They argued that provincial rulings, including Truchon v. Canada, are not broadly binding and that the rulings also made limited statements on the specific issue of mental illness.
They said the Carter v. Canada ruling had certain limitations.
The letter concluded by urging the government to suspend plans to expand MAID.
“We strongly object to suggestions that MAiD for mental illness needs to be made available as a matter of constitutional right, and support a suspension and review, not just a delay, of further expansion of MAiD.”