Doctors worry assisted death will become legal without a law

Assisted death may be legal in Canada before the country has a legal framework governing it — and that worries the people who’ll have to decide who gets help dying.

The federal Liberals are rushing to pass Bill C-14, which outlines who is eligible for assisted death, who can provide it and how these deaths get recorded. But even though they’ve cut short debate, it has yet to pass the House of Commons.

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Next week is a break week, which means the earliest C-14 could pass the House is Monday, May 30. That leaves barely a week for it to pass an independent-minded Senate and then get royal assent before Canada’s prohibition on physician-assisted death expires.

“There’s already a lot of anxiety in the medical profession about this,” says Jeff Blackmer, the Canadian Medical Association’s vice president of medical professionalism.

“There is an importance in having legislation in place by that June 6 deadline.”

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Many doctors will probably refuse to provide assisted death at all until a federal law is in place, Blackmer said.

“If June 6 comes and goes and there’s no federal legislation and no clear guidance in terms of what’s expected from physicians, what the process to be followed is, what the legal protections are. We’re anticipating a lot of physicians will probably take a bit of a wait-and-see attitude until they have clarity on some of that.”

There will never be a “perfect” assisted death law, Blackmer said, but Bill C-14 at least offers a necessary starting point.

“Absent that clarity, there will essentially be no agreement on what process should be followed,” he said.

“I’m not going to know: Do I need to get a second opinion? What sort of paperwork do I need to fill out? Who do I turn to for further information and guidance?”

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Bill C-14 allows those suffering “a grievous and irremediable medical condition” to ask for help ending their life from either a doctor or a nurse practitioner. It will lay the groundwork for provinces and territories to build upon, Federal Health Minister Jane Philpott has said.

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Medical professionals will have the right to opt out of providing such care.

If there’s no new law, the Supreme Court’s Carter ruling applies. Some things are clear: Competent, consenting adults suffering grievous and irremediable conditions are eligible for assisted death. The court’s decision only mentions physicians, so nurse practitioners would probably be excluded.

Pharmacists might be in a trickier legal position, however: The Carter ruling doesn’t mention them. But someone will have to dispense the lethal medication as required.

Liberal House Leader Dominic LeBlanc says the government remains committed to getting the bill passed by the court’s deadline.

16×9: Life, Death and the Law: Families making end-of-life decisions

But NDP justice critic Murray Rankin says he doesn’t see how that will be possible.

Blackmer said come June 7, regardless of legislation doctors may be presented with an influx of patients who have been waiting to come forward with requests.

“If you’re a doctor and there’s no law to guide you…you’re going to be very reluctant to put yourself on the line.”

With files from the Canadian Press and Anna Mehler Paperny