June 6 – the deadline for Canada to pass new assisted dying legislation – was a date many doctors, patients and politicians had likely circled in their calendars.
As of midnight tonight, the Criminal Code of Canada will no longer prevent a medical professional from helping a patient end their life. Some Canadians have followed the legal and ethical debate surrounding assisted death closely, but others may only just be tuning in as the deadline set by the Supreme Court of Canada passes.
Here’s a look at where we find ourselves, what it means, and how long the legal limbo might last.
What happens at the end of today?
Basically, the clock runs out. In early 2015, the Supreme Court of Canada rendered what has become widely known as the Carter decision, ruling that it should no longer be illegal for physicians to help a patient end their life under certain circumstances.
The country’s highest court gave the government a one-year grace period, deferring the application of the Carter decision so Ottawa could draft a law that would guide medically assisted death. That grace period was extended to June 6, 2016 last winter when it became clear the original deadline was too tight following the federal election.
But even with the extension, a new law still won’t be in place by the end of today.
So will doctors just help anyone die tomorrow?
No. The Carter decision, for now, will stand in as the law of the land on this matter, and it makes it clear that in order to seek help ending their life, a person must be suffering from a “grievous and irremediable” medical condition which causes “enduring suffering” that is intolerable to them.
That is quite a broad set of criteria, and could technically encompass mental illness as well as physical ailments or disease.
WATCH: Few Canadian doctors would perform assisted death without a law, says CMA
The trouble is, the Carter decision provides little guidance beyond that. There’s nothing in there on how long a patient needs to wait between making the request and actually dying, for example, and no requirements for the reporting of assisted death. There’s also no clear outline of which drugs or methods should be used to end a life.
These are just some of the gaps that experts say will give doctors every reason to refuse requests to die until the legalities are more clearly spelled out.
What are the provinces doing to try and give direction?
In Quebec, a provincial law is already on the books to guide doctors and the patients wishing to end their lives. In Quebec and every other province, however, medical associations have also issued guidelines for their members to try and fill the perceived vacuum.
But those are just guidelines, not the law, and they differ from province to province.
WATCH: A primer on the medically assisted death deadline
On Monday morning, Health Minister Jane Philpott pointed out that in some provinces and territories, the regulatory recommendations limit assisted death to people 18 and over, while in others there’s no such limit. Some sets of guidelines require two witnesses, some just need one. And in some jurisdictions there is no provision that requires someone to actually be there to watch a patient sign their request to die.
Philpott called it a “patchy approach” to the protection of the vulnerable.
“I believe that regulatory guidance alone is insufficient, given the nature of what you will be asked to do,” she told doctors gathered in Ottawa.
How long will we be in limbo?
Right now, the government’s assisted dying bill, C-14, is tied up in the Senate. Senators sent the legislation to committee last week, and it will now be the subject of at least one, possibly two days of hearings.
WATCH: Trudeau will wait for Senate recommendations on C-14 as assisted dying legislation expires
After that, if amendments are added, it will need to go back to the House of Commons to be voted on again. Once it passes that hurdle, it must receive royal assent like any other bill. It could easily be more than a week before all of this can take place, and the Senate has said it won’t be rushed on such an important piece of legislation.
WATCH: Medically-assisted dying bill passes moves to Senate
Once C-14 passes, however, it could almost immediately be subject to legal challenges.
The Liberals limited assisted death to people 18 and over whose death is “reasonably foreseeable.” Bill C-14 also doesn’t allow assisted death to be offered to people suffering from mental illness unless their “natural” death is somehow reasonably foreseeable (i.e. not suicide).
That’s far more restrictive than the Carter decision, so experts say it’s reasonable to expect people to take Ottawa to court.
Watch below: Ottawa has not been able to come up with a new law on medically-assisted dying ahead of Monday’s Supreme Court deadline to do so. In the meantime, provinces have come up with their own regulations for medically-assisted dying but the federal health minister has expressed concern they could be patchy with a federal framework. Su-Ling Goh reports.