The death with dignity decision explained

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A brief synopsis of Lee Carter v. Canada (Attorney General)

In February 2015, the Supreme Court of Canada, in a unanimous decision, confirmed that Canadians have the constitutional right to choose physician assistance in dying. The BC Civil Liberties Association is overjoyed by the Supreme Court’s ruling. This is a tremendous victory for the protection of human rights and compassion at the end of life.

This means that seriously and incurably ill Canadians who are suffering unbearably will have the choice to seek the assistance of a doctor to have a compassionate and peaceful death. Physician-assisted dying will now be recognized for what it is – a medical service.

The BCCLA filed the case in April 2011 on behalf of Gloria Taylor, who suffered from ALS, Dr. William Schoichet, a family doctor, and Ms. Carter and Mr. Johnson, a married couple of Roberts Creek, B.C., who accompanied Lee’s 89-year-old mother, Kathleen (“Kay”) Carter, to Switzerland to peacefully end her life.

Summary of the judgment

Three Lawyers-(You must credit Photo by Alistair Eagle, Courtesy of Lawyer's Weekly)

Carter v. Canada legal team. Image credit: Alistair Eagle, courtesy of Lawyers Weekly.

The Court determined that the criminal laws violate the Canadian Charter of Rights and Freedoms. In particular, the Court found that the laws deprived the section 7 right to life, liberty, security of Gloria Taylor and others suffering from serious and incurable diseases. The laws deny the section 7 rights of individuals to have control over choices that are fundamental to their lives and cause unnecessary suffering.

The Court wrote, “Section 7 is rooted in a deep respect for the value of human life. But s.7 also encompasses life, liberty and security of the person during the passage to death. It is for this reason that the sanctity of life “is no longer seen to require that all human life be preserved at all costs.” (Rodriguez, at p. 595, per Sopinka J.) And it is for this reason that the law has come to recognize that, in certain circumstances, an individual’s choice about the end of her life is entitled to respect.” (para. 63)

The Court determined that the deprivation of seriously ill Canadians’ rights to life, liberty and the security of the person is not in accordance with the principles of fundamental justice because the prohibition on assisted dying is overbroad. The criminal prohibition is overbroad because it applies to all Canadians, even individuals like Gloria Taylor who were competent, fully-informed, and free from coercion and duress. Moreover, the ban is not justified because Parliament could protect vulnerable people while still allowing competent, seriously ill and suffering adults the right to a physician-assisted death.

Suspension of invalidity

The Supreme Court allowed Parliament and the provincial legislatures 12 months to enact new legislation that upholds these fundamental human rights. The Court made it clear that no level of government was required to enact legislation.


The BCCLA team gathers with the Carter and Johnson family in preparation for the Supreme Court  ruling in Ottawa as a documentary film crew looks on.

The BCCLA team gathers with the Carter and Johnson family in preparation for the Supreme Court ruling in Ottawa as a documentary film crew looks on.

 The Court concluded that individuals who meet rigorous criteria should be able to avail themselves of assistance in dying.

An individual would need to:

  • be a competent adult;
  • clearly consent to the hastening of death;
  • have a grievous and irremediable medical condition (including an illness, disease or disability), and
  • be suffering intolerably.

How this now compares to the law/regimes in other countries

The Court’s ruling today means that Canada has joined the long list of countries that permit physician-assisted dying.

Many countries such Belgium, Luxembourg, the Netherlands, and the US states of Oregon, Washington, Montana, New Mexico and Vermont allow for aid in dying. Their history shows that the fears raised by opponents have not materialized, and death-with-dignity regulations are safe and work as designed.

The Court affirmed the findings grounding the trial judge’s conclusion that the evidence from permissive jurisdictions established that physician assisted dying could be regulated in a safe manner.

Parliament’s options

Gloria Taylor

Gloria Taylor became the first Canadian ever to win the right to ask a doctor for help in dying. Gloria passed away in 2012.

Despite this ruling, Parliament and the provincial legislatures are not obliged to enact legislation. The Court said they “may” enact a law on physician-assisted dying, should they so choose.If no action is taken, there will be no regulatory vacuum. Physician-assisted dying will be regulated in the same manner as other health care matters. That is, the provincial and territorial laws that apply to health care matters and the standards of the medical profession will govern physician-assisted dying.

This is not only a form of regulation, it is the form of regulation that Canada and Canadian society considers sufficient for comparable end-of-life medical decision-making, such as palliative sedation.

Next steps

We expect that the federal government and provincial legislatures will honour this ruling and recognize that physician-assisted dying is one of many choices that competent patients can make as part of compassionate end-of-life medical care.

The BC Civil Liberties Association welcomes the opportunity to work constructively with the federal and provincial governments to ensure that patients are free to seek appropriate medical treatment and make fundamental choices in the context of their physician-patient relationships.

The Role of BC Civil Liberties Association

The BC Civil Liberties Association launched this lawsuit because we believe that seriously and incurably ill patients should have a voice in how their lives should end.

We are Canada’s leading civil liberties organization, launching more public interest litigation than any other human rights organization in this country.

This is one incredible day in the long history of the BC Civil Liberties Association – and we will continue to work with Canadians to uphold our cherished rights and freedoms.

Learn more about our Carter v. Canada case.


63 thoughts on “The death with dignity decision explained

  1. Great result for your hard work. Please remain vigilant with respect to
    the new legislation that will arise as a result of this decision.
    We must be sure such does not water down the clear intent stated by the

    • Why is no one talking about the ethical implications this ruling has? Just like I don’t support hanging of criminals, I. Don’t believe this the right step towards a stronger democratic society. It is unethical for humans to take it upon themselves to end their life.

  2. Great work. Its a great sign for the health of our democracy to have a Supreme Court that clearly acts independently from the political process. I only fear that the Harper government will treat this like they did the ruling in Bedford and enact legislation that does not respect this ruling and severely constrains the gains made in this case.

  3. I am a supporter of this and truly belive it is the right of the person that is gravely ill to have the dignaty and the RIGHT to choose how to live their last days and how to end them. I have one question however… how does this new law effect the insurances? will this be considered a suicide? if so then the insurances are nil and void, which also is very wrong.

  4. Thank you for fighting for everyone’s right to choose when faced with such terrible circumstances in life.

  5. Thank you for all your hard work and tenacity. Words cannot do justice to the good that you do. Thank you.

  6. CONGRATULATIONS! Thank you for working so hard on this. This decision will make me and others less fearful about the possibility of a horrible end of life situation, as my mother experienced. You have made Canada a better place for all, whether they have need of such a right or not. Thank you again, Libby Dybikowski

  7. FINALLY! When the federal and ALL provincials governments in Canada enact this legislation, we will finally be able to call ourselves a civilized, compassionate society. Well done BCCLA and the families involved!

  8. What a tremendous, historical day for Canada!!!!!

    Thank you for your comitment and hard work to bring this to the Supreme Court.

    Excellent job. We continue to support you.

  9. My mother has advanced alzheimers. She wss diagnosed in her late 50’s. This devestating illness has left my mother unable to communicate with loved ones or have any quality of life. This rulng brings hope for all of the people and families who may have to face a devestating diagnosis in their lifetime. My sincerest thank-you for all your hard work and success in acheiving this result.

  10. Thank you all for this and your continued support for those with voices that are not heard.

  11. Congratulations on a job well done. My blessings and thoughts are with all those people who have been made to needlessly suffer through long and agonizing terminal illnesses. At last, they have been given back the right to control their own lives.

  12. This is wonderful news. My sincere thanks to the BC Civil Liberties Association, and my congratulations.

    I am now a senior with, I hope, many years to live. But the thought of ending my life in terrible suffering such as ALS, without any way out was very worrying to me.

  13. What will insurance company’s think of this with respect to insurance claims for the sick and dying.

  14. Congratulations on the decision. It’s a victory for millions of people. A very good day for all Canadians.

  15. SENT FEB 6th, 2015:
    Now maybe you can get us a “Patient Bill of Rights”
    As a disabled person who has been DELIBERATELY kept from participating in ANY OF MY HEALTHCARE due to the SYSTEMIC SELF-PROTECTIONIST AND DELIBERATE “DENY, DEFLECT, AND OBSTRUCTION” TACTICS with regard to MEDICAL ERROR, I know first hand how, the “HEALTHCARE” and LEGAL system collectively and deliberately interfered with my INFORMED CONSENT and so called “RIGHT TO LIBERTY AND SECURITY OF PERSON” as the MATTER OF COURSE for regularly covering up their DELIBERATE AND DEBILITATING MEDICAL FRAUD WHICH CAUSES THE MOST HARM.
    Besides, haven’t you heard ‘the word on the street’?? HUMAN RIGHTS ARE TAKEN FROM US, NOT ‘PROTECTED’ especially if you can’t AFFORD LEGAL REPRESENTATION.

    Q. Can I, as a full ‘Canadian Citizen’ who was born here RENOUNCE MY “CANADIAN CITIZENSHIP”??



  16. I am so grateful for this ruling. My mother suffered for so long, in the end unable to walk, unable to talk, unable to recognize anyone at all. She suffered a living hell that she would never have wished on the most helpless of creatures.

  17. I’m really happy that this happened, it’s a big step in human rights and I’m really proud of Canada.
    Thanks a lot for all the effort, I wish I were part of this.

  18. Congratulations on a well- deserved victory, BCCLA!
    You have accomplished a great humanitarian contribution to Canadian citizens!
    From experience I know that even for patients who – in the end- not make use of the opportunity to have assisted suicide, the knowledge that it is available to them if needed, is a great comfort and support in their last, most difficult period of life.
    Thank you !
    Francien Solitar

  19. This is long overdue!If the Government has done something sensible about this a long time ago many people would have avoided a lot of suffering!

  20. It’s about time…
    Finally a little scope for the same compassion we are able to bestow on our beloved companion animals. I hope this means no more prolongation of the painful dying of our beloved fellow human beings.

  21. You begin your press release above with this statement….the supreme court today confirmed that…”Canadians have the constitutional right to choose physician assistance in dying.”. But, of course, it is qualified….”have a grievous and irremediable medical condition (including an illness, disease or disability), and be suffering intolerably”.
    I don’t understand how this “constitutional right” can be so qualified. Why is there not a simple right to choose”physician assistance in dying?” or to have complete control over our body…our selves?

  22. Congratulations to all involved in bringing this important issue to the SCC. In what was a forgone conclusion (IMHO) the court spoke strongly and with unity. Interestingly, in what I’m not sure is standard practice, the court authored the decision as “The Court” instead of one of the Justices.
    To me this speaks of the unity of mind in coming to the decision and speaking with one voice.

    It is a momentous day in Canada and BCCLA, along with the families have changed the course of what is a right of all Canadians under the constitute.

    Well done!

    Randy Osborne

  23. I’m just worried that some provinces such as Quebec will not go along with this decision. I think it should have been passed as a humain wriths law for all Canadians instead of being treated in the same matter of provincial health care systems

  24. THANK-YOU !…A thousand Bravos !…I have multiple sclerosis…The torture of seeing deep sorrow in the eyes of people in my life, now won’t be so terrible…THANK-YOU ! (y) (y) <3

  25. The law banning “assisted suicide” was too broad.
    It should never have applied to end-of-life medical decisions.
    Canada can still prohibit causing a premature death.
    But now timely death is permitted for all Canadians.

    Here is some draft legislation that should be considered on the federal level. It should be added to that part of the federal criminal law
    that prohibits murder. A new lowest level of this crime will be created: causing premature death.

  26. I am forever grateful to those in the trenches who have won the battle for choice in Dying With Dignity. I telephoned my friends to announce our trip to Switzerland is off. Instead we’ll celebrate the Gloria Taylors, Lee Carter, Sue Rodriques et al. We will raise our glasses for you all.
    Carol Taylor

  27. Good work! I am 86 and reasonably healthy but look forward to Ontario passing a law that will permit doctor assistance to depart this life if my final time on earth is not worth living.

  28. YEAH!! YEAH!! YEAH!! Thank you so much for your efforts in getting this very important change through the Supreme Court. I feel very strongly that there needs to be far more choice in end of life options and this ruling is a fantastic step towards that. Your work is much appreciated.

  29. Congratulations on a hard fought and precedent setting victory! You folks at BCCLA worked tirelessly on this campaign in the face of determined and politically powerful resistance, so this is a huge milestone for everyone involved and to all Canadians for whom this decision may effect. Now hopefully you can sit back a little, pat yourself on the back, and catch your breath before the next big battle.

  30. Just want to say thank you! The assault on our civil liberties (around the world) scares the shit out of me. Your devotion and service to the good of society is appreciated. I am on a limited pension income but as soon as I have a little extra money you guys are at the top of my list for a donation.
    Thank you! Thank you!

  31. Dying should not be a privilege. Dying should be a Constitutional Right. I wish to thank the Supreme Court of Canada for making this unanimous decision that will allow Canadian citizens the choice and the freedom to seek physician assisted dying.

  32. Thank you Lee Carter!

    This news brought tears to my eyes, not because of the court but because of what my mother went through in the past year with her battle against cancer.

    She lost total control of every thing in her life, she was under so much pain “it feels like by body is on fire!” her body failed her. She lost mobility the ability to control her body functions needing assistance to go to the washroom with a lift, she couldn’t feed herself, we had to feed her by hand like she did to us whe we were little.
    The only thing I could do for her on her last day was hold her hand and tell her she’s going to be okay and in her final hours my sister and I sat by her side singing the same lullabies she Sang to us as baby’s, in the final moments of her life the only dignety I was able to provide to her was to wipe the spit up from around her mouth as she left us.

    It isn’t about killing people or committing suicide, its about giving people who will loose all and total control and dignety back and the right to choose and have some form of control.

  33. Congratulations to the BCCLA. Canada is a better place as a result of your efforts. Continue to press forward on the many fronts you are working.

  34. I congratulate and thank the BCCLA on this victory and for much hard work that was needed and done to achieve it. I am surprised to note, the in the sidebar to this article, the use of the euphemism “passed away” about Gloria Taylor. Reminds me how easy it will be to stay or return to a state of queasiness about death, even as we are able to make more choices about it.

  35. Finally, we are free to end our life with dignity. Congratulations to all who have done this great job!!!!

  36. Many thanks to all those at the BCCLA for the hard work you have put into this. I know I am speaking for about 85% of Canadians when I say we are very grateful. I read the above, and feel satisfied that we can move ahead confidently. My niggling worry, of course, is that the Harper Government will find ways to make this as difficult as possible. Perhaps I am judging Harper by his past record. Let’s hope he finally ‘sees the light’ and doesn’t throw roadblocks up at this most important issue.

    If the Harper Government does nothing, can the provinces pick up the Supreme Court ruling and run with it? Can the work from Quebec in Bill 52 become the basis of the assisted-dying procedures in the other provinces and territories? Perhaps when the health ministers of the provinces and territories meet they can devise a plan, where each carries out the same policy (the Quebec legislation) regarding medically assisted-dying?

    Again, MANY THANKS!

  37. I have been and remain totally supportive of the position the BC Civil Liberties Association has taken on doctor assisted suicide. Thank you for your leadership. Congratulations on your persuasiveness at Court. Gary Mullins

  38. Thank you for a good reason to return to my homeland at end-of-life, not only for my comfort, but for my family’s convenience. Will this law also honour advance directives/healthcare living will should I deteriorate mentally?

  39. Many, many thanks for initiating and supporting this case from its inception to its victorious conclusion yesterday. All Canadians should be proud of the work, the dedication and the skills that you employed to change this outdated law and to obtain a better future for those of us who will suffer at the end of life.

    Please pass my thanks on to the members of your team and to the families of the other plaintiffs.

    John Warren, Vice Chair of Dying With Dignity.

  40. You say “Canada has joined the long list of countries that permit physician-assisted dying.
    Many countries such Belgium, Luxembourg, the Netherlands, and the US states of Oregon, Washington, Montana, New Mexico and Vermont allow for aid in dying. Their history shows that the fears raised by opponents have not materialized, and death-with-dignity regulations are safe and work as designed.” That is a dishonest statement, as I assume the BCCLA actually does its research, and the list is obviously not at all long.

    Euthanasia (state sanctioned killing) is a very challenging issue. For those who don’t believe this is a slippery slope, consider the following examples from Belgium, none of which involved extreme physical pain or terminal diagnosis:

    -5 people put to death daily. Up 25% in past year. Children can now be euthanized (who decides?)

    -Botched sex change operation

    -Twin brothers who were afraid they would not be able to live together

    -Woman with depression . Her son later protests this . It’s not just an individual decision.

    -And now a murderer wants to be killed.

    What is it about Canada that will prevent this evolution of euthanasia? Who defines what is intolerable suffering? Who determines when a disease is truly terminal? Some are (ALS), some are quite uncertain (cancer, MS). Belgium is a liberal democracy that began to allow euthanasia years ago. If I can decide to kill myself with assistance under limited circumstances, why can’t I decide to kill myself under whatever circumstances I choose? If it is an inalienable right…

  41. Congratulations to everyone at the BCCLA. Very well written article Ms. Pastine! You are obviously an amazing lawyer.

  42. I understand what you are saying , but I can’t agree. God did not give us the right to take a life even if it is our own or our choise with assistance of a doctor.. It is not acceptable to God and I would rather suffer in this life than in the next. Also I have seen my share of family members die and I do know what suffereing is, I am not heartless, I just can’t agree with this. Thnak you for letting me voice my opinion.

    • You are free to follow the tenets of your religion – all the power to you! But now, people are not free to impose their religious views on others anymore. This is the perfect solution: you can never be forced to seek physician-assisted suicide if it goes against your faith, and I can now never be forced to bear unbearable pain to comply with your religious belief system.

  43. People need to be aware that this process is not as smooth and simple as it sounds. Lethal prescriptions are not 100% effective. People have vomited, inhaled vomitus, and gone into a coma only to awaken hours or days later. The Oregon health department has been unable to investigate doctors who prescribe poorly because the laws don’t allow them to review actual medical records, only the reports that the prescriber files himself. Vermont is now considering legislation to make protections stronger because the state realized there are problems with the laws as they currently exist. This ruling is not a victory for Canadians’ rights.

  44. Congratulations on the death with dignity decision rendered by the Supreme Court! I have been following your organization for some time, and have been an advocate for this since watching my mom die such a painful, debilitating disease 40 or so years ago.
    Thank you for not giving up on fighting for an individual’s right to choose death with dignity. While it may not have been possible for my mom, it will be for so many others. This will be a blessing for them.

  45. As someone who helped a loved one research and prepare for a trip to visit Dignitas in Switzerland in 2003 — which turned out to be unnecessary when stage four liver cancer took her life before we could leave — I am overjoyed at this decision and your work that has brought it about. Thank-you to the legal team, and thank-you to the brave souls and their families who were behind this momentous day.

  46. A million thanks for all your work on what is such an important victory for all Canadians.

    A particular thank-you to the generous and brilliant pro bono lawyers!

  47. Some people are more liable than others to become depressed about the progressive loss of independence associated with increasingly frailty due to degenerative non-malignant diseases. Disability and pain are characteristically perceived as intolerable by persons with depression.
    Time will tell whether this Supreme Court decision causes frail elderly people, through depression & despair, to see their frailty as an unbearable burden to others ( family, friends) & to see themselves as worthy of death, rather than seeking medical & social support.
    There will be a huge burden of responsibility on the medical professionals to ensure that the request is made with sound & stable mind, and that the condition has no means of being remediated.

  48. What is still missing from this debate is what to do if I become demented and don’t know that I exist. I’ll have no power to end my life even if I indicate VSED in my advanced directive. Right or wrong?

  49. Congratulations BCCL union on the Death with Dignity issue.
    There is a further issue however that will be coming forward in the next 20-30 years, and that is the Dementia tsunami estimated at 30% of the population. I know that I would wish for an assisted death if I could not meaningfully interact with my spouse or children, or was a threat to others or self because of dementia. We must now develop a legal remedy that allows a person of sound mind to clearly state their wishes on the Assisted Death issue prior to the onset of Dementia and before they become incapable.
    I would appreciate hearing from the BCCL as to their position on this matter.

  50. Thank you, Canada. Hopefully, one “side effect” of this ruling will be to make our lawmakers in the U.S. reconsider their regressive stance here.