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CMA to appear before Supreme Court in end-of-life case

The Canadian Medical Association (CMA) will appear before the Supreme Court of Canada on Oct. 15 when the court meets to consider whether the existing ban on assisted death is unconstitutional.

Earlier this summer the CMA was granted intervener status, and has framed its appearance as a “friend of the court” to offer its perspective on these complex issues.

In the Carter case, the Supreme Court will be asked to decide whether the existing prohibition on assisted death in the Criminal Code of Canada is unconstitutional under the Canadian Charter of Rights and Freedoms.

“We will not draw a black-and-white portrait for the court but highlight the complexities of this critical social, legal and ethical dilemma,” said CMA President Chris Simpson. “We will highlight the challenges posed to physicians’ understanding of their traditional roles if the court were to change the law.”

The Carter case began in 2011, when the BC Civil Liberties Association (BCCLA) joined Dr. William Shoichet, Gloria Taylor – who had an incurable, progressive disease – and the family of Kay Carter, who also had an incurable disease, to challenge the law against assisted dying.

In 2012, the B.C. Supreme Court ruled the Criminal Code of Canada provisions against assisted dying violated the rights of the gravely ill. The federal government appealed that decision, and the provincial Court of Appeal overturned the lower court ruling in October 2013 and upheld the ban, citing the 1993 case of Sue Rodriguez. The Supreme Court granted the BCCLA, the Carter family and others permission to appeal the case.

When the Supreme Court last considered the issue of assisted dying – in the Rodriguez case – it upheld the existing prohibition by a narrow margin of 5–4.

The CMA’s written argument to the court notes that a portion of the association’s membership believes patients should be free to choose medical aid in dying as a matter of autonomy. Others maintain physician participation in assisted dying would undermine long-established ethical principles applicable to the practice of medicine. However, respect for the alternative perspective is a unifying theme in the CMA’s presentation. This was highlighted in the policy motion endorsed at the CMA’s General Council meeting in August. It affirmed the right of all physicians, within the bounds of existing legislation, to follow their conscience when deciding whether or not to provide medical aid in dying.

The CMA has stressed that assisted dying is a societal issue, and earlier this year led a series of town hall meetings across Canada to gather public and member input on issues related to palliative care, advance care directives and euthanasia and physician-assisted dying.

The Supreme Court is expected to take several months before rendering a decision in the Carter case.

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