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Carter V. Canada (Attorney General), 2012 BCSC 886 Date: 20120615 Docket: S112688 Registry: Vancouver

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Carter V. Canada (Attorney General), 2012 BCSC 886 Date: 20120615 Docket: S112688 Registry: Vancouver IN THE SUPREME COURT OF BRITISH COLUMBIA Citation: Carter v. Canada (Attorney General), 2012 BCSC 886 Date: 20120615 Docket: S112688 Registry: Vancouver Between: Lee Carter, Hollis Johnson, Dr. William Shoichet, The British Columbia Civil Liberties Association and Gloria Taylor Plaintiffs And 2012 BCSC 886 (CanLII) Attorney General of Canada Defendant And Attorney General of British Columbia Defendant And Farewell Foundation for the Right to Die -and- The Christian Legal Fellowship -and- Canadian Unitarian Council -and- Euthanasia Prevention Coalition and Euthanasia Prevention Coalition – British Columbia -and- Ad Hoc Coalition of People with Disabilities Who are Supportive of Physician-Assisted Dying Intervenors Before: The Honourable Madam Justice Lynn Smith Reasons for Judgment Counsel for Plaintiffs Joseph J.M. Arvay, Q.C., Sheila M. Tucker, Alison M. Latimer, and Grace M. Pastine Counsel for Attorney General of Canada Donnaree Nygard, Keith Reimer, Toireasa Jespersen, Melissa Nicolls, Megan Volk and BJ Wray Carter v. Canada (Attorney General) Page 2 Counsel for Attorney General of British George H. Copley Q.C. Columbia and Craig E. Jones, Q.C. Counsel for Farewell Foundation for the Jason Gratl and Marius Adomnica Right to Die Counsel for Euthanasia Prevention Hugh R. Scher, Joel V. Payne Coalition and John A. Campion Counsel for Christian Legal Fellowship Gerald Chipeur, Q.C. Bradley Miller and Michael Morawski Counsel for Canadian Unitarian Counsel Tim Dickson and Brent L. Rentiers Counsel for The Ad Hoc Coalition of Angus M. Gunn, Jr. People with Disabilities Who are and Sarah F. Hudson 2012 BCSC 886 (CanLII) Supportive of Physician-Assisted Dying Place and Date of Hearing: November 14-18, 21-25, 28, December 1-2, 5-9, 12-14, 16, 2011, April 16, 2012 Vancouver, B.C. Place and Date of Judgment: Vancouver, B.C. June 15, 2012 Carter v. Canada (Attorney General) Page 3 Table of Contents I. SUMMARY...................................................................................................... 8 II. INTRODUCTION........................................................................................... 12 A. Nature of the Claim ....................................................................................... 12 B. Terminology .................................................................................................. 16 III. THE PLAINTIFFS ......................................................................................... 18 A. Gloria Taylor.................................................................................................. 19 B. Lee Carter and Hollis Johnson ...................................................................... 22 C. Dr. William Shoichet...................................................................................... 24 2012 BCSC 886 (CanLII) D. Standing of Dr. Shoichet and BCCLA ........................................................... 25 IV. CRIMINAL CODE PROVISIONS AND THEIR HISTORY............................. 30 A. The Impugned Provisions.............................................................................. 30 B. Legislative History ......................................................................................... 32 C. Private Members’ Bills and Senate Reports Since Rodriguez....................... 33 V. EVIDENTIARY AND PROCEDURAL RULINGS .......................................... 34 A. Evidence ....................................................................................................... 34 1. The Record ............................................................................................... 34 2. Evidence Admitted Past the Deadlines ..................................................... 35 a) The Royal Society Expert Panel Report and the Report of the Canadian Parliamentary Committee on Palliative and Compassionate Care............................................................................ 35 b) The Select Committee of the Assemblée Nationale de Québec ........... 37 B. Summary and Expedited Trial ....................................................................... 38 C. Scope of Reply.............................................................................................. 40 VI. EXPERT OPINION EVIDENCE .................................................................... 42 VII. MEDICAL ETHICS AND MEDICAL END-OF-LIFE PRACTICES ................ 53 A. Introduction ................................................................................................... 53 B. Relevance of the Ethical Debate ................................................................... 54 1. Positions of the Parties ............................................................................. 55 2. Analysis .................................................................................................... 57 C. Current State of the Law and Practice in Canada Regarding End-Of- Life Care........................................................................................................ 58 1. Palliative Care Practice............................................................................. 59 Carter v. Canada (Attorney General) Page 4 2. Assisted Suicide and Voluntary Euthanasia Practice................................ 63 3. The Law .................................................................................................... 64 a) The Informed Consent Requirement .................................................... 64 b) Potentially Life-Shortening Symptom Relief.......................................... 69 c) Palliative Sedation ................................................................................ 69 d) Withdrawal of Treatment against the Consent of Substitute Decision-Makers................................................................................... 69 e) Summary .............................................................................................. 70 D. Evidence ....................................................................................................... 71 1. Opinions of Ethicists ................................................................................. 71 2. Evidence of Practitioners .......................................................................... 78 2012 BCSC 886 (CanLII) 3. Positions of Professional Bodies............................................................... 85 4. Public Opinion........................................................................................... 88 5. Public Committees.................................................................................... 91 6. Prosecution Policies.................................................................................. 93 E. Analysis......................................................................................................... 96 1. Summary of the Ethical Debate ................................................................ 96 2. Conclusions about the Ethical Debate .................................................... 101 a) Would Canadian physicians be willing to assist patients with hastening death if it were legal to do so?............................................ 102 b) Does current medical practice with respect to end-of-life care make distinctions that are ethically defensible and is the distinction between suicide and assisted suicide ethically defensible? ......................................................................................... 102 c) Does the law attempt to uphold a conception of morality inconsistent with the consensus in Canadian society? ....................... 106 VIII. EVIDENCE FROM OTHER JURISDICTIONS ............................................ 111 A. The Major Challenges to the Effectiveness of Safeguards.......................... 113 B. Review by Jurisdiction................................................................................. 117 1. Oregon and Washington ......................................................................... 117 2. Netherlands............................................................................................. 139 3. Belgium................................................................................................... 152 4. Switzerland ............................................................................................. 174 5. Luxembourg............................................................................................ 178 6. Montana.................................................................................................. 180 7. Colombia................................................................................................. 182 Carter v. Canada (Attorney General) Page 5 C. Impact of Legal Physician-Assisted Dying on Vulnerable Populations........ 182 D. Analysis of the Evidence about Effectiveness of Safeguards...................... 188 1. What level of compliance have the permissive jurisdictions achieved with respect to their safeguards? ............................................................ 188 2. Do the safeguards effectively prevent abuse of vulnerable individuals? ............................................................................................. 192 3. What inferences can be drawn with respect to the likely effectiveness of comparable safeguards in Canada, given different cultural contexts?.................................................................................... 195 E. Impact on Palliative Care ...........................................................................
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