2An example of a new law is the Prince Edward Island Consent to Treatment and Health Care Directives Act, R.S. P.E.I. 1998, c. C-17.2 (proclaimed 2000) and an example of recent law reform with respect to advance directives is the Nova Scotia Personal Directives Act, S.N.S. 2008, c.8 and Personal Directives Regulations, N.S. Reg.31/2010.
3R. v. Morrison, [1998] N.S.J. No. 75, R. v. Morrison, [1998] N.S.J. No. 441; Golubchuk v. Salvation Army Grace General Hospital, [2008] M.J. 54, 2008 MBQB 49; R. v. Latimer, [1997] 1 S.C.R. 217; http://www.cbc.ca/fifth/givedeathahand/life.html. [Accessed 26 July 2011].
4Netherlands, Termination of Life on Request and Assisted Suicide (Review Procedures) Act, online: Dutch Ministry of Foreign Affairs – Netherlands Ministry of Foreign Affairs <http://www.healthlaw.nl/wtlovhz_eng.pdf> [Accessed 3 August 2011]; Belgium, The Belgian Act on Euthanasia of May 28th, 2002, trans. by Dale Kidd, online: Katholieke Universiteit Leuven Centre for Biomedical Ethics and Law <http://www.kuleuven.ac.be/cbmer/page.php?LAN=E&FILE=subject&ID=53&PAGE=1>; [Accessed 26 July 2011]; Switzerland, Criminal Code of the Swiss Confederation, art. 115, online: Legislationline <http://www.legislationline.org/legislations.php?jid=49<id=15>; [Accessed 26 July 2011].Oregon, The Oregon Death with Dignity Act, 127 O.R.S. § 800 at §§ 805, 810, 815, 825, 830, 835, 840 (2007); Washington, The Washington Death with Dignity Act, Ch.70.245 RCW; Montana, Baxter v. State of Montana, Montana First Judicial District Court December 2008 and Supreme Court of Montana, 2009 MT449.
6Criminal Code, R.S.C. 1985, c. C-46.
8Canadian Charter of Rights and Freedoms, Part I of the Constitution Act, 1982, being Schedule B to the Canada Act 1982 (U.K.), 1982, c.11.
9These definitions are drawn (and sometimes modified) from Dying Justice: A Case for Decriminalizing Euthanasia and Assisted Suicide in Canada.Toronto: University of Toronto Press, 2004 at 6–7 and Canada, Special Senate Committee on Euthanasia and Assisted Suicide, Of Life and Death – Final Report (Ottawa: Special Senate Committee on Euthanasia and Assisted Suicide, 1995), online: Senate of Canada <http://www.parl.gc.ca/Content/SEN/Committee/351/euth/rep/lad-e.htm>.Accessed 2 August 2011].
10Russel Ogden, Erling Christensen, Laurence Cattoire, John Lowman and Paul Zollman on behalf of the Farewell Foundation for the Right to Die v. Attorney General of Canada (April 8, 2011); Russel Ogden, Erling Christensen, Laurence Cattoire, John Lowman and Paul Zollman on behalf of the Farewell Foundation for the Right to Die v. British Columbia Registrar of Companies (April 8, 2011); Lee Carter, Hollis Johnson, Dr. William Shoichet, and the British Columbia Civil Liberties Association v. Attorney General of Canada (April 26, 2011).
12Bill C-384, An Act to amend the Criminal Code (right to die with dignity), first reading May 13, 2009, defeated April 21, 2010.
13Two-thirds of Canadians express support for legalizing euthanasia. Angus Reid Global Monitor: Montreal; Feb 2010. http://www.angus-reid.com/. [Accessed 26 July 2011]. ref
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105Criminal Code, R.S.C. 1985, c. C-46, s.217.
106Criminal Code, R.S.C. 1985, c. C-46, s.215(2).
107Criminal Code, R.S.C. 1985, c. C-46, s.217.
108Criminal Code, R.S.C. 1985, c. C-46, s.219.
109Rodriguez v. British Columbia (Attorney General), [1993] 3 S.C.R. 519 at 156, quoting from Ciarlariello v. Schacter,[1993] 2 S.C.R. 119, Nancy B. v. Hôtel-Dieu de Québec (1992), 86 D.L.R. (4th) 385 (Que. S.C.); and Malette v. Shulman (1990), 72 O.R. (2d) 417.
110Legal authority may come from a statute (for example, provincial/territorial health care consent legislation or provincial/territorial proxy directives legislation) or a court order.
111Ciarlariello v. Schacter, [1993] 2 S.C.R. 119 at 135.
112Gilmour J. “Death, Dying and Decision-Making about End of Life Care” in Downie J, Caulfield T, Flood C (eds.). Canadian Health Law and Policy 3d ed. Toronto: LexisNexis, 2007, 437 at 454.
113Gilmour J. “Death, Dying and Decision-Making about End of Life Care” in Downie J, Caulfield T, Flood C (eds.). Canadian Health Law and Policy 3d ed. Toronto: LexisNexis, 2007, at 448.
114Gilmour J. “Death, Dying and Decision-Making about End of Life Care” in Downie J, Caulfield T, Flood C (eds.). Canadian Health Law and Policy 3d ed. Toronto: LexisNexis, 2007, at 449.
115See, for example, Malette v. Shulman (1990), 72 O.R. (2d) 417. In this case, a physician was found liable for not respecting a woman's rejection of blood transfusions (through a Jehovah's Witness card) even though she was not, but for her need of blood, imminently dying.
116“Survey Results of Public, Health Care Provider, and Media Awareness Concerning End-of-Life Law and Policy in Canada, Final Report 2004” available online http://as01.ucis.dal.ca/dhli/cmp_documents/default.cfm?fuseaction=shwDocs2 [Accessed 26 July 2011]. This confusion may be exacerbated if individuals are aware that euthanasia is illegal and they are not clear on the distinction between euthanasia and the withholding and withdrawal of potentially life-sustaining treatment.
117Fleming v. Reid 82 D.L.R. (4th) 298 (Ont.C.A.), 1991 CanLII 2728 (On.C.A.)
118British Columbia, Representation Agreement Act, R.S.B.C. 1996, c. 405, Health Care (Consent) and Care Facility (Admission) Act, R.S.B.C. 1996, c. 181; Alberta, Personal Directives Act, R.S.A. 2000, c. P-6; Saskatchewan, Health Care Directives and Substitute Health Care Decision Makers Act, S.S. 1997, c. H-0.001; Manitoba, Health Care Directives Act, C.C.S.M. c. H27, Child and Family Services Act, C.C.S.M. c. C80, s. 25; Ontario, Health Care Consent Act, 1996, S.O. 1996, c. 2, Sch. A, Substitute Decisions Act, 1992, S.O. 1992, c. 30; Quebec, Civil Code of Québec, S.Q. 1991, c. 64, arts. 10–25, 2130–2185; New Brunswick, Infirm Persons Act, R.S.N.B. 1973, c. I-8; Nova Scotia, Personal Directives Act S.N.S. 2008, c.8; Prince Edward Island: Consent to Treatment and Health Care Directives Act, R.S.P.E.I. 1988, c. C-17.2; Newfoundland and Labrador, Advance Health Care Directives Act, S.N.L. 1995, c. A-4.1; Yukon Territory, Care Consent Act R.S.Y. 2003, c.21; Northwest Territories, Personal Directives Act, S.N.W.T. 2005, c.16; Nunavut, no legislation.
119For example, the Yukon sets the age at 16 (s. 27(1) while Alberta sets the age at 18 (s.3.1).
120See the studies referenced in Chapter One.
121See, for example, papers in 81 Texas Law Review (2003).
122The age of majority is established through statute in the provinces and territories (see, for example, British Columbia Age of Majority Act R.S.B.C. 1996, c-7).
123A rule which establishes that an individual under the age of majority, but capable of understanding and appreciating the nature and consequences of a decision to be made, should, at least in some circumstances, have that decision respected. This rule is grounded in respect for autonomy and, insofar as this respect is limited, tempered by concerns about protecting minors from making bad decisions.
124This ancient jurisdiction provides the courts with the authority to act to protect those unable to protect themselves. Historically, and particularly, this encompasses the young and the mentally disabled or ill. See Downie J. Dying Justice: A Case for Decriminalizing Euthanasia and Assisted Suicide in Canada, Toronto: University of Toronto Press, 2004, at 81–84.
125Gilmour J. “Death, Dying and Decision-Making about End of Life Care” in Downie J, Caulfield T, Flood C (eds.). Canadian Health Law and Policy 3d ed. Toronto: LexisNexis, 2007, 437 at 441–445.
126A.C. v. Manitoba (Director of Child and Family Services), 2009 SCC 30, [2009] 2 S.C.R. 181. It should be noted here that in this case, the Supreme Court of Canada considered the mature minor issue in the context of child protection proceedings (a context in which the potential consequences for the minor are, by definition, very serious).
127Joan Gilmour, “Death, Dying and Decision-Making about End of Life Care” in J. Downie, T. Caulfield, and C. Flood (eds.) Canadian Health Law and Policy 3d ed. Toronto: LexisNexis, 2007, 437 at 441–445. For example, Johnston v. Wellesley Hospital (1971), 17 D.L.R. (3d) 139 (Ont. H.C.), J.S.C. Wren, [1987] 2 W.W.R. 669 (Alta.C.A.), C.A.S. Metro Toronto v. K. (1985), 48 R.F.L. (2d) 164 (Ont. Fam.Ct.), Re Y.(A.) (1993), 111 Nfld. & P.E.I.R. 91, Walker (Litigation Guardian of) v. Region 2 Hospital Corp. (1994) 116 D.L.R. (4th) 477 (N.B.C.A.), Ney v. Canada (Attorney General), [1993] B.C.J. No. 993 May 3, 1993 B.C.S.C., Kennett Estate v. Manitoba (Attorney-General), [1988] M.J. No. 131, 18 March 1998, Van Mol (Guardian ad litem of) v. Ashmore, [1999] B.C.J. No. 31 (B.C.C.A.).
128See, for example, David C. Day, “The Capable Minor's Healthcare: Who Decides?” 86:3 (2007) Canadian Bar Review 379–420.
129This position is reflected in, for example, the Infants Act, R.S.B.C. 1996, c. 223 s.17.
130See, for example, Child and Family Services of Manitoba v. R.L.,[1997] M.J. 568, 154 D.L.R. (4th) 409; I.H.V. Estate (Re), [2008] A.J. 545, 2008 ABQB 250.
131See, for example, Sawatzky v. Riverview Health Centre Inc.,[1998] M.J. 506, 167 D.L.R. (4th) 359; Scardoni v. Hawryluck, [2004] O.J. 300, 69 O.R. (3d) 700; L.I.C. (Re), [2006] A.J. 190, 2006 ABQB 130; Yeung v. Capital District Health Authority (Dec. 15, 2006 – case concluded), Halifax HFX273970, (N.S.S.C.(T.D.)); Jin v. Calgary Health Region, [2007] A.J. 1100, 2007 ABQB 593; Golubchuk v. Salvation Army Grace General Hospital, [2008] M.J. 54, 2008 MBQB 49; Rotaru v. Vancouver General Hospital Intensive Care Unit, [2008] B.C.J. 456, 2008 BCSC 318, at paragraph four; Barbulov v. Cirone, [2009] O.J. 1439.
132Policy statements include: the Manitoba College of Physicians and Surgeons, Position Statement, 1602, “Withholding and Withdrawal of Life-Sustaining Treatment” (2008), online: http://www.bioethics.ca/statement.pdf [Accessed 2 August 2011]; the Canadian Medical Association, Canadian Nurses Association, Canadian Health Care Association, and Catholic Healthcare Association of Canada “Joint Statement on Resuscitative Interventions (Update 1995)” online: <http://policybase.cma.ca/policypdf/PD95-03.pdf>; [Accessed 26 July 2011]; the Canadian Medical Association, Canadian Nurses Association, Canadian Health Care Association, and Catholic Healthcare Association of Canada, “Joint Statement on Preventing and Resolving Ethical Conflicts Involving Health Care Providers and Persons Receiving Care” online: http://policybase.cma.ca/dbtw-wpd/PolicyPDF/PD99-03.pdf> [Accessed 26 July 2011]. For an illustrative professional report, see the Manitoba Law Reform Commissions report, “Withholding or Withdrawing Life-Sustaining Medical Treatment” 2003 (Report 109) online: http://www.gov.mb.ca/justice/mlrc/reports/109.pdf [Accessed 2 August 2011]. For an illustrative academic paper, see Downie J., McEwen K. “The Manitoba College of Physicians and Surgeons Position Statement on Withholding and Withdrawal of Life-Sustaining Treatment (2008): Three Problems and a Solution”. Health Law Journal. 2010;17:115–138..
133See, for a recent example, a series of comments in 10:3 American Journal of Bioethics.2010 Mar.
134A PubMed search for “futility ethics” returned 1263 hits.
135See, for example, the volume and nature of media coverage by searching “Samuel Golubchuk” on the internet.
136See, for example, the Manitoba College of Physicians and Surgeons, Position Statement, 1602, “Withholding and Withdrawal of Life-Sustaining Treatment” (2008), online: Canadian Bioethics Society <http://www.bioethics.ca/statement.pdf>Accessed 26 July 2011].
137See, for example, Downie J, McEwen K. “The Manitoba College of Physicians and Surgeons Position Statement on Withholding and Withdrawal of Life-Sustaining Treatment (2008): Three Problems and a Solution”. Health Law Journal. 2010;17:115–138..
138Criminal Code, R.S.C. 1985, c. C-46, s.220.
139Rodriguez v. British Columbia (Attorney General), [1993] 3 S.C.R. 519.
140Rodriguez v. British Columbia (Attorney General), [1993] 3 S.C.R. 172.
141Ontario Chief Coroner's Guidelines – Memorandum to Ontario Coroners – Memo a603 – November 29, 1991; Active Euthanasia and Assisted Suicide Crown Counsel Policy Manual, Province of British Columbia, Ministry of Attorney General, Criminal Justice Branch (Policy 11–3-93, File no. 56880–01, Eut 1).
143Section 241 of the Criminal Code states that: Everyone who (a) counsels a person to commit suicide, or (b) aids or abets a person to commit suicide, whether suicide ensues or not, is guilty of an indictable offence and liable to imprisonment for a term not exceeding fourteen years.
144Rodriguez v. British Columbia (Attorney General), [1993] 3 S.C.R. 519.
145Eerkiyoot (1949) and Lois Wilson (1985) described and referenced at “Assisted Suicides in Canada” online at http://www.righttodie.ca/assistedsuicides-canada.html. Maurice Genereux (1996) (R. V. Genereux (1999) 44 O.R. (3d) 339) described in Dying Justice: A Case for Decriminalizing Euthanasia and Assisted Suicide in Canada, Toronto: University of Toronto Press, 2004.
147Bert Doerksen (1998) described and referenced in Dying Justice: A Case for Decriminalizing Euthanasia and Assisted Suicide in Canada, Toronto: University of Toronto Press, 2004 and Michael Breau (2001) described and referenced at “Assisted Suicides in Canada” online at http://www.righttodie.ca/assistedsuicides-canada.html. [Accessed 26 July 2011].
151For example, the Euthanasia Prevention Coalition (http://www.epcc.ca) and the Canadian Parliamentary Pro-Life Caucus.
153The legislative history is reviewed in Marlisa Tiedemann and Dominique Valiquet in a Library of Parliament Report “Euthanasia and Assisted Suicide in Canada” 91–9E (revised 17 July 2008) available online at http://www2.parl.gc.ca/content/lop/researchpublications/919-e.htm#parliamentary. [Accessed 26 July 2011]. The latest bill, C-384, was a private member's bill introduced by Francine Lalonde of the Bloc Quebecois. It was defeated 228–59 May 2010.
154Russel Ogden, Erling Christensen, Laurence Cattoire, John Lowman and Paul Zollman on behalf of the Farewell Foundation for the Right to Die v. Attorney General of Canada (April 8, 2011); Russel Ogden, Erling Christensen, Laurence Cattoire, John Lowman and Paul Zollman on behalf of the Farewell Foundation for the Right to Die v. British Columbia Registrar of Companies (April 8, 2011); Lee Carter, Hollis Johnson, Dr. William Shoichet, and the British Columbia Civil Liberties Association v. Attorney General of Canada (April 26, 2011).
155Criminal Code, R.S.C. 1985, c. C-46.
156For a discussion of this defence and the Supreme Court of Canada's rejection of it, see R. v. Latimer, [2001] 1 S.C.R. 3.
157Criminal Code, R.S.C. 1985, c. C-46, s.745.
158Victor and Dorothy Ramberg (1941), George Davis (1942), Ron Brown (1978), Nachum Gal (1982), Robert Cashin (1994), Bruno Bergeron (1985), Alberto de la Rocha (1991), Scott Mataya (1991), Cheryl Myers and Michael Power (1993), Robert Latimer (1993), Jean Brush (1994), Danielle Blais (1996), Nancy Morrison (1997), Herbert Lerner (2000), Alain Quimper (2002), Tony Jaworski (2004) described and referenced online at Right to Die Society of Canada, online: http://www.righttodie.ca.
160R. v. Morrison,[1998] N.S.J. No. 75, online: QL (NSJ).
161Ramberg, Ramberg, Davis, described and referenced online at Right to Die Society of Canada, online: http://www.righttodie.ca.
162Bergeron and Blais, described and referenced online at Right to Die Society of Canada, online: http://www.righttodie.ca, R. v. Mataya (unreported Ontario Court of Justice (General Division), 24 Aug. 1992 Wren J. without a jury); R. v. de la Rocha (1993), Timmins, (Ont. Ct. (Gen. Div.)).; R. v. Myers and Power (23 Dec. 1994), Halifax, (N.S.S.C.).; R. v. Brush (2 March 1995) Toronto (Ont. Ct. J. (Prov. Div.)).
167Quimper (2002), described and referenced online at Right to Die Society of Canada, online: http://www.righttodie.ca, and R. v. Latimer,[2001] 1 S.C.R. 3.
168For example, the Euthanasia Prevention Coalition (http://www.epcc.ca) and the Canadian Parliamentary Pro-Life Caucus.
169See discussion of these options in, for example, the Special Senate Committee on Euthanasia and Assisted Suicide.
172Lee Carter, Hollis Johnson, Dr. William Shoichet, and the British Columbia Civil Liberties Association v. Attorney General of Canada (April 26, 2100).
173Rawls, J. Political Liberalism. New York: Columbia University Press, 1993.
174Sumner, W., Assisted Death. Oxford: Oxford University Press, 2011.
175Gutmann A, Thompson D. Democracy and Disagreement. Cambridge: Harvard University Press, 1996.
176Warren ME, Pearse H. Designing Deliberative Democracy: The British Columbia Citizens’ Assembly. Cambridge: Cambridge University Press, 2008.
177Kahane D, Weinstock D, Leydet D, Williams M. Deliberative Democracy in Practice. Vancouver: The UBC Press, 2009.
178John Stuart Mill, On Liberty, Penguin: Harmondsworth 1984 (originally published in 1859); Immanuel Kant, “What is Enlightenment?”, in Kant's Political Writings (ed. Hans Reiss), Cambridge: Cambridge University Press, 1974 (originally published in 1784); Jean-Jacques Rousseau, Du contrat social, Paris: Flammarion 1984 (originally published in 1762).
179Ciarlariello v. Schachter, [1993] 2 S.C.R 119 at 135 (emphasis added). See also Hopp v. Lepp (1980), 112, D.L.R. (3d) 67 (S.C.C.), and Reibl v. Hughes (1980), 114 D.L.R. 3d 1 (S.C.C.).
180Rodriguez v. British Columbia (Attorney General) [1993] 3 S.C.R 519 at 588.
181R. v. Big M Drug Mart Ltd.[1985] 1 S.C.R. 211 at 397.
182Law v. Canada Minister of Employment and Immigration),[1999] 1 S.C.R. 497.
183A canonical modern statement of the main families of views is Dworkin G. The Theory and Practice of Autonomy. Cambridge, UK: Cambridge University Press, 1988.
184Faden RR and Beauchamp TL. A History and Theory of Informed Consent. New York: Oxford University Press 1986.
185Young R. Medically Assisted Death. Cambridge University Press: Cambridge, 2007: 85.
186Glover J. Causing Death and Saving Lives. Penguin: Harmondsworth, 1997:100.
187Glover J. Causing Death and Saving Lives. Penguin: Harmondsworth, 1997: 93–103.
188Uniacke S. “The Doctrine of the Double-Effect.” In: Ashcroft RE, Dawson A, Draper H, McMillan JR(eds). Principles of Health Care Ethics, Second Edition. Wiley: Chichester, 2007: 263–268.
189Uniacke S. “The Doctrine of the Double-Effect.” In: Ashcroft RE, Dawson A, Draper H, McMillan JR(eds). Principles of Health Care Ethics, Second Edition. Wiley: Chichester, 2007: 263–268.
190Hyman DA. Does technology spell trouble with a capital ‘I’?: Human Dignity and Public Policy. Harvard Journal of Law and Policy. 2003;27:3–18..
191Kleespies PM. Psychological and ethical considerations concerning the de-breather and assisted suicide: A commentary on Ogden. Death Studies. 2010;34:318–324. doi: 10.1080/07481181003613859..
192Ogden R. ”The de-breather and NuTech: A reply to Kleespies. Death Studies. 2010;34:325–329. doi: 10.1080/07481181003613875..
193Sensen O. Human Dignity in Historical Perspective: The Contemporary and Traditional Paradigms. European Journal of Political Theory. 2011;10:71–91..
197Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, and Social Sciences and Humanities Research Council of Canada, Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans, December 2010. http://www.pre.ethics.gc.ca. [Accessed 26 July 2011].
198Graaf van der VR, Delden van JJM. Clarifying Appeals to Dignity in Medical Ethics from an Historical Perspective. Bioethics. 2009;23(3):151. doi: 10.1111/j.1467-8519.2008.00646.x..
199Schroeder D. “Dignity: Two riddles and four concepts.”. Cambridge Quarterly of Healthcare Ethics. 2008;17(2):203. doi: 10.1017/S0963180108080262..
200See Regan T. The Case for Animal Rights Berkeley: University of California Press, 1983, and Singer P. Animal Liberation: A New Ethics for our Treatment of Animals. New York: New York Review of Books, 1975.
201Seifert J. What is Life? Amsterdam: Rodopi; 1997: (97).
203Sensen O. Human Dignity in Historical Perspective: The Contemporary and Traditional Paradigms. European Journal of Political Theory. 2011;10:71–91..
205Benatar D. The trouble with universal declarations. Developing World Bioethics. 2005;5:220–224. doi: 10.1111/j.1471-8847.2005.00119.x..
208Cohen-Almagor R. The Right to Die with Dignity: An Argument in Ethics, Medicine, and Law. New Brunswick, NJ: Rutgers University Press, 2001.
210Feinberg J. Harm to Self: The Moral Limits of the Criminal Law. New York, NY: Oxford University Press, 1986 (354).
211Rodriguez v British Colombia (Attorney General), [1993] 3 S.C.R. 519, [1993] S.C.J. No. 94.
212Rodriguez v British Colombia (Attorney General), [1993] 3 S.C.R. 519, [1993] S.C.J. No. 94.
213Rodriguez v British Colombia (Attorney General), [1993] 3 S.C.R. 519, [1993] S.C.J. No. 94.
214Rodriguez v British Colombia (Attorney General), [1993] 3 S.C.R. 519, [1993] S.C.J. No. 94. at para 129.
215Rodriguez v British Colombia (Attorney General), [1993] 3 S.C.R. 519, [1993] S.C.J. No. 94. at para 230.
216Rodriguez v British Colombia (Attorney General), [1993] 3 S.C.R. 519, [1993] S.C.J. No. 94. at para 200.
217Pullman D. Dying with dignity and the death of dignity. Health L.J. 1996;4:214..
218Rodriguez v British Colombia (Attorney General), [1993] 3 S.C.R. 519, [1993] S.C.J. No. 94 at para 211.
219Goodin R. The political theories of choice and dignity. American Philosophical Quarterly. 1981;18(2):97..
220Pullman D. Dying with dignity and the death of dignity. Health L.J. 1996;4:197..
221Goodin R. The political theories of choice and dignity. American Philosophical Quarterly. 1981;18(2):97..
222Pullman D. “Dying with dignity and the death of dignity.”. Health L.J. 1996;4:202..
223Sensen O.“Human Dignity in Historical Perspective: The Contemporary and Traditional Paradigms.” In: European Journal of Political Theory 20111071–91..
225Kass L. “Neither for love nor money: Why doctors must not kill.”. Public Interest. 1989;94:38..
226Ashcroft RE. “Making sense of dignity.”. Journal of medical ethics. 2005;31:680. doi: 10.1136/jme.2004.011130..
227Bayertz K. “Introduction: Sanctity of Life and Human Dignity”, in Bayertz K(ed.). Sanctity of Life and Human Dignity. Dordrecht: Kluwer; 1995: ix.
228Singer P. “Is the Sanctity of Life Ethic Terminally Ill?”. Bioethics. 1995;9:343 n16. doi: 10.1111/j.1467-8519.1995.tb00368.x..
229Kant I.J.W. Ellington trans., Grounding for the Metaphysics of Morals, 3d ed. Indianapolis: Hackett Publishing, 1993:36.
230Velleman JD. “A Right of Self-Termination?”. Ethics. 1999;109(606):624. doi: 10.1086/233924..
231Kamm F.M. “Physician-assisted suicide, euthanasia, and intending death”, in Battin MP, et al (eds.). Physician Assisted Suicide: Expanding the Debate. New York: Routledge, 1998: 28.
233A similar argument was developed in the famous “Philosopher's Brief” written by five (broadly) Kantian moral and political philosophers – Ronald Dworkin, Judith Jarvis Thompson, Thomas Nagel, John Rawls, and Robert Nozick – and submitted as amicus curiae to the American Supreme Court in 1997. See “Assisted Suicide: The Philosopher's Brief”, The New York Review of Books. March 27, 1997.
235Macklin R. “Dignity is a Useless Concept”. British Medical Journal. 2003;327:1419. doi: 10.1136/bmj.327.7429.1419..
236Arguments such as these are canvassed in Young R. Medically Assisted Death. Cambridge: Cambridge University Press, 2007: chapter 7.
237Brock D. Conscientious refusal by physicians and pharmacists: who is obligated to do what, and why? Theoretical Medicine and Philosophy. 2008;29:187–200. doi: 10.1007/s11017-008-9076-y..
238It is appropriate to note at this point that the decision not to grant Sue Rodriguez the right to receive medically assisted death was grounded not in the Justices’ denial of the value of individual autonomy, but in large measure on slippery slope reasoning on the part of the majority Justices. It is quite likely that the same Supreme Court would have decided the issue differently, given the fact that two of the reasons that the Court had this worry–namely that no other country had decriminalized it and there was no data to either confirm or disprove the worry–now no longer exist. See Jocelyn D, Bern S. “Rodriguez Redux”. Health Law Journal. 2008;16:27–54.. On the general appropriateness of the Supreme Court engaging in slippery slope reasoning, given that it does not have the wherewithal with which to handle the relevant evidence, see Freedman B. “The Rodriguez Case: Sticky Questions and Slippery Answers”. McGill L.J. 39:644..
241These points are made in most philosophical treatments of euthanasia and physician-assisted suicide. See, most recently, Warnock M and Macdonald E. Easeful Death: Is there a case for assisted dying? Oxford: Oxford University Press, 2009.
242The Schoonheim case. Dutch Supreme Court. November 27, 1984. Nederlandse Jurisprudendie. 1985;06.
243Legemaate J. The Dutch Euthanasia Act and related issues. Journal of Law and Medicine. 2004;11:312–23..
244Baxter v Montana, Montana First Judicial District Court, Cause No. ADV07–787, December 5, 2008 at page 23.
245Baxter v Montana, Supreme Court of Montana, DA 09–0051, December 31, 2009.
246Baxter v Montana, Supreme Court of Montana, DA 09–0051, December 31, 2009 at page 24–5.
252Freeman M. Denying Death Its Dominion: Thoughts on the Dianne Pretty Case. Medical Law Review. 2002;10:245. doi: 10.1093/medlaw/10.3.245..
253R. (on the application of Pretty) v DPP. British Medical Law Reports. 2001;63:1.
255R.(on the application of Purdy) v DPP British Medical Law Reports. 2008;104:231. B.M.L.R. 2009;106;170 (HL)
257Purdy. W.L.R. 2009;3:403 at [40].
258Purdy. W.L.R. 2009; 3:403 at [85].
260Editorial. A law on assisted dying would be merciful. The Observer. August 2, 2009.
261For further discussion, see McLean SAM, Connelly C, Mason JK. Purdy in Scotland: We hear but should we listen? Juridical Review. 2009;4:265–284..
262Vanderpool HY. Doctors and the dying of patients in American history. In: Weir RF. Physician assisted suicide. Bloomington: Indiana University Press, 1997.
263Rietjens JA, Heide van der A, Onwuteaka-Philipsen BD, Maas van der PJ, Wal van der G. A comparison of attitudes towards end-of-life decisions: survey among the Dutch general public and physicians. Social Science and Medicine. 2005;61(8):1723–32. doi: 10.1016/j.socscimed.2005.03.024. Oct..
264Legemaate J. The Dutch Euthanasia Act and related issues. Journal of Law and Medicine. 2004;11:312–23..
265Wal G van der, Maas PJ van der. Euthanasie en andere medische beslissingen rond het levenseinde. Den Haag: SDU uitgevers; 1996.
266Legemaate J. The Dutch Euthanasia Act and related issues. Journal of Law and Medicine. 2004;11:312–23..
268Heide van der A., et al. , End-of-life practices in the Netherlands under the Euthanasia Act New England Journal of Medicine 2007356191957–65..
269Netherlands, Termination of Life on Request and Assisted Suicide (Review Procedures) Act, online: Dutch Ministry of Foreign Affairs – Netherlands Ministry of Foreign Affairs <http://www.healthlaw.nl/wtlovhz_eng.pdf> [Accessed 3 August 2011].
270Hoge Raad. 24 December 24, 2002. NJ 2003/167.
271Onwuteaka-Philipsen BD et al. Evaluatie wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding. Den Haag: ZONMW; 2007:101.
273Nys H. Euthanasia in the low countries: a comparative analysis of the law regarding euthanasia in Belgium and the Netherlands. Ethical Perspectives. 2002;9:73–85. doi: 10.2143/ep.9.2.503847..
274Deliens L, Mortier F, Bilsen J, et al. End-of-life decisions in medical practice in Flanders, Belgium. A nationwide survey. Lancet. 2000;356:1806–11. doi: 10.1016/s0140-6736(00)03233-5..
275Nys H. Physician assisted suicide in Belgian law. European Journal of Health Law. 2005;12:39–42. doi: 10.1163/1571809054663131..
277Griffiths J, Bood A, Weyers H. Euthanasia and Law in the Netherlands. Amsterdam: Amsterdam University Press, 1998.
278Nys H. Euthanasia in the low countries: a comparative analysis of the law regarding euthanasia in Belgium and the Netherlands. Ethical Perspectives. 2002;9:73–85. doi: 10.2143/ep.9.2.503847..
279Section 2.1.a of the Dutch Euthanasia Act.
280Section 3.1 of the Belgian Act.
281Section 2.1.a of the Dutch Act.
283Section 2.1.2 of the Luxemburg Act.
284Section 2.1.3 of the Luxemburg Act.
286Lee v. State of Oregon, US District Court Fed. Suppl. 1994 Dec.27; 869:1491–503; US District Court Fed. Suppl. 1995 Aug.3; 891: 1429–39; US Court of Appeals Ninth Circuit Fed. Suppl. 1997 Feb 27; 107:1382–97.
288Pain Relief Promotion Act 1999 (passed House of Representatives but failed to move through the Senate), Lethal Drug Abuse Prevention Act 1997 (never brought to vote in House or Senate), and Assisted Suicide Prevention Act 2006 (never Reported out of Committee in the Senate).
289Memorandum. Dispensing of Controlled Substances to Assist Suicide. From John Ashcroft, Attorney General to ASA Hutchinson, Administrator The Drug Enforcement Agency, November 6, 2001 66 Fed. Reg. 56,607. Directive repudiated in Oregon v. Ashcroft, decision affirmed by the Ninth Circuit Court in Oregon v. Ashcroft, decision affirmed by the US Supreme Court in Gonzales v. Oregon 1997 (with different reasons).
2903 Oregon Revised Statutes (O.R.S.) § 127.
295para 195, p. 69, Q 2135.
297Interestingly, this pattern is also replicated in Switzerland; see Marini MC, Neuenschwander H, Stiefel F. Attitudes toward euthanasia and physician assisted suicide: A survey among medical students, oncology clinicians, and palliative care specialists. Palliative and Supportive Care. 2006;4:251–255. doi: 10.1017/s1478951506060329..
298House of Lords Select Committee, supra cit, at para 197, at p. 70.
299Available online at <http://www.samw.ch/dms/en/Ethics/Guidelines>. [Accessed 26 July 2011]. For discussion, see Guillod O, Schmidt A. Assisted suicide under Swiss law. European Journal of Health Law. 2005;12:25–38. doi: 10.1163/1571809054663140..
301Bosshard G, Ulrich E, Bär W. 748 cases of suicide assisted by a Swiss right-to-die organisation. Swiss Medical Weekly. 2004;133:310–317. doi: 10.4414/smw.2003.10212., p. 311.
302Bosshard G, Ulrich E, Bär W. 748 cases of suicide assisted by a Swiss right-to-die organisation. Swiss Medical Weekly. 2004;133:310–317. doi: 10.4414/smw.2003.10212..
303Guillod O, Schmidt A. Assisted suicide under Swiss law. European Journal of Health Law. 2005;12:25–38. doi: 10.1163/1571809054663140., p. 31.
306Tuffs A. Swiss Government considers stricter laws on assisted suicide. British Medical Journal. 2009;339:3061. doi: 10.1136/bmj.b3061..
309Onwuteaka-Philipsen BD et al. Evaluatie wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding. Den Haag: ZONMW, 2007.
310Maas PJ, Delden JJM van, Pijnenborg. Medische beslissingen rond het levenseiden. Het onderzoek voor de commissie Remmelink. Den Haag, Sdu uitgeverij, 1991.
311Onwuteaka-Philipsen BD et al. Evaluatie wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding. Den Haag: ZONMW, 2007; p. 279.
312Onwuteaka-Philipsen BD et al. Evaluatie wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding. Den Haag: ZONMW, 2007; p. 282.
313Onwuteaka-Philipsen BD et al. Evaluatie wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding. Den Haag: ZONMW, 2007; p. 111.
314Onwuteaka-Philipsen BD et al. Evaluatie wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding. Den Haag: ZONMW, 2007; p. 132.
315Onwuteaka-Philipsen BD et al. Evaluatie wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding. Den Haag: ZONMW, 2007; p. 99.
316Onwuteaka-Philipsen BD et al. Evaluatie wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding. Den Haag: ZONMW, 2007; p. 102.
317Onwuteaka-Philipsen BD et al. Evaluatie wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding. Den Haag: ZONMW, 2007; p. 103.
318Onwuteaka-Philipsen BD et al. Evaluatie wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding. Den Haag: ZONMW, 2007; p. 103.
319Onwuteaka-Philipsen BD et al. Evaluatie wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding. Den Haag: ZONMW, 2007; p. 100.
320Ibid., Onwuteaka-Philipsen BD et al. Evaluatie wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding. Den Haag: ZONMW, 2007; p. 109.
321Bilsen J, Cohen J, Chambaere K, et al. Medical End-of-Life Practices under the Euthanasia Law in Belgium. New England Journal of Medicine. 2009;361:1119–21. doi: 10.1056/NEJMc0904292..
322Bosshard G, Ulrich E, Bär W. 748 cases of suicide assisted by a Swiss right-to-die organisation. Swiss Medical Weekly. 2003;133:310–317. doi: 10.4414/smw.2003.10212..
323Fischer S, Huber CA, Imhof L, et al. Suicide assisted by two Swiss right-to-die organisations. Journal of Medical Ethics. 2008;34:810–814. doi: 10.1136/jme.2007.023887..
327Eg Keown J. Euthanasia examined. Cambridge University Press, 1995.
328Bilsen J, Cohen J, Chambaere K, et al. Medical End-of-Life Practices under the Euthanasia Law in Belgium. New England Journal of Medicine. 2009;361:1119–21. doi: 10.1056/NEJMc0904292..
329Heide A van der, Deliens L, Faisst K, et al. on behalf of the EURELD consortium End-of-life decision-making in six European countries: descriptive study. Lancet. 2003;362:345–50. doi: 10.1016/S0140-6736(03)14019-6..
330E Verhagen, PJJ Sauer. The Groningen Protocol — Euthanasia in Severely Ill Newborns. N Engl J Med 2005; 352:959–962.
331Minister van Justitie en VWS. Regeling levenbeëindiging pasgeborenen. Staatscourant 13 maart 2007.
332Commissie levensbeëindiging pasgeborenen. Jaarverslag 2009/2010. Den Haag, 2011.
333For example, provincial consent legislation could include the following statement and definitions (a modified version of the provisions in the Ontario Health Care Consent Act, 1996 S.O. 1996, c.2, Sch.A., ss.2 and 10): “A health practitioner who proposes a treatment for a person shall not proceed with the treatment, and shall take reasonable steps to ensure that it is not administered, unless, (a) he or she is of the opinion that the person is capable with respect to the treatment, and the person has given consent; or (b) he or she is of the opinion that the person is incapable with respect to the treatment, and the person's substitute decision-maker has given consent on the person's behalf in accordance with this Act. “Treatment” means anything that is done for a therapeutic, preventive, palliative, diagnostic, cosmetic, or other health-related purpose. “Treatment plan” means a plan that: (a) is developed by one or more health practitioners; (b) deals with one or more of the health problems that a person has and may, in addition, deal with one or more of the health problems that the person is likely to have in the future given the person's current health condition; and (c) provides for the administration to the person of various treatments or courses of treatment and may, in addition, provide for the withholding or withdrawal of treatment in light of the person's current health condition. A sample policy statement for a health care regulator is The Manitoba College of Physicians and Surgeons Position Statement on Withholding and Withdrawal of Life-Sustaining Treatment. An alternate policy statement for a health care regulator is found in Downie J, McEwen K. The Manitoba College of Physicians and Surgeons Position Statement on Withholding and Withdrawal of Life-Sustaining Treatment (2008): Three Problems and a Solution. Health Law Journal. 2010;17:115–138..
335Onwuteaka-Philipsen BD et al. Evaluatie wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding. Den Haag: ZONMW; 2007.
336Ganzini L, Goy ER, Dobscha SK. Oregonians’ reasons for requesting physician aid in dying. Archives of Internal Medicine. 2009;169(5):489–92. doi: 10.1001/archinternmed.2008.579. Mar 9.. Erratum in: Arch Intern Med. 2009 March 23;169(6):571.
337See also Delden JJM van, Battin MP. Euthanasia: not just for rich countries. In: Green R, Donovan A (eds). Global bioethics. Oxford: Oxford University Press: 243–261.
338The Supreme Court of Canada can, in effect, change the Criminal Code as it can strike down or read in content to ensure that the Criminal Code is consistent with the Charter. This is, however, reactive as a case must come before the Court before it can take such steps.
340An example of such a bill can be found in Downie J, Bern S. “Rodriguez Redux”. Health Law Journal. 2008;16:27–54..
341Prosecutorial discretion is discussed by the Supreme Court of Canada in, for example, R. v Lyons. Supreme Court Reports. 1987;2:309. R. v Beare. Supreme Court Reports. 1988;2:387. R. v Power. Supreme Court Reports. 1994;1:601. and Fraser v Public Service Staff Relations Board. Supreme Court of Canada. 1985;2:455.
342While some jurisdictions have created independent public prosecution services (e.g., Nova Scotia under the Public Prosecutions Act, S.N. 1990, c.21, all have retained a policy power for the Attorney General.
345For an example of a restorative justice program (for youth aged 12–17 charged with a particular set of criminal offences), see the description of the restorative justice program in Nova Scotia. Available at http://gov.ns.ca/just/rj. For more information and resources on restorative justice, see the Nova Scotia Restorative Justice Community University Research Alliance. Available at <http://www.nsrj-cura.ca> [Accessed 26 July 2011].
346For a detailed discussion of the use of restorative justice in the context of assisted suicide and euthanasia, see Llewellyn J and Downie J. “Restorative Justice, Euthanasia, and Assisted Suicide A New Arena for Restorative Justice and A New Path for End of Life Law and Policy in Canada”Alberta Law Review, Special Issue on Restorative Justice, 2011: 48:4.
347Sherman LW, and Strang H. 2007. Restorative Justice: The Evidence. London: Smith Institute.
348An example of draft legislation to describe and establish these oversight functions and a national oversight commission is included in Downie J., Bern S. “Rodriguez Redux”. Health Law Journal. 2008;16:27–54..