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Canadian court OKs doctor-assisted suicide, but who’s eligible?

In March, Canada's Supreme Court ruled unanimously that all Canadians have a constitutional right to have doctors help them die. Special correspondent John Larson reports from British Columbia on how doctors, patients and politicians are grappling with how to set rules and eligibility in the next year.

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  • GWEN IFILL:

    Four U.S. states, Oregon, Washington, Montana, and Vermont, now have laws allowing doctors to help people die, as do a handful of European nations.

    But no country has ever launched physician-assisted suicide on the scale now under way in Canada. Earlier this year, the Supreme Court there ruled unanimously that all Canadians have a constitutional right to have doctors help them die.

    The court gave the government just one year to regulate medically assisted death for the entire nation.

    Special correspondent John Larson reports from British Columbia.

  • ELAYNE SHAPRAY:

    My pain or discomfort is virtually constant.

  • JOHN LARSON:

    When medically assisted death was argued before the Canadian Supreme Court, Elayne Shapray's statement was exhibit A.

  • ELAYNE SHAPRAY:

    I cannot move or turn over in bed. In effect, I am a prisoner of my own body. I no longer consider my life worth living unless I possess the means to leave it at the time of my choosing.

  • JOHN LARSON:

    Shapray was a nurse, an active mother of two, until multiple sclerosis struck. Now 68 years old, she can no longer do much of anything without help, including — and this is why she's exhibit A — take her own life.

    How far away are you from that point where you would no longer be able to end your own life?

  • ELAYNE SHAPRAY:

    I can see it from here.

  • JOHN LARSON:

    The question of whether doctors should be allowed to help people like Elayne die was at the center of the Canadian Supreme Court decision.

    The court ruled that laws making physician-assisted death illegal violated Canadians' constitutional rights in cases where an adult clearly consents to the termination of life and has a grievous and irremediable medical condition. The most recent polls show 86 percent of the Canadian general public approve.

  • DAVID LEMON:

    There's no question there's going to have to be some serious thought about finding the right balance, but it is something whose time has come. It has to be.

  • SUSAN WAGNER:

    I think people do have the right to decide for themselves about the end of their life, and how — the quality of that.

  • DR. DONALD LOW:

    Hi. I'm Dr. Donald Low.

  • JOHN LARSON:

    Last year, a famous Canadian microbiologist pleaded for a change in the law just eight days before he died from brain cancer.

  • DR. DONALD LOW:

    There's a lot of clinicians — of opposition to dying with dignity. I wish they could live in my body for 24 hours, and I think they would change that — change that opinion.

  • JOHN LARSON:

    The high court's decision came sooner than he would have imagined.

    The court's decision left room for interpretation, however. For example, a patient's condition must be, among other things, severe and incurable. But that's not the same as terminal. For example, what if a patient has severe arthritis? Would they be eligible? Or what if they're disabled or mentally ill?

    Remember, Shapray suffers from M.S., a debilitating, but not life-ending disease.

    You're not in the end stage of a terminal illness.

  • ELAYNE SHAPRAY:

    It's an interminable illness.

  • JOHN LARSON:

    Interminable.

  • ELAYNE SHAPRAY:

    Interminable. How do you weigh that? How do you measure that, unless you're sitting in my wheelchair?

  • DR. WILL JOHNSTON, Euthanasia Prevention Coalition:

    Well, it seems clear from what the Supreme Court has said that you need not be terminally ill to qualify.

  • JOHN LARSON:

    Dr. Will Johnston, an outspoken opponent of physician-assisted death, says the court's liberal language, that the patient may suffer from an disease or disability, and that suffering is only defined as intolerable to the individual, leaves the door open for abuse.

  • DR. WILL JOHNSTON:

    You do not even need to be physically ill, because they specifically stated that psychological suffering would qualify as well.

  • GRACE PASTINE, British Columbia Civil Liberties Association:

    So what the court said was that the right to assisted dying should be available only in narrow circumstances.

  • JOHN LARSON:

    Grace Pastine of the British Columbia Civil Liberties Association, which successfully brought the case to the Supreme Court, says the specifics of exactly who will be eligible for assisted dying have yet to be determined, but should be narrowly defined.

  • GRACE PASTINE:

    The court made it very clear that physician-assisted dying would only be an option for individuals who are mentally competent and able to make a fully informed voluntary choice. I think, for example, someone who suffered from a type of severe mental illness wouldn't be able to qualify because they wouldn't be able to meet the consent requirements.

  • JOHN LARSON:

    The Canadian Medical Association, for years firmly opposed to doctor-assisted dying, this month announced it now supports patients who seek medical aid in dying, as well as a physician's choice to participate.

    Still, opponents like Dr. Johnston hope pain management, palliative care, will be sufficient for most patients and doctors.

  • DR. WILL JOHNSTON:

    We can do that without turning our 2,400 years of medical ethical history on its head, without crossing that bright line between attempting to treat the symptoms of the patient and intending to kill the patient.

  • LESLIE LAFOREST:

    But many, many people do not, in fact, have that painless death.

  • JOHN LARSON:

    Leslie Laforest was diagnosed three years ago with a recurrence of her stage four anal cancer. But although her cancer is in remission, she knows, if it returns, her death could be prolonged and painful.

  • LESLIE LAFOREST:

    I have absolutely the strongest will that I will not go through that final chapter, whenever that comes.

  • JOHN LARSON:

    Laforest testified in the case that went to the Supreme Court that current law would force her to take her life early, while she could still do it herself, a point that the high court referenced in its decision.

    You want to walk down the black list for me?

  • LESLIE LAFOREST:

    One of the scenarios is gassing myself, obviously, carbon monoxide from my car. And then I plan in my mind, it's got to be when my husband's out of town, because it would be horrifying for him, and my daughter at school or away on vacation.

    Then I need to go to Home Depot and I have to buy some hose. And then I have got to get some duct tape. The problem is, then I start to think, but, wait a second, is there really going to be enough carbon monoxide to actually do the job? Or will it be just enough to kind of put me into a coma or make me in a vegetative state, where I actually don't die?

  • JOHN LARSON:

    An important twist on all of this, of course, is that the clock is ticking. The high court gave the government just one year to come up with a new national law. That's just 12 months to agree on something they have been completely unable to agree upon for many years.

    LIBBY DAVIES, Member of Parliament for Vancouver East: Whether or not that will actually happen is, I think, a matter of speculation, because I think there's, you know, a number of us who are worried that the government is going to drag its feet on this.

  • JOHN LARSON:

    A liberal member of parliament, Libby Davies, has supported right-to-die issues. She says, despite the court's ruling, the current government may delay any new law until after the national elections next October.

  • LIBBY DAVIES:

    Which would make it incredibly tight. And if it were a different government that had, you know, a whole bunch of other things on their agenda, it would make it very difficult.

  • JOHN LARSON:

    Difficult because Canadian provinces and territories, similar to our states, administer the country's health care. Ideally, they, too, would have to be consulted to craft any new law.

    Is there a sense here that that can get done?

  • LIBBY DAVIES:

    Oh, I think it's entirely possible. I mean, we have provincial federal territorial discussions and policy developments all the time. It's part of the Canadian reality. It's the way this country works. What is critical and what would make it an obstacle is if the federal government basically kind of walks away and says, well, you know, we really want nothing to do with this.

  • JOHN LARSON:

    If no federal law is passed, current provincial law, in accordance with the court's decision, will have to suffice, at least until something is sorted out.

  • ELAYNE SHAPRAY:

    There's not a lot left.

  • WOMAN:

    Here's your medicine, Elayne.

  • JOHN LARSON:

    When the case went to the Supreme Court, lawyers requested Elayne Shapray be given special consideration, a waiver that would allow a doctor to end her life while the government writes a new law. The court turned her down, meaning Elayne will have to wait a full year before a doctor could legally end her life.

  • JOHN LARSON:

    You feel like you have a year?

  • ELAYNE SHAPRAY:

    I think I would rather not answer that question.

  • JOHN LARSON:

    For NewsHour, John Larson in Vancouver, British Columbia.

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