A call for Canada to legalize assisted suicide has thrust back onto the agenda a divisive and emotionally complex issue that no politician wants to touch.
For once, the federal Conservatives, NDP and Liberals are on the same page: When it comes to Canadians' right to die, they won't go there.
That leaves families and a small group of advocates with no recourse but to ask the provinces for discretion when it comes to prosecuting these cases.
The Royal Society of Canada's report, released Tuesday, argues that it's unconscionable to make it a crime to help tormented people end their lives. Canadians need compassion and clarity when it comes to legislation that governs what is permissible when a person wants to die, the expert panel recommended.
The report calls for a system modelled after countries such as the Netherlands, where euthanasia has been legal since 2002, in which patients may request assisted suicide or euthanasia when a doctor has determined they are competent to make the decision, and have done so voluntarily.
But despite the ambitious proposals, there are no signs Ottawa wants to have a debate.
"We have no plans to propose any reforms to this area of the law," Justice Minister Rob Nicholson said. And the opposition echoed that reluctance: "We don't want to go down that road," NDP MP Jack Harris said.
The panel contends that the need to change Canada's euthanasia law is so urgent that provinces should take matters into their own hands, by instructing prosecutors when not to pursue charges in cases of compassionate killing.
British Columbia is the only province that has given prosecutors those instructions, issuing guidelines in homicide cases "motivated by compassion."
B.C. last updated its euthanasia and assisted-suicide policy manual in 2004. But with its courts embroiled now in Gloria Taylor's right-to-die case in Vancouver – the first since the country was gripped 18 years ago by the case of amyotrophic lateral sclerosis patient Sue Rodriguez – Attorney-General Shirley Bond is reluctant to comment on whether further changes are needed.
"End-of-life care is one of the most challenging and profound medical, legal and ethical questions of our time," she said. "I can't speak to any of the specifics of this case, as it is before the courts. … I am not in a position to comment today about any other future action the province may take."
Alberta Justice spokesman David Dear put it more bluntly. "The Criminal Code is the Criminal Code. And our prosecutors approach it as such."
It should come as no surprise that politicians are squeamish, says University of Toronto law professor Bernard Dickens: There's limited political capital to be made fighting for the right to die.
"It does require a certain amount of courage, if not recklessness," he said. "This report should be a stimulus to have that thought through. We've had a number of very sad prosecutions."
The Canadian Medical Association is also opposed to legalization. The proposal to put doctors in charge of deciding who's of sound enough mind to elect to die, and then of executing that death, makes some physicians uncomfortable.
"It's not something I support or endorse," said Daren Heyland, a professor of medicine at Queen's University and a critical-care physician at Kingston General Hospital. "It's not the real problem. We have issues around the quality of end-of-life care that can't be solved with euthanasia."
The report rejects the notion that legalizing assisted suicide and euthanasia would lead to a "slippery slope" of deaths without consent – observing that in the grey uncertainty of end-of-life care, difficult decisions are already being carried out.
"It's going on," said Jocelyn Downie, Canada Research Chair in Health Law and Policy at the University of British Columbia, who wrote the legal chapter of the report. "But very few charges are being laid, and very few convictions in the face of those charges, and even fewer jail terms."
Quebec's Select Committee on Dying with Dignity, which heard from hundreds of witnesses both for and against euthanasia since its creation in 2009, was to report back this fall. It's still working on recommendations.