Quebec's groundbreaking right-to-die law has cleared a major hurdle after the province's top court sided with the government in allowing doctors to legally end a patient's life.
The ruling by the Quebec Court of Appeal means the first law of its kind in Canada remains in effect – and it is already being invoked by patients. Quebec Health Minister Gaétan Barrette told The Globe and Mail a patient suffering from terminal cancer asked about applying the law this month. However, no procedures to end the patient's life were initiated.
Dr. Barrette said Tuesday's court ruling marks a significant step in allowing Quebec patients the right to make their own choices.
"This judgment says Quebec has the right to offer patients a continuum of care at the end of their life," he said. "This is a judgment in favour of citizens. We shouldn't see it as a victory for the government." Several provinces have started to seek information from Quebec as they look at drafting their own possible laws, he said.
The ruling from Quebec's three-member appeal court clears up the legal uncertainty shrouding the province's medically assisted dying law since earlier this month. On Dec. 1, the Quebec Superior Court temporarily suspended the law and declared it inoperative until the Criminal Code ban on assisted death is lifted.
But the appeal court overturned the decision, stating that the lower court erred in saying that federal laws took precedence over Quebec's initiative. Quebec's law falls under health care, which is a provincial matter, and the legislation sets up strong guidelines that limit its risks.
Ottawa has already indicated it sees value in Quebec's law. Prime Minister Justin Trudeau this month praised Quebec's "responsible and rigorous approach to such a delicate and sensitive topic."
The federal government is seeking "a uniform criminal law for all Canadians," Justice Minister Jody Wilson-Raybould said in a statement on Tuesday.
"We recognize the leadership that Quebec has demonstrated in developing its own legislation on physician-assisted dying," said Christian Girouard, a spokesman for Ms. Wilson-Raybould. "We will continue to work with Quebec, as well as the other provinces and territories, to develop a co-ordinated approach to physician-assisted dying across the country."
All eyes now turn to Ottawa to see how it will accomplish that. The Supreme Court of Canada struck down the Criminal Code ban on physician-assisted death last February, but it suspended the effect of its ruling for 12 months to allow the federal government and the provinces time to draft legislation.
Ottawa is seeking a six-month extension that would bring the deadline to August. Arguments for the extension are to be heard next month.
Dying With Dignity Canada opposes any further federal delays and says the Quebec court ruling may have repercussions across the country. Canadians who want medically assisted dying wonder why they have to wait "when Quebeckers have the right to die today," said Wanda Morris, the head of the group.
"This is a truly remarkable day that clears the path forward for Quebec residents to openly request compassionate assistance to die," she said in a statement. "There is no longer any legal ambiguity. Health-care providers in [Quebec] should feel comforted knowing that their government and their top court support this critical health-care treatment."
Quebec's law is still facing legal challenges. Paul Saba, a Montreal family doctor who has led the fight against the law, said he will challenge Quebec's end-of-life legislation on its merits beginning next month. He said Quebec's initiative amounts to euthanasia. "Euthanasia is not medical care – it never has been and it never will be," Dr. Saba said in an interview.
The law lacks adequate safeguards and the province should instead work on improving access to palliative care across Quebec, he said.
Dr. Barrette said Quebec has reached a consensus on the issue. "We've had the debate in Quebec and we listened to the population. People want this choice," the minister said. He cited numerous safeguards provided by the law and said the rules are "very strict."