Palliative Care: Captive and Casualty of Carter v Canada?

Abstract

When the Carter v Canada case found the prohibition against euthanasia and physician-assisted suicide unconstitutional, it simultaneously launched an existential threat to the discipline and vocation of palliative care—the view that there is no distinction between palliative care and physician-assisted death. This confronting narrative is often supported by reference to the Carter case, but what did the court actually say? The chapter examines the Carter case to present the court’s findings and observations with respect to palliative care. The chapter also explores subsequent Federal legislative initiatives establishing the practice of “medical assistance in dying” (MAID) as well as initiatives taken to improve palliative care. The reader will perhaps find it interesting to know that the trial court’s findings are consistent with the definition, practice and purposeful vision of palliative care—to address suffering with life-affirming care while not hastening or postponing death. Legal and clinical clarity could be achieved if Canadian law and policy-makers uniformly adopted and cohesively advanced this definition. Yet such clarity does not appear to be forthcoming. It is hoped that this detailed review provides groundwork that can help increase transparency and in turn offer assistance towards securing palliative care as a right of all Canadians.