ANDRÉ PICARD | The Globe and Mail

On Feb. 6, 2016 – one year after the historic Supreme Court ruling in the case of Kathleen Carter and Gloria Taylor – physician-assisted death will be legal in Canada. The Canadian Medical Association last week debated what life would be like for physicians and patients in this brave new world. One thing was clear: We are woefully unprepared for Feb. 7.

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The Court said the Criminal Code’s prohibitions on assisted suicide will no longer apply “to the extent that they prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.” It also stated that physicians cannot be compelled to hasten a person’s death.

In the yawning gap between this straightforward theory and the complexities of everyday practice lie many questions:

• When a patient asks for a hastened death, who will they ask?

• What do the terms “grievous and irremediable” and “enduring suffering that is intolerable” mean?

• Who will determine a patient’s capacity to consent?

• If a physician can’t be compelled to perform the act, does he or she have an obligation to refer to a doctor who will?

• How long will the “cooling off” period be between a request and administration of a lethal drug?

• Who will train doctors to administer these drugs?

• Does a physician have to administer a lethal drug in hospital, or can patients take pills on their own at home?

• Will there be a billing code for assisted death?

• What do you write on the death certificate?

• Will life-insurance payouts be denied because a person is opting for a form of suicide?

The Supreme Court suspended its ruling for one year to give the federal government time to come up with an amended law (or not), and to allow provincial governments and regulators to prepare.

The government of Stephen Harper, which didn’t like the ruling, did nothing until July, when it appointed a committee to consult Canadians (and stipulated it could not consult during the election campaign). Ottawa is clearly abdicating its responsibility.

The provinces, led by Ontario, have appointed their own consultative committee, but it won’t report till year’s end

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