Holland: Euthanasia Act (passed 2001, in effect 2002)

Active Euthanasia (including Physician-Assisted Suicide, often now referred to as "Medically Assisted

Dying") is permitted on the following conditions:

The attending physician must:

a. Be convinced that the patient has made a voluntary and carefully considered request;

b. Be convinced that the patient’s suffering was unbearable, and that there was no prospect of

improvement;

c. Have informed the patient about his situation and his prospects;

d. Have come to the conclusion, together with the patient that there is no reasonable alternative in

the light of the patient’s situation;

e. Have consulted at least one other, independent physician, who must have seen the patient and

given a written opinion on the due care criteria referred to in a. to d. above, and nurses involved

in the patient’s care must be consulted; and,

f. Have terminated the patient’s life or provided assistance with suicide with due medical care and

attention.

This law codified a twenty year practice of not prosecuting doctors for engaging in AE.

Physicians may follow instructional directives requesting AE (so some incompetent patients will be

subject to this legislation).

Competent minors apparently permitted to seek AE under this legislation, but children 12-16 need

parents’ approval.

Permits non-residents to be euthanized. (“Euthanasia tourism”)

Other jurisdictions that have laws permitting euthanasia or physician-assisted suicide:

Belgium/Luxembourg: Permits physician-assisted suicide/medically-assisted dying and euthanasia since

2002 and 2009, respectively.

Switzerland: Permits physician-assisted suicide/medically-assisted dying if no selfish motive involved

(since 1980s).

United States: Montana: The Montana Supreme Court ruled on December 31, 2009 that state law

does not prohibit physician-assisted suicide/medically-assisted dying (but did not hold that it was a

constitutional right).

Oregon enacted a Death With Dignity Act in 1997. The Death With Dignity Act permits physician-
assisted suicide/medically-assisted dying by allowing competent patients in the final six months of a

terminal illness to apply to a physician for a prescription for a self-administered lethal medication. 1050

individuals have used this legislation as of 2012 (roughly 2.3/1000 deaths in 2012). About 64% of those

granted assisted dying made use of it. To obtain a prescription for a self-administered lethal medication,

a patient would need to be a state resident and to make two oral requests followed by a written request

witnessed by two people who are not related or connected to the individual. Two doctors must affirm that

the patient has six months or fewer to live.

Washington (state) implemented physician-assisted suicide/medically-assisted dying legislation in March

2009, following a state plebiscite in November 2008 (59% in favour of legislation permitting assisted

suicide). The legislation is similar to the Oregon legislation.

Vermont adopted a PAS/medically assisted dying law in May 2013.

Canada: Rodriguez v. the Attorney General of BC – in 1993, the Supreme Court of Canada ruled 5-4 that

there was no Charter protected right to euthanasia (AE or PAS), but the court held that Canada’s criminal

code could be amended to permit euthanasia. Various private members’ proposals have been put forth

since that time, but no law has yet been passed – and none is likely to in the near future, despite support

from an apparent majority of Canadians. The College Des Medecins Du Quebec has recently endorsed

euthanasia for exceptional situations – uncontrollable pain or interminable suffering, for example –

in which euthanasia could be considered to be a final step required to assure the provision of quality

care. Subject to a careful and thorough decision-making process involving all parties concerned, some

treatments could be deemed appropriate even if they contravene certain legal stipulations.

(Physicians, Appropriate Care and the Debate on Euthanasia: A Reflection (October 2009),

Page 3-4, available at: http://www.cmq.org/en/medias/profil/commun/Nouvelles/2009/~/media/

208E2B537FB144FAAE33DEB458D3AA90.ashx?110905 )

Currently under judicial review: Carter/Taylor/BC Civil Liberties Association case. In June 2011,

Gloria Taylor (and several other plaintiffs) applied to BC Supreme Court for a declaration that the

assisted suicide provisions of the Criminal Code do not apply to physicians. The BC Supreme Court ruled

in June 2012 that the assisted suicide provisions were unconstitutional and gave the federal government

one year to change them. The Court gave Taylor a personal exemption that legally permitted her to seek

physician assistance in dying. Taylor had ALS, and died on October 5, 2012 without exercising that

permission. In a split decision on October 10, 2013, the BC Court of Appeal overturned this decision.

Leave to appeal to the Supreme Court of Canada is being sought. Elayne Shaprey a woman with MS has

joined the case.