Euthanasia (Medical Assistance in Dying) in Ontario, Canada

A proposal for thesis research

David Langer 2018
1. My research interest is the legal - constitutional mechanism used to implement the regime
of medical assistance in dying ('MAiD') in Ontario, within the framework of recent Criminal
Code of Canada amendments (An Act to amend the Criminal Code and to make related
amendments to other Acts (medical assistance in dying), SC 2016, c 3) and Carter v. Canada,
[2015] 1 SCR 331. I have studied law and undergraduate level computer science, and my
research abilities (and experience as a legal researcher) motivate my pursuit of graduate
level study… Interests subordinate to the general topic of MAiD in Ontario are:
1.1. Foreign law and Carter, 2015: the ‘undermining’ of Rodriguez v British Columbia
(Attorney General), [1993] 3 SCR 199 by incidental reliance (via Ontario (AG) v Fraser,

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2011 2 SCR 3) on Planned Parenthood of Southeastern Pa. v Casey, 505 US 833 (1992)

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(Carter, 2015), an American abortion matter affirming Roe v Wade, 410 US 113 (1973);
where the, ‘matrix of legislative and social facts,’ (Carter, 2015) mirrored the doctrinal
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linguistics of Planned Parenthood: ‘ … whether the law's growth in the intervening
years has left Roe's central rule a doctrinal anachronism discounted by society,’
(Planned Parenthood, 1992).
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1.2. MAiD potential trespasses on ‘Indigenous’ rights and freedoms (Six Nations Indian
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Reserve no. 40).

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1.2.1. An ‘American Indian,’ exhibited as having self-administered lethal toxins, under

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Oregon’s Death with Dignity Act, 1994 (Carter v Canada (AG), 2012 BCSC 886
(CanLII)).
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1.2.2. The preamble to SC 2016: ‘… spiritually appropriate end-of-life care for

Indigenous patients.’
1.2.3. UN Charter principles: Art. 7 of the United Nations Declaration of the Rights on
Indigenous Peoples, 2007 (UNDRIP mentioned in R v Francis-Simms, 2017 ONCJ
402 (CanLII)).
1.2.4. Consent: Hamilton Health Sciences Corp. v. D.H., 2014 ONCJ 603 (CanLII) and the
Ontario court as an ‘appropriate forum,’ to make health care decisions for
‘aboriginals.’
1.2.5. Provincial ‘health care,’ and the Great Law: ‘aboriginal rights,’ (R v Van der Peet,
[1996] 2 SCR 507; s. 35(1) Constitution Act 1867).
1.2.6. The principles of reconciliation, and the adequacy of representing ‘aboriginal’
society by expert opinion (Carter, 2012; Delgamuukw v British Columbia, [1997] 3
SCR 1010).
 1.2.7. Delegation of authority, from SC 2016 to Council of Canadian Academies:
sufficiency as duty to consult (Haida Nation v British Columbia (Minister of Forests),
SCR 511).
1.3. Conflict of interest: College of Physicians and Surgeons as regulator of health care
professionals while promoting certain views of MAiD to the Council of Canadian
Academies [and Senate] per SC 2016 (Submission to the Council of Canadian
Academies: Expert Panel on Medical Assistance in Dying in Canada, 2017).
1.3.1. Mental illness ‘as sole underlying condition’: decision making capacity (College of
Physicians and Surgeons submissions).
1.4. Secrecy: the principle of open justice and amendments to Ontario privacy legislation
(Vital Statistics Act, 1990; Freedom of Information and Protection of Privacy Act, 1990;
Municipal Freedom of Information and Protection of Privacy Act, 1990).
1.5. Foreseeability as legal criteria in criminal law: ‘[whether a patient’s] natural death has
become reasonably foreseeable within the meaning of s. 241.2(2)(d) of the Criminal
Code,’ (AB v Canada (Attorney General) 2017 ONSC 3759).

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1.5.1. Capacity: s. 4 of the Health Care Consent Act, 1996.
1.6. Expert opinion generally: Carter, 2012 (White Burgess Langille Inman v. Abbott and
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Haliburton Co., [2015] 2 SCR 182, and R v Abbey [1982] 2 SCR 24 (psychiatric opinion)).
1.7. The economics of provincially applied MAiD (SC 2016 preamble and Ontario
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government).
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1.7.1. Cost benefit analysis of patient long-term care (palliative care as defined in
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Carter, 2012) versus terminations by MAiD and euthanasia, in Ontario [this analysis
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may also relate to access to information and open justice].

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1.7.2. The profit (or cost-saving) motive: organ harvesting, taxation, insurance (OHIP),
corporate investment and foreign investment.
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1.8. Terminating the life of children by MAiD [euthanasia]: consideration by the Council of
Canadian Academies and its expert panel.
1.9. Possible comparative law: Russia (Федеральный закон от 07.06.2017 г. № 120-ФЗ),
Australia (Voluntary Assisted Dying Act, 2017), the United Kingdom (Suicide Act 1961;
Nicklinson and Lamb v the United Kingdom - 2478/15; 1787/15; Pretty v the United
Kingdom 2346/02; Ross v Lord Advocate [2016] ScotCS CSIH_12; Fleming v Ireland
[2013] IEHC 2); the Vatican (S.2801 Norme in materia di consenso informato e di
disposizioni anticipate di trattamento), Israel (Dying Patient Law, 2005; ‫ )הלכה‬and Saudi
ّ ‫)وال تقتلواْ النّفس الّتي‬.
Arabia (4:29 ‫ وال تقتلواْ أنفسكم‬and 17:33 ‫حرم هللا‬
1.10. Division of powers and constitutional analysis.
1.10.1. Core protected areas of provincial health care and the criminal law: PHS
Community Services Society, 2011 citing R. v Morgentaler, [1988] 1 S.C.R. 30;
Morgentaler v. The Queen, [1976] 1 S.C.R. 616; R. v Morgentaler, [1993] 3 S.C.R.
 463 (federal prohibition of dangerous or socially undesirable medical treatments -
abortion).
1.10.2. Code exemptions as non-prohibitory health care administration provisions:
‘Parliament may determine what is not criminal as well as what is, and may hence
introduce dispensations or exemptions in its criminal legislation’ (Carter, 2015; ss.
241.1 and 241.2 Code; Morgentaler v The Queen, [1976] 1 SCR 616, dissenting
opinion of Laskin J); ‘A crime is an act which the law, with appropriate penal
sanctions, forbids,’ (Reference re Validity of Section 5 (a) Dairy Industry Act, [1949]
SCR 1).
1.10.3. Delegation of criminal law power to the province (Morgentaler, 1988).
1.10.4. Code exemptions and the preservation of a mother’s health in comparison to
MAiD (euthanasia): the history of the Bourne defence of necessity and abortion
(Morgentaler, 1975 and Laskin dissenting; Regina v Morgentaler (No. 5), 1973
CanLII 1282 (QC CS)).
1.10.5. Interjurisdictional immunity: Canada (AG) v PHS Community Services Society

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[2011] 3 SCR 134 citing Rodriguez, 1993 and cited by Carter, 2015.

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1.11. Visualized analysis of MAiD and its juridical terminology: for example, submissions of
College of Physicians and Surgeons of Ontario to the Council of Canadian Academies,
2017 (see attached chart).
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1.11.1. Dynamic case law and legislative analysis: for example, the CanLII API visualized
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dynamically (Langer, http://student.athabascau.ca/~davidla107/).

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1.11.2. Linguistics of MAiD terminology: textual correlations and trends (A.B. v Canada
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(AG), 2017 ONSC 3759 (CanLII)): http://voyant-

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tools.org/?corpus=ac5aa75fb0b1067dc8bddec0c83a23c6 and trends from this

corpus, http://voyant-
tools.org/?corpus=ac5aa75fb0b1067dc8bddec0c83a23c6&query=medical&query=
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assistance&query=dying&query=death&query=foreseeable&query=court&withDist
ributions=raw&docIndex=0&mode=document&view=Trends and some
correlations, http://voyant-
tools.org/?corpus=ac5aa75fb0b1067dc8bddec0c83a23c6&query=foresee*&query
=death&view=Correlations