Defining "assisted death" is extremely important. For the purpose of this presentation, the term "assisted death" will encompass all related terms such as "euthanasia", "assisted-suicide", "dying with dignity" and other synonymous terms.

Sue Rodriguez, a 42-year-old woman suffering from the debilitating, terminal illness, amyotrophic lateral sclerosis, wished to have a qualified physician assist her in terminating her life at the time of her choosing. Section 241(b) of the Criminal Code,(1) however, makes it a criminal offence to assist a person to commit suicide. Ms. Rodriguez applied to the Supreme Court of British Columbia for an order declaring s. 241(b) invalid under the Canadian Charter of Rights and Freedoms

In a five to four decision, the Supreme Court of Canada dismissed the appeal and found s. 241(b) to be constitutional (Smith 1993).

On October 15, 2014, the Supreme Court of Canada will hear the case of Carter v. Canada. The BCCLA filed a lawsuit to challenge the laws that criminalize doctors for helping competent, seriously ill individuals who wish to hasten death. The "death with dignity lawsuit" argues that the right to control when and how to die is integral to the life, liberty, and security of seriously ill Canadians (BCCLA 2013).

Recent media exposure in BC: Gloria Taylor & Kathleen Carter

Christianity: Assisted Suicide violates the commandment "Thou shalt not kill" [Suicide, (2004)]
Qu’ran: "’And do not kill yourselves, surely God is most Merciful to you.’ — Qur'an, Sura 4 (An-Nisa), ayat 29 [12].” [Qur’an (n.d.)]
Hinduism/Buddhism/Jainism: Assisted Suicide violates the code of ahimsa [a-HEM-sa] (Sanskrit for not to injure/ or more commonly known as non-violence).
Ghandi included selfish acts, and those driven by anger, hostility etc. to be included in the umbrella of violence. There is an emphasis on all existence being of a common nature and connected, such that harming others is equivocal to harming oneself. [Misra, G. (2009)]
Depending on the depth of your philosophy of Ahmisa, it could be argued that assisted suicide, under certain circumstances is nonviolent in nature, while others would consider it as bad as murder. In this way individual philosophy has a way of intensifying the issue at hand. But the take home message is that most major religions oppose assisted dying.

Misra, G. (2009). Non-violence: An imperative for a flourishing collective life. Psychological Studies, 54(3), 169-170. doi:10.1007/s12646-009-0023-4
Suicide (2004). Stanford Encyclopedia of Philosophy Retrieved From http://plato.stanford.edu/entries/suicide/#ChrPro
Qur'an (n.d.) Quran.com Retrived from http://quran.com/4

Where legal, it is currently not required that patients have a psychiatric review prior to requesting assisted death. Psychiatric review is only conducted if patient is suspected of having a judgement impairing disorder. [McCormack, R., & Price, A. (2014)]
Because psychiatric disorders such as depression have noted biological constructs, some argue that there is a certain predictability in the behavior of those who have it, and other disorders. It is also argued that the decision-making abilities of depressed people are hindered. This should be considered when patients request assisted death. [Tsou, J. Y. (2013)]

McCormack, R., & Price, A. (2014). Psychiatric review should be mandatory for patients requesting assisted suicide. General Hospital Psychiatry, 36(1), 7-9.
Tsou, J. Y. (2013). Depression and suicide are natural kinds: Implications for physician-assisted suicide. International Journal Of Law And Psychiatry, 36(5-6), 461-470. doi:10.1016/j.ijlp.2013.06.013

Putting aside cultural and religious views, authors Mendelson and Bagaric (2013) argue that the societal function of law is to protect life. They explain that statistically, legalizing assisted suicide leads to an increase in the destruction of life and is therefore unlawful. The legalization of suicide is primarily fueled by the understanding that suicide survivors need help, not capital punishment. This does not hold true for assisted suicide.

Mendelson, D., & Bagaric, M. (2013). Assisted suicide through the prism of the right to life. International Journal Of Law And Psychiatry, 36(5-6), 406-418. doi:10.1016/j.ijlp.2013.06.012

Washington state passed its own Death With Dignity Law in November 2008 and enacted in March 2009. The act is available to residents who have fewer than six months to live.
Six months later, the Montana Supreme Court passed the Death With Dignity law.

- Euthanasia is viewed as an “exceptional but accepted part of medical practice” in the Netherlands and has been practiced dating back to the 1973 Postma case -
- Technically, practices of assisted suicide and euthanasia are illegal in the Netherlands, however, have been increasingly practiced since the 1990s as it remains decriminalized under certain circumstances.
- Of the physicians interviewed in a study I reviewed, 88% of them had a request to deliver euthanasia
- 53% of the physicians interviewed confirmed they had performed euthanasia before.
- A majority of the cases studied included end of life for people who were older than 65, with an even higher number of people over the age of 80
- The role of the physician is key, as the doctor administers a lethal injection to someone suffering “unbearably” and “hopelessly”
- The request must be voluntary, and made repeatedly, to count as a valid request for Euthanasia.
- There is no requirement that the person be terminally ill, rather that people who are mentally ill, nonsomatic and simply old age with physical deterioration, loneliness and lack of independence.
- There have been instances in which the elderly skip palliative care and opt for euthanasia instead.
- A third of all Dutch doctors hold physician assisted suicide in very old people who are tired of living

- In the Indian Supreme Court there is a difference between the act of killing and not saving a persons life. This is the distinction between the two types of euthanasia under Indian law: active and passive.
- The court defined this as “active euthanasia entails the use of lethal substances or forces to kill a person, and passive euthanasia entails withholding of medical treatment for continuance of life. An important idea behind this distinction is that in passive euthanasia the doctors are not actively killing someone; they are simply not saving them.”

- Switzerland is very liberal in their euthanasia laws
- Article 115 of the Swiss penal code considers assisted suicide a crime if the motive is selfish. It must be performed for “altruistic reasons”
- This doesn’t require the involvement of a physician, nor that the patient be terminally ill, this would cover the mentally ill.
- Suicide is not considered a crime; there is just a search for rationality.
- Performing euthanasia with the role of the doctor is considered less severe than murder, however, still illegal as it is not part of the doctor’s role.
- Any citizen in Switzerland may altruistically assist suicide
- Decriminalizing euthanasia is being proposed to the Swiss parliament, because of the lack of palliative care resources available.

- People from all over the world use the euphemism “going to Switzerland” as a place for assisted suicide, to receive the prescribed drugs. This creates the name “suicide tourism”
- Based off of a study, assisted suicide affected people of all ages – 611 people were studied, in which 58.5% of people were women and the median age was 69.
- The three reasons most recorded were neurological disease, cancer and rheumatic and cardiovascular disease.
- Even tourists are administered the lethal prescription to take their own life in Switzerland.