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Q: Euthanasia vs Withdrawal of Care ( Answered,   0 Comments )
Subject: Euthanasia vs Withdrawal of Care
Category: Relationships and Society > Law
Asked by: lepacha-ga
List Price: $30.00
Posted: 07 Dec 2003 21:18 PST
Expires: 06 Jan 2004 21:18 PST
Question ID: 284607
What are the legal differences between Euthanasia and Withdrawal of
Care in the province of Quebec?

Request for Question Clarification by techtor-ga on 10 Dec 2003 22:18 PST
Hello Lepacha,
It seems to me that the definition of euthanasia and withdrawal of
care is not finalized in Canada. What I could find is a text of the
special report called "The Special Senate Committee on Euthanasia and
Assisted Suicide", which does have definitions based on several
people's opinions, though they do not seem to have been effected in
law. Would you consider quotes from this document acceptable in
answering your question?

Clarification of Question by lepacha-ga on 11 Dec 2003 09:40 PST
Hi Techtor,

I would like to know what the Civil Code (Qc), Criminal Code and all
other legislations say about the subject. What are the
responsibilities of the doctor/institution? Are there any differences
between minors and adults? What if the patient is not conscious?

Let me know if you need any other information.
Subject: Re: Euthanasia vs Withdrawal of Care
Answered By: techtor-ga on 11 Dec 2003 11:55 PST
Hello Lepacha, 
After some more research, I was able to find some relevant texts
online that refer to Euthanasia and withdrawal of care in Canada. I
believe I have found enough to merit a posted answer.
I believe Canada still considers Euthanasia illegal in essence, but
there's a dilemma on whether refusing medication is legal or not,
based on what I found. The article by Duhaime and company captures
probably the gist of the whole topic for you.

Duhaime and Company - Euthanasia in Canada
Quoted text:
- Two sections of Canada's Criminal Code are relevant:
    "14. No person is entitled to consent to have death inflicted on
him, and such consent does not affect the criminal responsibility of
any person by whom death may be inflicted on the person by whom
consent is given.
    "241. Everyone who counsels a person to commit suicide or aids or
abets a person to commit suicide, whether suicide ensues or not, is
guilty of an indictable offence and liable to imprisonment for a term
not exceeding fourteen years."
Euthanasia is still criminally liable. Note though that the above
clauses criminalize a more active kind of euthanasia.

- This section seems to indicate that withdrawal of care is also not legal:
'Section 215 of the Criminal Code says that "every one is under a
legal - duty to provide necessaries of life to a person under his
charge if that person is unable, by reason of (...) illness, mental
disorder or other cause, to withdraw himself from that charge and is
unable to provide himself with the necessaries of life." The Courts
have captured medical treatment under this section, essentially
preventing doctors from withholding or withdrawing life-sustaining

However, there is this general clause that somewhat condones
withdrawing medical treatment should the patient be the one desiring

"On the other side of the coin, Canadian citizens have a basic right
to refuse medical care and treatment and they have a right to decide
what medical treatment they accept or reject, even if the rejection of
a life-saving procedures leads to their death. This is part of the
Canadian  Charter of Rights and Freedoms  : "every one has the right
to (...) security of the person and the right not to be deprived
thereof." Quebec's Civil Code reiterates this principle. This would
include, for example, Jehovah Witnesses refusing blood transfusions.

Living wills present another legal dilemma. They are documents which
set out guidelines for dealing with life-sustaining medical procedures
in the eventuality of the signatory's sudden debilitation. Living
wills would, for example, inform medical staff not to provide
extraordinary life-preserving procedures on their bodies if they are
incapable of expressing themselves and suffering from an incurable and
terminal condition."

So, I believe that, in relating to your sub-questions above, the
resposibilty of the doctor under the currect Criminal Code should be
to keep providing medical care, but if the patient refuses the medical
treatment, the doctor may comply and not give the treatment.
There are no mentions of differences between minors and adults, so the
ruling applies to all.
If the patient is not conscious, the Criminal Code items prevent the
physician from acting. Most likely, it will be a relative or Living
Will document that will decide.

Canadian Law Dictionary
- "Euthanasia:
The putting to death, by painless method, of a terminally-ill or
severely debilitated person through the omission (intentionally
withholding a life-saving medical procedure, also known as "passive
euthanasia") or commission of an act ("active euthanasia'). See also
living will."

If I were to differentiate the two in my own terms, Euthanasia is
wilfully depriving a person of life to relieve him or her from
suffering, while withdrawal of care can be considered one form of
euthanasia, the passive type. I base this on what I have read in the
above clauses.
Quote from section *Witholding or withdrawing treatment*
'As Mr. Justice Sopinka stated in the Rodriguez decision, there is "a
common law right of patients to refuse consent to medical treatment,
or to demand that treatment, once commenced, be withdrawn and
discontinued" and that "this right has been specifically recognized to
exist even if the withdrawal from or refusal of treatment may result
in death."'

Of Life and Death - Table of Contents
- This is the table of contents of the report by the The Special
Senate Committee on Euthanasia and Assisted Suicide. It just contains
summarized recommendations on modifying Canadian Law.

Of Life and Death - Report
- This is the Final Report with the findings and recommendations of
the committee. Definitions by members of the committee for euthanasia
and withdrawal of care are given.

Quoted text:
"The Committee has defined withholding life-sustaining treatment as
not starting treatment that has the potential to sustain life - for
example, not instituting cardiopulmonary resuscitation (CPR); not
giving a blood transfusion; not starting antibiotics; or not starting
artificial hydration and nutrition.

Withdrawing life-sustaining treatment is stopping treatment that has
the potential to sustain life. Examples include removing a respirator
or removing a gastric tube supplying artificial hydration and

Withholding and withdrawing life-sustaining treatment can be
voluntary, non-voluntary and involuntary:

Voluntary : done in accordance with the wishes of a competent
individual or a valid advance directive. For example, a physician
removes a respirator at the request of a competent individual.

Nonvoluntary : done without the knowledge of the wishes of a competent
or an incompetent individual. For example, when a physician, at the
request of the family, removes a gastric tube supplying artificial
hydration to an individual in a persistent vegetative state whose
prior wishes cannot be determined.

Involuntary : done against the wishes of a competent individual or a
valid advance directive. For example, CPR is withheld from a competent
individual who has requested that all treatment be provided despite
the fact that the health care team has stated that CPR will be

"...Canadian courts have recognized a common law right of patients to
refuse consent to medical treatment, or to demand that treatment, once
commenced, be withdrawn or discontinued (Ciarlariello v. Schacter,
[1993] 2 S.C.R. 119). This right has been specifically recognized to
exist even if the withdrawal from or refusal of treatment may result
in death (Nancy B. v. Hotel-Dieu de Quebec (1992), 86 D.L.R. (4th) 385
(Que.S.C.); Mallette v. Shulman (1990), 72 O.R. (2d) 417 (C.A.).

You will also find citations of various laws in this report.

Other possibly relevant links:
Euthanasia Law and Policy

Euthanasia and Assisted Suicide

eMJA: "Death talk": debating euthanasia and physician-assisted suicide in Australia

Refuting the Rhetoric by ROBERT PANKRATZ, M.D., Canada Physicians for Life

Google Search words used:
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I hope this has been a most helpful answer. If you need anything else,
or have a problem with the answer, do please post a Request for
Clarification before rating and I shall respond as soon as I can.
Thank you.
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