The Conflict between Open-Ended Access to Physician-Assisted Dying and the Protection of the Vulnerable: Lessons from Belgium's Euthanasia Regime for the Canadian Post-Carter Era
Bibliographic record
Abstract
With the Carter case, the Canadian Supreme Court invalidated Canada’s criminal law provisions prohibiting Physician Assisted Dying (PAD), but it gave the federal and provincial legislators an opportunity to create a regulatory structure around the practice aimed at protecting people who are vulnerable. An influential Provincial Territorial Advisory Group immediately recommended the introduction of a regime that would be more lenient and open-ended than Belgium’s, which is currently arguably the most liberal regime. This chapter shows why the federal parliament can and should respond by introducing an exceptional regime, based on the criminal law, that allows PAD only in narrow circumstances, under strict conditions, and with appropriate prior review. The strong pressure to create a Belgian-style regime makes it crucially important to understand what is happening in real life in a system that combines open-ended access criteria with a reliance on competency and informed consent assessment by individual physicians, and only limited post-factum reporting and evaluation. Following an overview of the key features of the Belgian system, the chapter discusses key evidence and relevant case reports to highlight some of the problematic features of this system. The author concludes with a call for the introduction of an exceptional regime, situated within the criminal law, which combines rigorous review and prior authorization with post-factum reporting.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.023 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.017 | 0.021 |
| Scholarly communication | 0.015 | 0.004 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.006 | 0.008 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".