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Euthanasia and assisted suicide: comparison of legal aspects in Switzerland and other countries.

The purpose of this paper is to present the legal aspects associated with assisted suicide in Switzerland and compare them with those in other countries. Like euthanasia, assisted suicide is a subject that induces much discussion in many countries. While the law is very liberal in some countries, such as Belgium and the Netherlands (where both euthanasia and assisted suicide take place), these practices are very controversial in other countries, such as France, where they remain taboo subjects. In the United States of America, the laws concerning assisted suicide can differ greatly from one state to another. For example, in Oregon, assisted suicide is allowed if applied by a medical doctor; in others, this act is illegal. In Canada, it is punishable according to the Criminal Code. In Switzerland euthanasia is punishable by law. However, the penal code does not condemn assisted suicide, whether carried out by a medical doctor or another person, provided it is not carried out through selfish motives. The application of these practices has become simplified in recent years and societies for the right to die with dignity based on this principle have come into being (Exit and Dignitas). In the French- and German-speaking parts of Switzerland the association Exit assists individuals living in Switzerland with serious progressive and incurable disease in their engagement to end their life. The association Dignitas, in the German-speaking part of Switzerland, also undertakes--in the same circumstances--to assist individuals coming from foreign countries. Dignitas welcomes several such individuals every year, especially from Germany, where a similar approach does not currently exist.

Cross-Cultural Comparison↗

Tightening the reins: recent trend in the application of the insanity defence in Canada.

This article gives a critical overview of the Canadian courts' recent pronouncements on the so-called 'insanity defence', irresistible impulse, non-insane automatism and the disposition and rights of insanity acquittees. The inconsistencies and conflicts between a number of court decisions relating to section 16(2) of the Criminal Code are highlighted and reform proposals analysed.

Canada↗

Firearm-related injuries in Canada: issues for prevention.

We reviewed the available data on firearm-related injuries in Canada to suggest strategies for prevention in the context of the proposed amendments to the Criminal Code (Bill C-17) currently before Parliament. The risk of death from a firearm in Canada is equivalent to the risk of death from a motor vehicle crash. We discuss the risks associated with firearms with regard to suicides, homicides and "accidents." We also discuss the accessibility of firearms. This article builds upon a recently published update on the epidemiologic basis of the public health approach for the prevention of firearm-related injuries and deaths. The key to the etiologic approach to preventing such injuries and deaths is to view the incidents, regardless of their medicolegal circumstances, as having one factor in common: the discharge of a firearm.

Accident Prevention↗

The role of the medical laboratory technologist in drinking and driving cases. Part 1: The Criminal Code and blood collection for alcohol analysis.

Police officers can now demand blood samples from suspected impaired drivers in Canada to determine their Blood Alcohol Concentration. The medical laboratory technologist has been given the authority to take blood samples for legal purposes, as well as the authorization to complete certificates used as evidence in court. The proper procedures for the taking of blood samples and the completion of certificates are described in detail. The Criminal Code offences dealing with drinking and driving, the means by which police officers can legally obtain blood samples, the Blood Alcohol Kit, and the provision of providing blood collection evidence in court are discussed to aid the technologists in understanding their role in this process. The Criminal Code definitions of a "qualified medical practitioner", a "qualified technician", and "approved containers" are also described.

Alcoholic Intoxication↗

Criminalization of assisted suicide challenged.

In September 1999, Jim Wakeford, a Toronto man with HIV/AIDS, launched a civil action against the Attorney General of Canada, challenging the constitutionality of sections of the Criminal Code that criminalize assisted suicide.

Crime↗

"Bad law" argument in Morgentaler v. The Queen.

The issues raised by the Crown on appeal in Morgentaler v. The Queen from the acquittal of the accused were rendered moot when the Supreme Court of Canada declared the abortion statute (section 251 of the Criminal Code) to be unconstitutional. There was no need for the Court to discuss either the issue of the use of the "defence of necessity" or defence counsel's "bad law" argument. Nevertheless, Chief Justice Dickson found the "bad law" argument of defence counsel, Morris Manning, Q.C., "so troubling," he felt "compelled to comment" on it. Mr. Manning argued that, although the jury was to take its instructions in the law from the judge, it had a right not to apply the law in the case to the facts because the abortion statute was "bad law." In his decision, Chief Justice Dickson reiterated that it is the duty of the judge to instruct the jury in the law and the function of the jury to apply the facts to the law, and that Mr. Manning was wrong to tell the jury otherwise. Among other things, the Chief Justice used a "racist jury" example to demonstrate Mr. Manning's error. The author argues in this comment that the Chief Justice's example was ill-conceived and inapposite, and concludes that the jury and Mr. Manning should be commended for helping to rid Canada of an oppressive abortion law.

Abortion, Induced↗

The right to die in Canadian legislation, case law and legal doctrine.

This article discusses moral, social, medical and legal problems pertaining to the so-called 'right to die' from the perspective of Canadian criminal legislation (the Criminal Code), constitutional law (the Charter of Rights and Freedoms) and court rulings. Regarding the latter, the opinions delivered in Nancy B v Hôtel-Dieu de Quebec and Rodriguez v British Columbia (Attorney General) are especially significant. In Rodriguez, the Supreme Court of British Columbia unequivocally rejected the petitioner's submission that the Charter of Rights and Freedoms guarantees the right to die. This judgment was upheld on appeal by both the British Columbia Court of Appeal and the Supreme Court of Canada. In addition, the article addresses the complex problem of legislating the right to die in Canada. Several options are examined, such as professional judgment and advance health care directives including living wills and powers of attorney for health care. In this context, the recommendations adopted by both the Law Reform Commission of Canada and provincial commissions are analysed. Finally, the article discusses the legislation proposed recently in Alberta, Manitoba, Newfoundland, Ontario and Saskatchewan. It seems doubtful, however, whether a nation-wide solution will be found in the near future.

Advance Directives↗

CMA abortion survey.

Responses to the question as to whether abortions should be performed at the woman's request during the first trimester of pregnancy were evenly divided. There was support for abortion on socioeconomic grounds, during the first trimester, from 61.5% of the respondents. Termination of pregnancy beyond the first trimester was supported by a majority of the respondents only in cases in which the woman's life is in danger (73.9%) or in which there is evidence of a severe physical abnormality in the fetus (70.6%) or in cases in which the woman's physical health is in danger (55.5%). Those who said they would not support abortion under any circumstances constitute, at most, 5.1% of the respondents. Support for the maintenance or the elimination of therapeutic abortion committees was addressed in two questions and in both cases the respondents were evenly divided. The responses to these two questions were compared and found to be logically consistent. Only physicians should perform abortions, and they should be performed in hospitals with the woman either as an inpatient or, during the first trimester, as an outpatient. The performance of first-trimester abortions in provincially approved abortion clinics was supported by 47.3% of the respondents. Of the 885 respondents who wished to see some amendment to the Criminal Code, 409 stated that the term "health" as used in the Criminal Code relative to the legal grounds for therapeutic abortion should be defined.

Abortion, Therapeutic↗

Borowski v. Attorney General of Canada, 30 April 1987.

The Court upheld the decision of a lower court that provisions of the Criminal Code providing that abortions may be authorized by therapeutic abortion committees do not violate sections of the Canadian Charter of Rights and Freedoms. It ruled that a fetus is not included within the terms "everyone" or "every individual" and thus not entitled to the rights conferred on born persons. It based its ruling on the status of the fetus historically under common law and its status under present-day law in the United States and the European Economic Community. It also pointed to legislative history indicating that the Charter was intended to be neutral with respect to abortion and the rights of the fetus.

Abortion, Induced↗

The Canadian Criminal Code provisions for mentally disordered offenders: a survey of experiences, attitudes, and knowledge.

OBJECTIVE: To systematically survey Alberta psychiatrists and lawyers regarding their knowledge of, attitudes toward, and experiences with the Criminal Code provisions regarding mentally disordered offenders to better understand the lack of impact in practice patterns. METHOD: A survey design was used, and 2 questionnaires, 1 for lawyers and 1 for psychiatrists, were developed and mailed out. RESULTS: Out of 245 surveys sent to psychiatrists, 141 were returned, giving a response rate of 57%. The number of lawyers practising criminal law could not be determined, and 5273 surveys were sent to all lawyers on the Law Society of Alberta mailing list. Of these, 564 were returned, giving an overall response rate of 11%. The response rate for lawyers practising criminal law is unknown. Overall, lawyers were younger than psychiatrists. Most of the respondents in both groups were men. Overall, attitudes toward offenders with mental illness were very similar among lawyers and psychiatrists. Compared with lawyers, psychiatrists had significantly more correct responses to the items assessing knowledge. With a highest possible knowledge score of 27, the average score was 16 (SD 5.7) for psychiatrists and 13 (SD 7.23) for lawyers. CONCLUSIONS: The lack of familiarity with many of the key provisions among psychiatrists and lawyers is worrisome and suggests the need for educational materials to improve knowledge of the Criminal Code provisions governing mentally disordered offenders.

Adolescent↗

Living wills and medical treatment of the terminally ill.

A terminally ill individual may sign a living will, which is a document requesting to be allowed to die a natural death, have it witnessed and address this wish to a relative, physician, lawyer or medical facility. No legislation, however, exists in Canada concerning living wills. Consequently, establishing the legal situation is based on both legislative and non-legislative sources. This article explores implications of the Criminal Code, the application of rules of criminal and civil law, provisions of the Charter, living will legislation in the United States and the power of attorney approach regarding this controversial issue.

Canada↗

Legal Network report calls for decriminalization of prostitution in Canada.

In December 2005 the Canadian HIV/AIDS Legal Network released Sex, work, rights: reforming Canadian criminal laws on prostitution. The report examines the ways in which the prostitution-related provisions of the Criminal Code, and their enforcement, have criminalized many aspects of sex workers' lives and have promoted their social marginalization. Evidence indicates that the criminal law has contributed to health and safety risks, including the risk of HIV infection, faced by sex workers. The Legal Network calls for the decriminalization of prostitution in Canada, and for other legal and policy reforms that respect the human rights and promote the health of sex workers. Despite the report's Canadian focus, its human rights analysis is relevant to the situation of sex workers in other countries where prostitution is illegal and sex workers face rights abuses. In this article, Glenn Betteridge, the principal author of the report, briefly sets out the case for law reform.

Canada↗

Reports call for end to harms caused by Criminal Code prohibitions surrounding prostitution.

The sale of sexual services between consenting adults is legal under Canadian law, yet the Criminal Code prohibits many activities related to prostitution and the sex trade. As a result, many people who work in the sex trade come into conflict with the law. In recent reports, two Canadian organizations have called for the repeal of the current Criminal Code prohibitions on activities related to the sex trade. Pivot Legal Society's report, "Voices for Dignity: A Call to End the Harms Caused by Canada's Sex Trade Laws," was released in March 2004. The Conseil permanent de la jeunesse, a 15-member advisory panel to the Québec government, released "Prostitution de rue: avis" in April 2004.

Canada↗

An update on elder abuse and neglect.

Abuse and neglect of the elderly represent an important social problem in Canada. Forms of elder abuse and neglect include physical, psychological and material abuse; neglect, both intentional and unintentional; and violation of legal rights. The definitions, signs, and symptoms of elder abuse and neglect are discussed, as are estimates of incidence and prevalence, and descriptions of possible risk factors. The evolution of legislation regarding the reporting of elder abuse and neglect is reviewed, as are relevant areas of common law, the Civil Code, and the Criminal Code. This is followed by an overview of practical considerations in clinical management, and finally by recommendations for further research.

Aged↗

[Penal aspects of psychiatric intervention: management modes and impact of new criminal legislation].

Psychiatry and criminal justice have been closely related for a long time. Traces of such ties can already be found during the 19th century through the establishment of the contemporary systems of social control. Various questions that will mark the development of policies in this domain were important objects of discussion and analysis: Is mental illness a cause of criminality? Should the "insane" be held responsible for their crimes? What are the appropriate measures to heal, reform, control? In other words, should we consider the individual as sick or as criminal? If these questions are formulated differently nowadays they haven't lost any of their relevance. In this article, we will briefly present the forms of intervention available to the criminal justice system when dealing with persons suffering from mental health problems. This presentation is based on recent studies conducted in Montreal, elsewhere in Canada, as well as in the United States. The main stages of the criminal justice process will be examined, taking into account the recent modifications to the Canadian Criminal Code and its impact on the relations between the courts and psychiatric facilities. This type of situation is not without impact on community mental health for two main reasons. First, with the diminishing public funding of various health services there seems to be a growing practice of criminalization of persons suffering from mental health problems, especially the most vulnerable segments of this population. Secondly, there is a growing trend, in the criminal justice system, of requiring support from community groups or facilities to deal with these criminalized individuals. In the coming years criminalization will constitute an increasing and complex challenge for community mental health.

Canada↗