캐나다의 정신장애와 의료진조력사망에 관한 헌법적 고찰

Abstract

With the development of medical technology, the phenomenon of "medicalization of death" has occurred, and as the period of death is delayed, the number of patients who have to live in extreme pain for a delayed time is increasing. Patients in irreversible conditions that are not treatable and no longer recoverable want to be assisted by professional physicians to ensure that the process leading to death is safe and comfortable while clearly expressing their intention to end their lives. However, most countries punish the act of assisting the suicide of others as a crime, so it is practically impossible to die with the assistance of a physician. Nevertheless, some countries have legalized assisted deaths, such as the Netherlands, Belgium, Canada, Oregon, and Washington, USA. The Supreme Court of Canada recognized the Constitutional Right to end one's own life with medical assistance and emphasized the need to balance individual independence and autonomy with the protection of the vulnerable. Accordingly, the Canadian Parliament legalized medical assistance in dying by stipulating eligibility for medical assistance in dying, safeguards, implementation methods and review of medical assistance in dying, along with provisions exempting criminal penalties for physicians, nurses and person aiding practitioners. Medical assistance in dying would also be available to patients with mental disorders in Canada from March 17, 2024. However, the Canadian Parliament postponed the implementation to March 17, 2027, four years later, because it did not have a complete medical health system to implement the medical assistance in dying of mentally disabled people. The argument that discrimination against mental disorders violates the right to equality and the right to liberty and security of the person and that it is inevitable for special protection for the structurally vulnerable mentally disabled is sharply confronting Canada's legislation. We considered what kind of discussions are taking place on mental disorders and medical assistance in dying in Canada from a constitutional point of view, and looked at the legislation.