The Canadian Supreme Court on Friday unanimously overturned a 1993 ban on doctor-assisted suicide on grounds that it impinged on citizens’ rights. But just how much this ruling will affect individuals hoping to die in Canada remains to be determined over the next 12 months.

No one can stop able-bodied people from ending their lives, the case argued, so preventing terminally ill patients from receiving the help they need to do so should be considered a discriminatory act.

The ruling says that Canadian provinces can no longer “prohibit physician-assisted death” in consenting patients with incurable diseases that cause “enduring and intolerable suffering.” This actually leaves a lot of room for interpretation, and the supreme court has given the government one year to work out the details before the ban is lifted.

A big question: Will Canada choose to allow assisted suicide, euthanasia, or both? And will the country allow non-residents to take advantage of whichever they offer?

Legal euthanasia allows a doctor to administer lethal drugs to a patient – or deprive them of those necessary to their survival – in order to quicken their death. In 2014, Quebec passed the Act Respecting End-of-Life Care, which is meant to allow euthanasia by the end of 2015.

Counter-intuitively, this nationwide ruling in support of the right to die might actually be bad news for the Quebec law: Many nations and states that support the right to die still ban doctor-administered euthanasia in favor of doctor-assisted suicide. If Canadian governments make the same call, the 2014 law could be in jeopardy.

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Physician-assisted suicide has seen wider legalization, probably because it seems less likely to be misused. Laws that allow this option say that patients have to take the lethal medication themselves. They often have to make multiple requests for the drugs and go through a waiting period. In the United States, getting a prescription for drugs intended for suicide takes a lot of jumping through hoops. But in the end, it’s the patient – not the doctor – who makes the final decision.

Vermont, Oregon and Washington state all have laws in place to support physician-assisted suicide. Other allowances exist in other states: In 2009, a Montana court ruled that physicians who assist mentally sound, terminally ill, consenting patients in ending their lives shouldn’t be held criminally liable. And in New Mexico, a judge recently ruled that seeking aid in dying is a terminally ill patient’s constitutional right.

“If a doctor is allowed to give a patient a lethal injection, the doctor is the last actor,” Alan Meisel, a bioethicist at the University of Pittsburgh, told Vox.com. “In Oregon and Washington, the patient is the last actor. And that lets them reserve the right not to act at all.”

U.S. citizens have already indulged in “suicide tourism.” Brittany Maynard, a 29-year-old with terminal brain cancer, famously moved to Oregon from California so that she could get help ending her own life. On Nov. 1, after completing her “bucket list” and surrounded by family, she took a fatal dose of barbiturates prescribed to her by a doctor. Maynard made many statements to the news media about her decision, using her illness and chosen method of death as a platform to promote wider understanding and legalization.

But Canada is unlikely to become the next go-to destination unless it promises less red tape than U.S. states, where residency is easy to obtain. And then there’s Switzerland: A recent study found that 611 non-Swiss individuals visited Switzerland to die between 2008 and 2012. While several European countries allow euthanasia, assisted suicide or both, Switzerland has the most lenient right-to-die laws of all.


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