Assisted suicide is climbing up the public agenda, whether politicians want it to or not

A few years from now we may look back on the last couple of weeks as a tipping point in the debate over assisted suicide. Or is it death with dignity, the right to die, physician-assisted dying or euthanasia? What you call it often depends on where you stand.

It was on the agenda for Canada's health ministers when they met in Toronto, though they were reluctant to talk in detail about their discussion.

"What I can say collectively is that there are many standing here that are torn on this matter and believe that this is a conversation whose time has come," Manitoba Health Minister Theresa Oswald told reporters, according to The Canadian Press.

"That doesn't mean that they are fors or againsts. I think that there are people standing here – and certainly in my province –that believe we should be having a national conversation about this."

Oswald said the Manitoba government takes no position on the issue but that any conversation must be "entrenched in compassion."

[ Related: Will late SARS scientist Donald Low’s deathbed plea rekindle debate over assisted suicide? ]

Federal Health Minister Rona Ambrose told reporters she was willing to have that conversation.

"It is an important conversation to have and of course all of us have had these conversations around the kitchen table," CP reported her saying.

But she quashed any prospect that a conversation could lead to legislation. Ottawa's official policy is to oppose sanctioning assisted suicide, in line with a 2010 motion tabled in the House of Commons, Ambrose said.

But there's evidence the conversation is destined to leave the kitchen table soon based on three developments.

While the Parti Quebecois' so-called values charter is creating a lot of political heat for the province's minority government, the right-to-die legislation it tabled last spring potentially could have a much deeper impact on Canada as a whole.

The federal government vowed it would review any Quebec law to see if it violates Criminal Code sections against assisted suicide. As CP reported last June, Bill 52 is seen mainly as a health-oriented measure that is within provincial jurisdiction. It calls for an expansion of palliative care, setting physician protocols for sedating patients until they die a natural, pain-free death and guidelines for patients who want that pain to end.

"It's not assisted suicide," Quebec Health Minister Rejean Hebert said Friday. "It's medical aid for dying."

Other ministers at the meeting "were very interested of what's going on in Quebec and very interested in following ... the evolution of this bill," he said.

[ Related: Landmark B.C. assisted suicide appeal adjourned due to lawyer’s illness ]

Meanwhile, the B.C. courts are dealing with a renewed constitutional challenge to the ban on assisted suicide. The B.C. Court of Appeal is hearing a federal appeal of a B.C. Supreme Court ruling last year that declared the prohibition violated Charter rights to equal treatment, discriminating against people with disabling injuries or illnesses because the able-bodied can legally kill themselves.

At a hearing last spring, Joe Arvay argued people with debilitating illnesses now have a cruel choice, end their lives before they become too sick to do so or face a painful death.

"So they're given the choice: torture or early death," he told the court, according to CP. "And some people will take the early death, because they were driven to that choice by the law."

Whatever the B.C. court's ruling, the case is bound to reach the Supreme Court of Canada two decades after the high court rejected a Charter challenge in the Sue Rodriguez case.

Finally, respected scientist Dr. Donald Low's YouTube video made the issue personal. The Toronto microbiologist who was the face of the SARS crisis, days away from dying of a brain tumour, explained how his illness had eroded his dignity and robbed him of final control of his fate.

Most people clearly understand the pros and cons of legalizing assisted suicide, so I won't rehash them here. And polls suggest a majority of Canadians support physician-assisted death under tightly controlled rules.

What we should be watching for is a change in the social current, as happened in the equally contentious debates over legal abortion and gay marriage.

[ Related: Ontario premier conflicted on assisted suicide, supports national debate ]

Sometimes legislation or court decisions simply affirm what society has already accepted. Politicians, professionally adept at reading the public mood, may then sign on.

"It is a rare government that would pull the pin on a grenade and toss it into its own nest while it is trying to drive an agenda focused on tax credits, pipelines, trade deals and sound fiscal management," Toronto Star columnist Tim Harper wrote last month, not long after Low's plea pushed the debate back into the forefront.

"But a brave government would see an issue hurtling at them down the highway and look beyond the next Throne Speech, budget and election.

"We may have hit that point on assisted suicide with the mix of an aging population and an empowered baby boom generation, used to exercising control and power over their own destiny, demanding that right on decisions concerning their death."

Harper said the inevitable Supreme Court decision will likely put the issue back in the hands of Parliament, where it belongs.

"We owe Low a vote of gratitude for posthumously hastening a public debate over something already the subject of heart-wrenching private debate."