In February 2015 in the case of Carter v. Canada, the Supreme Court of Canada ruled that the criminal prohibition of assisting in suicide and of consenting to one's own death is contrary to the Canadian Charter of Rights and Freedoms.

This decision marked a change in ruling since 1993, where the prohibition of assisted suicide was challenged by Sue Rodriguez, claiming the prohibition violated the Canadian Charter of Rights and Freedoms. In this case, the Court ruled the criminal prohibition to be in accord with the charter.

Essentially, over a period of 20 years, during which time other similar cases were brought to court, the Supreme Court of Canada changed its stand on assisted suicide, from ruling its prohibition to be well founded, to ruling its prohibition to be contrary to the charter of rights and freedoms.

Once the Supreme Court made its decision in February 2015, it delegated to the Canadian Parliament the amendment of the criminal code so as to remove the prohibition of assisted suicide. As of June 17, 2016, assisted dying was legalized and opened for regulation in Canada.

In Canada, assisted dying is a blanket term and it consists of euthanasia, where a medical professional administers to the person requesting death a substance that causes death, and assisted suicide, where a medical professional provides the person requesting death a self-administering substance that causes death.

The criteria for obtaining assisted dying according to Canada's updated criminal code are: to be at least 18 years of age, competent in making decisions regarding health, have a grievous and irremediable medical condition, have requested assisted dying, and have been informed of other means of relieving suffering.

While Canada's criminal code has been updated to include assisted dying and criteria for obtaining it, there are still many ambiguities in terms of its implementation and who qualifies to obtain it. One ambiguity is whether assisted dying should be extended to prison inmates.

As Canada considers extending assisted dying to prison inmates, it looks to the experience of other countries who have legalized assisted dying and how they handle the question of prison inmates.

In Belgium, there have been two controversial cases of inmates requesting or considering euthanasia. The first was Frank Van den Bleeken, a convicted rapist and murderer, and the second Farid Bamouhammad, a convicted gangster.

Van den Bleeken claimed he was unable to change his ways and it would be better to die than spend the rest of his life in jail. His request was initially granted but the medical professional assigned to euthanize him refused, arguing Van den Bleeken was eligible for psychiatric treatment.

Bamouhammad was put in isolation for an extended period while in prison, and it was this experience, which he described as living "in darkness, in hell" that caused him to consider euthanasia as a way to escape the suffering. He did not follow through with a request for euthanasia, and has since then been released from prison and has confessed remorse for his actions.

Given the criteria of eligibility for assisted dying in Canada’s criminal code, it is clear how many prison inmates meet the criteria for accessing assisted suicide, especially since many suffer serious health problems.

However, it is not clear if correctional facilities will extend assisted to their inmates due to the unique context and environment of a prison. Investigations and research have been undertaken to determine how exactly the law will be applied to the prison context.

However, as Canada's law currently stands, inmates of correctional facilities in Canada should have the same access to medical and healthcare as they would if they were free. Since assisted dying is considered a medical treatment, it follows that prison inmates should have equal access to assisted dying.

There are many who argue euthanasia should not be extended to prison inmates. Firstly, there are those who argue a convicted person in prison should face their whole sentence and not be able to escape by death. Another perspective is that assisted dying is not the best medical option for prison inmates.

Many prison inmates, like Van den Bleeken, suffer from many psychological and physical disorders and pain but they do not receive the care they should. This leads to request for euthanasia, but rather than let these inmates die from lack of care, they should be able to access the treatment they need to cope with their suffering.

It is often seen as a last act of freedom to request for assisted dying. Since prison inmates are generally restricted in their freedom, it would seem right to grant them this exercise of their freedom.

However, as can be seen by Van den Bleeken and Bamouhammad, euthanasia is requested by prison inmates when they are at their lowest, and have lost hope of changing and being released. But, as Dr. Viktor Frankl noted in his work, Man’s Search for Meaning, "There is nothing conceivable which would so condition a man as to leave him without the slightest freedom."

Not even prison, with its isolation or severe mental and physical suffering, can condition its inmates to be completely void of freedom. And while there is freedom, there is hope for change. Inmates who request assisted dying exercise their freedom, but in so doing, they are deceived, as well as everyone involved, in thinking they have no freedom to do otherwise.

Cover credit: Toon Pool