OTTAWA—The lead lawyer who won the landmark Carter case at the Supreme Court of Canada has blasted the Liberal government’s bill to limit medically assisted suicide as “clearly unconstitutional.”

As a wrenching and emotional debate over how to legalize medical aid in dying began in earnest Thursday, Vancouver lawyer Joe Arvay, a paraplegic, rolled his wheelchair into the justice committee, shifted his body into a witness chair before microphones, and took aim at Bill C-14 and the minister responsible for it.

He said in the wake of the ruling in Carter v. Canada, Justice Minister Jody Wilson-Raybould’s proposal to limit the legal right to a doctor-assisted death to only those with incurable disease, disability or illness whose natural death is reasonably foreseeable is “not Carter compliant.”

“Parliament cannot now exclude a whole category of such persons — the physically disabled whose natural death is not reasonably foreseeable — from their charter right,” Arvay said.

He argued Parliament’s response must be “must be more procedural rather than substantive,” like setting out how many doctors must sign off or other safeguards to ensure a patient gives voluntary, informed consent. He said the government has “become captured by the rhetoric of the disabled rights organizations.”

At the Senate committee, Arvay went further and criticized the minister’s claims the bill passes constitutional muster: “To suggest the bill is constitutional because the minister thinks there’s some people who believe it should only go this far is, in my respectful submission, is not legal reasoning and has no merit.

“The Carter decision is the final word on the minimum rights that Canadian citizens are entitled to and those minimum rights are not limited to illnesses that are terminal. (Wilson-Raybould is) just wrong, I’m sorry to say.”

The top court declared unanimously in February 2015that the Criminal Code’s absolute ban on assisted suicide was unconstitutional, struck it down and gave Ottawa a year to rewrite it

Other witnesses appearing at the committee, such as Catherine Frazee, professor of disability studies at Ryerson University, however, pleaded for amendments to build in greater safeguards to protect the “vulnerable.”

Witnesses proposed a range of amendments:

Judicial review of every medical-assistance request.

Mandatory palliative care consultations for patients wanting to a doctor’s help to die.

Restrictions on who can aid a patient to die so as to exclude nurses, pharmacists or family members.

A guaranteed right of physicians to refuse treatment on religious or conscience grounds.

Stricter reporting and data-gathering requirements for greater transparency.

“I believe this is the single most important decision you will ever make as senators,” said ethicist Margaret Somerville, professor in law and medicine at McGill University. “I believe it will be the landmark decision of the 21st century.” She urged a conservative, “very strict, limiting” approach. “It must not become the normal way to die.”

Psychiatrist Harvey Chochinov, who holds the Canada Research Chair in Palliative Care at the University of Manitoba and was a member of a Conservative government-appointed external review committee in response to the Carter decision, said fears of a “slippery slope” are justified.

He extrapolated from statistics in Belgium to warn the proposed Canadian regime could lead to 8,000 to 10,000 people a year in Canada dying with medical assistance.

University of Toronto professor Trudo Lemmens, who holds the Scholl Chair in health law and policy, cited an academic article this month that says since Belgium legalized euthanasia in May 2002, there have been 9,400 cases up to 2015; there are now more than 5 reported euthanasia cases per day.

Sen. George Baker pointed to Quebec Health Minister Gaétan Barrette’s confirmation that about 50 cases of doctor-assisted death have occurred in Quebec since a provincial law took effect early this year, and said there are not enough court resources to require Superior Court judges to review and decide on every application.

But Arvay’s criticisms were personal and forceful.

“For many disabled people — and I’m one of them — we’ve managed to tolerate and adapt to our suffering and choose life over death. But to suggest that all physically disabled people have to subscribe to that notion is not just patronizing, it’s infantilizing,” he said.

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“It’s treating all physically disabled people as children incapable of agency and autonomy and I just find that incredibly offensive. The trial judge did. The Supreme Court of Canada did. I don’t get why this government doesn’t understand that.”

Asked whether there would be significant gaps if the legislation fails to pass by the high court’s June 6 deadline, the Canadian Medical Association’s vice president Dr. Jeff Blackmer said it is “hard to say.”

He said the medical community has passed draft or final regulations in almost all provinces and that “by and large we’d be ready to go on June 6” with or without the federal bill, although Bellemar acknowledged it’s “hard to say what that would look like province to province.”