One reason cited in the decision was the increasing meaninglessness of geographic borders: "In the new ruling, the court found the breadth of the Charter has changed since the early 1990s. It also said the social landscape has evolved, because assisted dying is permitted in other places such as Belgium, Switzerland, and Oregon." In fact, Kathleen Carter, the mother of a plaintiff in this case, traveled to Switzerland to commit suicide.***

In the U.S., it's not just Oregon. Washington and Vermont also allow terminally ill adults to get lethal prescriptions from doctors, but the laws require any patients to be residents of those states. (A court in Montana struck down laws penalizing doctors.) Since the Canadian charter covers individuals "without discrimination based on race, national or ethnic origin," Friday's ruling would seem to allow Americans access to assisted suicide in Canada—perhaps opening up a corridor for suicide tourism—but no one is exactly sure what the ruling means for foreign nationals, according to Canadian advocates, and the answer could depend on what sort of law if any parliament passes.

"Death with dignity," as advocates call it, was in the news in the U.S. in November, when 29-year-old Brittany Maynard, terminally ill with aggressive brain cancer, chose to end her life. That case brought out intense passions, especially among social conservatives for whom "pro-life" doesn't just mean opposition to abortion laws—it also means the preservation of adult life. Overall, however, a majority of Americans seem to favor assisted suicide, though the way the question is phrased changes the level of support:

Support for Assisted Suicide

Gallup

Maynard's situation is unusual. A more typical case is perhaps that of John Rehm, the husband of NPR host Diane Rehm:

His Parkinson’s disease had become unbearable. “He just kept getting weaker,” the NPR host told NBC News. “We called in the doctor and John said to him: ‘I am ready today.’ He said ‘I can no longer use my legs, I can no longer use my arms, I can no longer feed myself.’ And knowing with Parkinson’s it is going to get worse rather than better, he said ‘I wanted to die.’” He asked the doctor for help. The answer they got surprised and disappointed both of them. “The doctor said ‘I cannot do that legally, morally or ethically’,” Rehm said. “He said ‘I don’t disagree with your wish that you could die with the help of a physician but I cannot do it in the state of Maryland.’” John Rehm had to deliberately die by dehydration. It took nine days. “John said he felt betrayed,” Rehm said. He said, ‘I felt that when the time came, you would be able to help me.’”

As health care improves and prolongs life, cases like this may become more and more common. People who would have died much sooner will instead survive to suffer from slower, more painful illnesses. Despite efforts to expand hospice and palliative care, a report this week found a 12 percent jump over the last 15 years in the number of Americans who suffered pain in the last year of life.