In a quiet Vancouver home filled with family photographs and cherished memories, Lee Carter reflects on the extraordinary legacy of his mother, Kay Carter, whose name became synonymous with Canada’s journey toward medical assistance in dying legislation.
“My mother was always clear about what she wanted,” Lee tells me during our interview at his home. “She had terminal spinal stenosis and faced the prospect of a slow, painful death. She didn’t want her final chapter to be written that way.”
Kay Carter, who passed away in 2010 at the age of 89, became the face of a landmark legal battle that fundamentally transformed Canada’s approach to end-of-life care. After being denied the option of medical assistance in dying in her home country, Kay made the difficult decision to travel to Switzerland, where she could legally end her life on her own terms.
“The journey to Switzerland was both physically and emotionally exhausting,” Lee recounts. “She had to make arrangements while her condition was deteriorating, travel across the globe, and say goodbye to family members who couldn’t make the trip. No one should have to leave their country to die with dignity.”
Kay’s experience prompted her family to join forces with the British Columbia Civil Liberties Association in launching what would become known as the Carter v. Canada case. The legal challenge argued that prohibitions against medical assistance in dying violated Canadians’ rights under the Charter of Rights and Freedoms.
Dr. Ellen Thompson, a palliative care specialist at Toronto General Hospital, explains the significance of the case: “Before the Carter decision, many Canadians with terminal illnesses faced impossible choices. Some ended their lives prematurely while still physically capable, others endured suffering they deemed intolerable, and those with means traveled abroad for assisted dying.”
In February 2015, the Supreme Court of Canada unanimously struck down the ban on physician-assisted dying, ruling that prohibiting the practice violated Canadians’ rights to life, liberty, and security of the person. The ruling set in motion a process that would eventually lead to the legalization of medical assistance in dying (MAiD) across the country.
Though Kay never lived to see the fruits of her family’s advocacy, her influence on Canadian policy has been profound. Since MAiD legislation was enacted in 2016, thousands of Canadians have chosen this option, with the program expanding to include those whose natural death is not reasonably foreseeable.
“She would be pleased but also concerned about implementation,” Lee says. “My mother believed strongly in autonomy and choice, but she also believed in robust safeguards and comprehensive palliative care options.”
Recent statistics from Health Canada show that 13,241 Canadians received MAiD in 2022, representing 4.1% of all deaths in the country—a significant increase from previous years. The program continues to evolve, with ongoing discussions about extending eligibility to those with mental illness as their sole underlying medical condition.
For the Carter family, the legal victory represents both a personal and public triumph. “Kay was always someone who stood up for what she believed in,” says her daughter Price Carter, who joined Lee in the legal battle. “She wouldn’t back down when she knew something wasn’t right.”
As Canada continues to navigate the complex ethical and practical considerations surrounding MAiD, medical ethicists emphasize the importance of balancing autonomy with adequate protections. “The evolution of MAiD legislation reflects our growing understanding of dignity at the end of life,” notes Dr. Michael Sanderson of the Canadian Medical Association. “But we must ensure that vulnerable populations are protected and that choosing death never becomes an alternative to proper care and support.”
Fifteen years after Kay Carter’s death, her legacy continues to resonate across Canadian society. The right-to-die movement she helped catalyze has fundamentally altered how Canadians approach end-of-life decisions, empowering individuals to make choices aligned with their values and circumstances.
As our society continues to grapple with these profound questions about autonomy, dignity, and the boundaries of medical care, one question remains at the heart of this ongoing national conversation: How do we honor individual choice while ensuring that our healthcare system provides comprehensive support for all possible end-of-life journeys?
