Laws prohibiting medically assisted death in Canada were struck down by the Supreme Court of Canada in February. The court gave the federal government a year to deliver a new law allowing consenting adults with an “intolerable” – though not necessarily terminal – condition the right to seek medical help to end their lives.

Making life-and-death decisions goes with the territory of being a physician.

It’s a huge responsibility, for it can never be easy to subject a patient to high-risk surgery or a course of treatment that could save a life, but just as easily end it.

Circumstances often leave doctors with no choice but to quickly act when a patient has suffered a severe trauma and requires emergency treatment.

Other cases present a different challenge – the seemingly hopeless cause of a patient with advanced disease when those patients or their loved ones plead for an intervention, no matter how slim the chances of success, that could prolong life.

Sometimes the treatment succeeds and patients recover or live for years. But even if a patient dies after last-chance treatment, physicians can at least comfort themselves with the knowledge they did everything medically possible – and that they honoured the wishes of patients or their families.

All the above decisions are rooted in the long medical tradition of saving lives wherever possible and, at the very least, doing no harm.

What, then, of the patient with a terminal or chronic condition who asks their physician to help them die quickly and painlessly?

That is a proving to be a bridge too far for some physicians, who are not only unwilling to assist in ending a life, but would refuse to refer patients to doctors who would.

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