<<< HUMAN RIGHTS PETITION FORM >>>

Note: Member of Parliament Svend Robinson (Burnaby-Kingsway) has agreed to
present the following petition to Parliament this fall.  It is the
Society's task to ensure that as many Canadians as possible have the
choice of signing this document.  Our aim is to collect the great number
of signatures ever obtained on a petition dealing with a social issue.  We
hope you will "lend a hand" - literally.

Petition Forms may also be obtained by requesting one or more sheets
through E-mail: rights@freenet.victoria.bc.ca

Each form has provision for twelve (12) signatures.


TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLED:

WE, THE UNDERSIGNED RESIDENTS OF CANADA, DRAW TO THE ATTENTION OF THE
HOUSE THE FACT THAT THE CURRENT CRIMINAL CODE DENIES PEOPLE WHO ARE
SUFFERING FROM TERMINAL OR IRREVERSIBLE AND DEBILITATING ILLNESS THE RIGHT
TO CHOOSE FREELY AND VOLUNTARILY TO END THEIR LIVES WITH THE ASSISTANCE OF
A PHYSICIAN;

THEREFORE, YOUR PETITIONERS CALL UPON PARLIAMENT TO AMEND THE CRIMINAL
CODE TO ENSURE THE RIGHT OF ALL CANADIANS TO DIE WITH DIGNITY, BY ALLOWING
PEOPLE WITH TERMINAL OR IRREVERSIBLE AND DEBILITATING ILLNESS, THE RIGHT
TO THE ASSISTANCE OF A COMPASSIONATE PHYSICIAN IN ENDING THEIR LIVES AT A
TIME OF THEIR CHOICE, SUBJECT TO STRICT SAFEGUARDS TO PREVENT ABUSE AND TO
ENSURE THAT THE DECISION IS FREE, INFORMED, COMPETENT AND VOLUNTARY. 

PRINT NAME CLEARLY   Signature   Street Address   City   Prov   Post Code