(Quebec) The College of Physicians asks Quebec to broaden access to medical assistance in dying for people with severe disabilities, rather than just people with severe and incurable “neuromotor” disabilities. This question, which is not unanimous, must be examined in depth, pleads the former MP Véronique Hivon.
The deputies began on Tuesday in Parliament the special consultations on Bill 11, tabled earlier this winter by the Minister for Health and Seniors, Sonia Bélanger. This bill, which takes up the main orientations of Bill 38, which died on the order paper before the call of the last election, has the effect of extending medical aid in dying to people suffering from serious and incurable illnesses, such as alzheimer’s, and to those who have a serious and incurable neuromotor handicap. This second point is controversial.
The College of Physicians asks Quebec not to limit access to medical assistance in dying only to people with a neuromotor disability. “The College wishes that all people with severe disabilities, in an incurable state, afflicted with unrelievable suffering and meeting the established criteria, can have access to medical assistance in dying,” he said. The Quebec Association for the Right to Die with Dignity is of the same opinion.
“The Criminal Code and the guidelines established by the Supreme Court in the Carter decision in 2015, which guide medical assistance in dying across Canada, in no way qualify the notion of disability. There are indeed serious handicaps from birth, which are not necessarily neuromotor. THE [Collège des médecins] therefore requests the withdrawal of this qualifier. Quebec law must fairly grant Quebecers access to this care, not restrict it. From a medical point of view, this situation is unacceptable,” adds the College.
Quebec stays the course
In a press scrum on Tuesday, Minister Sonia Bélanger reiterated that it is important, for her, “to clarify the notion of disability” in the proposed expansion of medical assistance in dying.
“That’s why it is specified in neuromotor disability. The concept of disability is an extremely broad concept. We can talk about visual handicap, auditory handicap, sensory handicap, motor handicap. You see what we’re navigating through. So, we arrive in a very complex concept, I think it is extremely important that we can bring the nuances and mark out, as a precautionary principle, ”she said.
The woman who is described as the mother of medical assistance in dying, the former PQ MP Véronique Hivon, asked parliamentarians on Tuesday to take all the time necessary to hear citizens who wish to express themselves on the inclusion of neuromotor disabilities, or indeed of all disabilities, to the widening of access to this care.
“The issue of disability must at least be the object, through the current exercise of consultations, of meticulous attention and complete openness to hear all the stakeholders who wish to be heard, including opponents, I would even say fundamentally the opponents, so that the deliberative process has all the legitimacy possible and cannot be questioned,” she said.
Advance requests
The Quebec Federation of Alzheimer Societies for its part asked on Tuesday that medical assistance in dying be a treatment that is part of “the discussion that the professional caregiver will have with his patient [au moment du diagnostic d’un trouble neurocognitif majeur, comme l’alzheimer]with the aim of planning and preparing for the different stages of life with [ce trouble] ».
“The competent professional will have to take the time and above all choose the right moment to start this discussion, especially since a diagnosis brings a multitude of emotions, between fear, anger, denial, misunderstanding, bereavement and sometimes even relief” , she said.
The Federation also added that medical assistance in dying “should always be considered in a situation of advanced cognitive decline, as a treatment of last resort, after the medical team has tried everything to relieve the physical and psychological suffering of the person “.
“It also assumes that medical assistance in dying should in no way become the easy solution to the inability of our health and social services system to adequately care for and support the most vulnerable people in our society, until the end of life,” she said.
With Fanny Lévesque, The Press
Bill 11, in a nutshell
- The government is proposing to extend medical assistance in dying to people with serious and incurable diseases, such as Alzheimer’s, and to people with severe and incurable neuromotor disabilities. It also proposes allowing citizens to make an advance request for medical assistance in dying.
- The bill does not list the conditions or illnesses that would now qualify. It also excludes mental disorders from the enlargement planned to access this care.
- Quebec also proposes to require palliative care homes to offer medical assistance in dying. According to the Alliance of palliative care homes in Quebec, 25 of the 35 palliative care homes in Quebec already offer it.
- Bill 11 also removes the criterion of imminent end of life from the conditions that a person must meet to obtain medical assistance in dying. It also allows specialized nurse practitioners to administer it.