Practice guide issued by Quebec health care profession regulators
Introduction
Sean Murphy*
Quebec’s Act Respecting End of Life Care (ARELC) was passed in June, 2014 and comes into effect in December, 2015. When enacted, the law purported to legalize euthanasia in the province, but its actual legal effect was questionable because Canadian provinces do not have jurisdiction over criminal law. Only the Canadian federal government can make laws governing homicide and suicide.
However, in February, 2015, the Supreme Court of Canada released its decision in the case of Carter vs. Canada. The Court struck down the criminal prohibition of homicide and assisted suicide to the extent that it prevents the provision of physician assisted suicide and physician administered euthanasia for a certain class of patients. The Court specified that the law cannot prevent the procedures for competent adults who are suffering intolerably as a result of a grievous and irremediable medical condition, which cannot be relieved by other means acceptable to the patient. The declaration of invalidity was suspended for one year to allow the government time to revise the law.
The federal government under Conservative Prime Minister Stephen Harper took no action until mid-July, when it appointed a panel to study the issue and offer advice about legislative options. The government was defeated in the federal election in October, and it remains unclear what direction the new Liberal government will take.
ARELC thus comes into force about two months before the Supreme Court ruling in Carter takes effect, while the criminal prohibition of euthanasia and assisted suicide is still in place. However, the guidelines for euthanasia in ARELC are actually more restrictive than those proposed by the Supreme Court of Canada in Carter, so it seems doubtful that the federal government will challenge the Quebec law.
In August, 2015, the state regulators of the professions of medicine, pharmacy and nursing jointly issued an 88 page Medical Aid in Dying Practice Guide to direct the provision of euthanasia in Quebec. The Guide appears to be available only in French, and is currently accessible only through a password protected portal on the Collège des médecins du Québec website, or by making an access to information request. However, the Guide also states that it can be reproduced as long as the source is acknowledged.
What follows is a partial machine assisted English translation of the Guide set opposite the original French text. For ease of reference, each translated segment is identified by a translation number (T#). Only those parts of the Guide that appear to have some relevance to freedom of conscience are reproduced here.