Right-to-die already weighing on Quebec’s conscience

 New law has hospitals, doctors grappling with old fears, new moral burdens

Toronto Star

Allan Woods

MONTREAL—Quebec passed a landmark euthanasia law earlier this month meant to end the agony in the final days of a terminal patient’s life. But the legislation has lumped the province’s medical community with an existential burden it is only now confronting.

Doctors are weighing their consciences against their looming legal responsibilities to dying patients. It’s not entirely clear which one will win the day.

“I’ve been working in clinical ethics as a physician for 24 years and this is going to be one of our biggest challenges,” says Dr. Eugene Bereza, director of the centre for applied ethics at Montreal’s McGill University Health Centre.

The process that led to Bill 52, the so-called Medical Aid in Dying legislation, was wrenching enough in a society where the government, school and hospitals were a proxy for the Catholic Church not two generations ago. . . . [Full text]

West Island Palliative Care Residence clarifies care it offers following passage of Quebec’s end-of-life legislation

Hospice statement 5 June following passage of euthansia law in Quebec

Will continue to provide care and comfort to terminally ill but will NOT act to hasten natural process of death

For immediate release

KIRKLAND, Quebec – June 5, 2014 – In light of the passage today by the National Assembly of new Quebec end-of-life legislation, the West Island Palliative Care Residence wishes to clarify that the new legislation will not change in any way the services it provides to terminally ill patients.

The Residence will continue to act in the way it always has – to provide the best possible care and comfort, including symptom relief to the dying but without taking any actions that hasten the natural process of death.

The new Quebec legislation permits, under certain conditions, Quebec health institutions and health professionals to provide “medical aid in dying” – the administration of drugs or other actions to intentionally cause the death of a patient. The legislation also permits any health professional as well as “palliative care hospices,” of which the West Island Palliative Care Residence is one, the option to choose not to do so, provided patients are informed that this is the case.

The West Island Palliative Care Residence has chosen to exercise this option and to make no change to the type and methods of care it delivers, meaning it will not take actions that intentionally cause a patient’s death.

“The goal of good palliative care is never to hasten the end of life,” said Teresa Dellar, Co-Founder and Executive Director of the Residence. “We make the last days of life as comfortable and pain-free as possible so patients can live them in the best possible manner.” In fact, she noted, good palliative care from early on in a terminal illness has been shown in clinical studies to both extend patients’ lives and improve their quality of life.

“If we as a society are going to offer more choices to patients at the end of life, as this legislation does, then we must ensure one of those choices is ready access to high-quality palliative care in the patient’s community, as we offer at our Residence,” continued Ms. Dellar. “If quality palliative care is available, few will choose to end their lives prematurely. We can’t allow the premature ending of lives to become a substitute for our responsibility to provide compassionate care and symptom relief at the end of life.”

The West Island Palliative Care Residence will be changing its application forms and information for patients and families to comply with the new legislation and make it clear to them that the Residence will not provide the intentional end-of-life services now permitted.

About palliative care

Palliative care does not hasten death – as do euthanasia and assisted suicide – but ensures it is as comfortable, dignified and pain-free as possible. It is a conservative estimate that palliative care could be useful in more than half of Canadian deaths, or more than 125,000 patients per year. As proportionately fewer Canadians die suddenly or quickly from accidents or acute illnesses, more face end of life with chronic illnesses or diseases such as cancer that can extend over a relatively long period of time. Many dying patients end up in hospital ERs during the last weeks of life, an indicator of poor-quality end-of-life care and a very expensive and unsatisfactory alternative to palliative care.

About the West Island Palliative Care Residence

The West Island Palliative Care Residence is an independent, community-based, non-profit institution, accredited by the Quebec government to provide end-of-life palliative care services to residents of the West Island of Montreal. The Residence allows terminally ill patients to die in comfort and with dignity in a warm, home-like environment, close to their family, and in their community. It is not part of or affiliated with any hospital or health institution and services are provided without charge. The Residence has 23 beds in two pavilions, making it the largest freestanding palliative care residence in Canada. Since opening in 2002, the Residence has welcomed more than 2,500 patients in the final stages of ALS, multiple sclerosis, cardiovascular disease and cancer, as well as 10,000 of their family members. To learn more, visit ww.wipcr.ca

For more information:
Joanne Myers, Director of Development
Tel.: 514 693-1718, ext. 234
Mobile: 514 978-0793

Project article on Quebec euthanasia bill published in Turkish law journal

Project article on Quebec euthanasia bill published in Turkish law journalThe three part series Redefining the practice of medicine: Winks and nods and euthanasia in Quebec (Bill 52: An Act respecting end-of-life care) has been translated into Turkish and published in volume 14 of the Comparative Current Criminal Law Series by Özyeğin University in Istanbul.

Quebec euthanasia bill stalled

The government of Quebec was unable to convince the opposition Liberal Party to complete debate on Bill 52, legislation to legalize euthanasia, in order to bring it to a vote before the Quebec National Assembly adjourned for two weeks.  The government has tabled a budget, which takes precedence over other bills.  It is believed that the government will call an election when the Assembly returns, which means that the euthanasia bill will not pass.  It could be resurrected by a government formed after the election. [CBC News]

Quebec official considers expanding euthanasia to minors, dementia patients

Although Bill 52, Quebec’s euthanasia legislation, has not yet passed the National Assembly, the secretary of the Collège des médecins du Québec, the state regulator of medical practice, has suggested that grounds for euthanasia will likely be broadened after the bill passes.  Dr. Yves Robert, speaking of Alzheimer patients and those under 18, said “We will have to think about that, not only for [incapable] adults but
obviously for youngsters who face terminal diseases.” [National Post]  His statement is consistent with statements made by various groups giving evidence in committee hearings.  For example, the Quebec Commission on Human Rights and Youth Rights takes the position that failing to provide euthanasia for mentally incompetent patients and minors would constitute a violation of human rights, and warned legislators that if they did not amend the bill to include it, the change would be forced through civil action.