Medical leaders grapple with new euthanasia dilemma: What to write on the death certificate

National Post

Sharon Kirkey

As Canada inches closer to granting doctors the power to end the lives of consenting patients, medical leaders are grappling with a new dilemma: should deaths by lethal injection be classified “death by natural causes” on death certificates?

Quebec’s College of Physicians is considering recommending doctors list the underlying terminal disease as the cause of death in cases of “medical aid in dying” on public death records – and not euthanasia.

The college says it wants to ensure life insurance is paid to families in cases of euthanasia and says the province’s assisted-death law will require any doctor who administers euthanasia to report the death to a special oversight body. That information will be kept confidential or shared with the college and/or the doctor’s hospital.

Euthanasia opponents are denouncing the proposal as an attempt to conceal the truth. It is also creating unease among some doctors who worry misstating death certificates could make it difficult to track how often assisted death is occurring once the practice becomes legal in Canada in February, and whether it is being performed legally. . . [Full Text]

Quebec MDs to get euthanasia guide to prepare for legalized assisted death

Unclear whether other provinces and territories will adopt a similar practice

The Canadian Press

Sheryl Ubelacker

The college that regulates Quebec doctors will soon provide practitioners with detailed guidelines – including what drugs to use – for euthanizing terminally ill patients who seek help to end their lives.

But it’s unclear whether other provinces and territories will adopt a similar practice when doctor-assisted death becomes legal across the country early next year.

With the passage of Bill 52 in June 2014, Quebec became the first jurisdiction in Canada to legalize medical aid in dying for mentally competent patients who meet a strict set of criteria. The law goes into effect in December, allowing physicians to begin helping patients with an incurable condition and intolerable physical or psychological suffering to die. . . [Full Text]

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]

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.

Hearings on Quebec Bill 52: College of Physicians

Dr. Charles Bernard, Dr. Yves Robert, Dr. Michelle Marchand

Tuesday 17 September 2013 – Vol. 43 N° 34

Note: The following translation is the product of a first run through “Google translate.”  In most cases it is sufficient to identify statements of interest, but more careful translation is required to properly understand the text.

Original Text

Caution: machine assisted translation

M. Bernard (Charles) : Merci, M. le Président. Alors, M. le Président, Mme la ministre, Mmes, MM. les parlementaires, alors le Collège des médecins du Québec vous remercie de lui permettre de vous présenter ses réflexions sur le projet de loi n° 52 concernant les soins de fin de vie, et j’ajouterais que nous sommes honorés d’être les premiers à auditionner devant cette commission en cette journée de rentrée parlementaire, alors on vous en remercie. Thank you, Mr. President. So, Mr. President, Madam Minister, Mrs, Mr. parliamentarians, while the College of Physicians of Quebec thank you for allowing him to present his thoughts on Bill No. 52 on the end-of-life, and I would add that we are honored to be the first to audition before the Committee on this day parliamentary session, so we thank you.
Alors, ce projet de loi constitue, à nos yeux, un jalon très important dans la réflexion sur les soins de vie, et, à notre avis, il devrait être adopté. Amorcée en mai 2006 à l’occasion de notre assemblée générale annuelle, cette réflexion s’est transformée en un vaste débat public, à l’issu duquel la Commission spéciale sur la question de mourir dans la dignité a remis sont rapport en mars 2012. D’entrée de jeu, vous nous permettrez de souligner le travail exceptionnel effectué sur ce sujet extrêmement complexe et sensible par tous les parlementaires, et en particulier le vôtre, Mme la ministre, vous avez fait preuve d’un respect, d’une qualité d’écoute, d’une rigueur et d’une compréhension des enjeux d’une rare qualité, et nous vous en remercions sincèrement, cela mérite d’être souligné. So this bill is, in our view, a very important milestone in thinking about life care, and, in our opinion, should be adopted. Began in May 2006 at our annual general meeting, the discussion turned into a broad public debate, the end of which the Special Committee on Dying with Dignity are handed over in March 2012. From the outset, please allow us to recognize the outstanding work done on this topic extremely complex and sensitive by all parliamentarians, particularly yours, Madam Minister, you have demonstrated compliance, quality listening, rigor and an understanding of the challenges of a rare quality, and we sincerely thank you, it deserves to be highlighted.

Full Translation