{"id":4935,"date":"2014-07-29T00:02:22","date_gmt":"2014-07-29T07:02:22","guid":{"rendered":"https:\/\/news.consciencelaws.org\/?p=4935"},"modified":"2018-04-26T22:49:36","modified_gmt":"2018-04-27T05:49:36","slug":"redefining-the-practice-of-medicine-euthanasia-in-quebec-part-2-arelc-in-detail","status":"publish","type":"post","link":"https:\/\/news.consciencelaws.org\/?p=4935","title":{"rendered":"Redefining the Practice of Medicine- Euthanasia in Quebec, Part 2: ARELC in Detail"},"content":{"rendered":"

\"Redefining
\nAbstract<\/h2>\n

An Act Respecting End-of-Life Care<\/em> (“ARELC”) is intended to legalize euthanasia by physicians in the province of Quebec.\u00a0 It replaces the original Bill 52, the subject of a previous commentary<\/span><\/span><\/a> by the Project.\u00a0ARELC purports to establish a right to euthanasia for a certain class of patients by including it under the umbrella of “end-of-life care.”\u00a0 ALERC calls euthanasia for competent patients “medical aid in dying” (MAD).\u00a0 ALERC provides for but does not\u00a0 identify euthanasia for incompetent patients, called here Euthanasia Below the Radar (EBTR).
\n\u00a0<\/a>
\nARELC’s definition of palliative care clearly distinguishes palliative care from\u00a0MAD.\u00a0 In defining MAD, the statute does not say “kill,”\u00a0 but employs a euphemism: “hastening death.”\u00a0 Nonetheless, it is obvious that ARELC authorizes a physician to kill patients.<\/p>\n

The MAD guidelines for euthanasia restrict it to legally competent persons at least 18 years old who are insured under the provincial Health Insurance Act.<\/em>\u00a0 Beyond age, legal competence and residency\/insurance, someone seeking euthanasia must be at “the end of life,” suffering from an incurable serious illness, in an advanced state of irreversible decline and suffering from constant and unbearable physical or psychological pain.\u00a0 The patient need not be terminally ill and is free to refuse effective palliative treatments.<\/p>\n

A qualifying patient must personally make a written request for MAD “in a free and informed manner.” It must be signed in the presence of professional, who must also sign the request. The attending physician must confirm the eligibility of the patient and the free and informed nature of the request. He must verify the persistence of suffering and a continuing desire for euthanasia, speak to other members of the health care team and see that the patient is able to discuss the decision with others. However, the physician cannot advise family members unless the patient so wishes. Thus, a physician may kill a patient without the knowledge of the family. Finally, the attending physician must obtain a written opinion of an independent physician confirming eligibility for euthanasia.<\/p>\n

Only physicians may administer the lethal drugs or substances, and, having done so, must remain with a patient until he dies. Physicians who provide MAD must report the fact to institutional authorities or the College of Physicians, as well as the Commission on End-of-Life Care.<\/p>\n

A central role in the provision of euthanasia is assigned to institutional councils of physicians, dentists and pharmacists (or, in their absence, institutional directors of care).\u00a0 They are to adopt MAD guidelines, and then review reports from physicians who have provided the procedures to “assess the quality of the care provided.” The Coll\u00e8ge des m\u00e9decins is also to receive such reports from physicians and, apparently, to\u00a0establish or at least recognize “clinical standards” relative to the procedures.<\/p>\n

In addition to the MAD protocol, ARELC permits a substitute decision-maker to order that an incompetent patient be starved and dehydrated to death.\u00a0 This provides an alternative form of euthanasia subject to none of the restrictions or conditions imposed by MAD guidelines: hence the term used here – “Euthanasia Below the Radar” (EBTR).\u00a0 Since death by starvation and dehydration would be a painful process, it is likely that, in such circumstances, continous palliative sedation (CPS) would be used to anesthetize the patient. This may lead to the under-reporting of the actual number of euthanasia cases and further confusion about continuous palliative sedation.<\/p>\n

Canadian criminal law is not affected by ARELC.\u00a0 <\/em>A physician who does what ARELC requires in the MAD protocol will have provided excellent evidence that the killing was intentional, planned and deliberate. Conforming to the Act Respecting End-of-Life Care<\/em> would seem to increase the likelihood that a physician – and anyone counselling, aiding, abetting his act – could be charged and convicted for first degree murder, for which the punishment is life imprisonment without parole for 25 years. [Full Text<\/strong><\/a>]<\/p>\n","protected":false},"excerpt":{"rendered":"

Abstract An Act Respecting End-of-Life Care (“ARELC”) is intended to legalize euthanasia by physicians in the province of Quebec.\u00a0 It replaces the original Bill 52, the subject of a previous commentary by the Project.\u00a0ARELC purports to establish a right to euthanasia for a certain class of patients by including it under the umbrella of “end-of-life … Continue reading “Redefining the Practice of Medicine- Euthanasia in Quebec, Part 2: ARELC in Detail”<\/span><\/a><\/p>\n","protected":false},"author":5432,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[32,162,8],"tags":[1825,3381,1197,3383,3382,3379,410,3380],"post_folder":[],"class_list":["post-4935","post","type-post","status-publish","format-standard","hentry","category-canada","category-euthanasia","category-legal-commentary","tag-act-respecting-end-of-life-care","tag-dehydration","tag-jocelyn-downie","tag-manslaughter","tag-murder","tag-palliative-sedation","tag-quebec","tag-starvation"],"yoast_head":"\r\nRedefining the Practice of Medicine- Euthanasia in Quebec, Part 2: ARELC in Detail - 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