Quebec was a forerunner in terms of medical assistance in dying. With admirable serenity, we carried out this collective reflection in the early 2010s, under the aegis of a cross-party parliamentary commission which first listened to Quebecers before transforming these consultations into a law, adopted in 2015.
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It happened slowly, delicately, surely.
In Quebec, politics has not been towed by the courts to regulate this care, this ultimate care. Ottawa was. While Quebec was marking out in a law what Quebecers wanted, Ottawa was fooling around with the puck, and it was the Supreme Court that forced its hand in 2015.
It must be said that the courts have evolved at breakneck speed in recent years in this area. The Carter judgment of the Supreme Court (2015) and that of the Superior Court of Quebec in the cases of Jean Truchon and Nicole Gladu (2019) sealed the judicial catch-up in the face of popular consensus.
During the time of the debates on medical assistance in dying, I often wrote on the question. I was—I am—resolutely in favor of medical assistance in dying, for those who choose this care. I saw both of my parents die of catastrophic cancers and I want to be able to have access to it, if the same thing happened to me.
Would I have recourse to it, if I were condemned?
That’s not the point; the question is to have the choice. And most of us now have that choice.
I say that most of us have the choice, because there are still categories of patients who do not have access to medical aid in dying (MAID). For example, people with neurocognitive diseases, such as Alzheimer’s.
Is it desirable, in absolute terms, that people knowing they are condemned to die of diseases such as Alzheimer’s can have access to MAID? I think so. There too, the consensus is very strong: 86% of Quebecers agree (80% across Canada).
But this issue is complex: the person suffering from terminal cancer can, in all lucidity, request MA. The person with dementia will not be lucid when receiving MAID. She will have to record her request in all lucidity… Long before her death.
The issue is complex, but it is not because the debates are complex that they should be avoided. Quebec parliamentarians are currently working on a bill that would expand the boundaries of MAID to those people with, for example, Alzheimer’s.
I’m back to 15e and 16e words of this column, where I mentioned the social and political debates that framed the adoption of the Quebec law on assisted dying, which took place in a remarkable serenity.
Seven years later, the National Assembly is not leading the debate on the expansion of MA 2.0 with remarkable serenity. On the contrary.
Currently, the deputies are studying Bill 38 in a climate of urgency, because the wall of the end of the parliamentary session is approaching (Friday). This bill responds to the report (tabled in December) on expanding medical assistance in dying.
But the study of the project was marked by a cacophony which is neither serene nor remarkable and which, I fear, will create confusion if it is adopted.
Basically, I summarize:
- The government pulled a rabbit out of its hat by wanting to include paralyzed people (it backed off);
- The advance MA request for people with a disease like Alzheimer’s is very complex to implement in reality and requires attention to very fine details… Incompatible with the current rush;
- Minister Christian Dubé affirmed that people with Lou Gehrig’s disease could finally have access to MAID, but they are already eligible for it: this is a small mistake that betrays his lack of detailed knowledge of the file;
- The College of Physicians came to throw a stone into the pond by demanding that Quebec “harmonize” its practices with the federal government, which looks like a scarecrow… Which scared parliamentarians, indeed.
In short, the current debate is all crooked. The government did not prioritize Bill 38 in its parliamentary calendar. It was therefore deposed at the eleventh hour. Result: the deputies hold the debates in a hurry, the eye on the clock which will ring the end of the session… Tomorrow.
And if there is an issue that deserves to be done in an obligatory serenity, without urgency, taking all the time it takes to analyze, to reassure, to explain, to weigh up… It is definitely that of the end of life.
Question for deputies: what is the hurry?
It is a staunch defender of medical assistance in dying who writes these words: I am afraid of what our deputies are going to adopt, pressed for time, I am afraid that we are legislating all wrong. It would be terrible for the perception we have of MAID.