Disability and Medical Assistance in Dying | Clarifications are needed

In the show Everybody talks about it on Sunday, February 19, 2023, Minister Sonia Bélanger and host Guy A. Lepage discussed the availability of medical aid in dying (MAID) for people with disabilities.


The host notably mentioned patients suffering from multiple sclerosis. But this example does not reflect reality. A few medical, legal and practical clarifications are necessary. Indeed, people suffering from a neurodegenerative disease, such as multiple sclerosis, amyotrophic lateral sclerosis (ALS) or Parkinson’s, for the best known, have been eligible for MA since March 2021 as serious “diseases”. and irreversible. They do not fall within the scope of “disability”. What is in question with the evolution of the law are the motor handicaps existing from birth for example or, another example, following an accident with paraplegia. However, it is important to specify that, despite the progress made by Bill 11 on other subjects, people affected by this type of disability already have the right to request an evaluation under federal law.

Let’s remember the facts. Currently, section 241 of the Criminal Code includes, among the potential beneficiaries of MAID, people affected by a “disease, condition or disability”, in accordance with the historic decision of February 6, 2015 of the Supreme Court of Canada. . This is not the case with Quebec’s Law 2, which only mentions cases of “disease”. This is because the Quebec law was passed in June 2014, before the Court’s decision and before the federal law was passed two years later.

Fortunately, to clarify the situation, a directive dated May 2021 from the College of Physicians of Quebec, the regulatory body, informed all medical practitioners in the WMA of the legality of carrying out medical assistance in dying for people affected by a disability, based on the Criminal Code.

Nevertheless, because it remains, the difference in terminology perpetually sows doubts about who is authorized to receive medical assistance in dying. It generates a distinction in rights between Quebecers, whose access to MAID seems to be restricted, and all other Canadian citizens. As a practitioner of medical assistance in dying, I regularly observe that this subject of semantics on disability weighs on patients: many are those who doubt their right to access medical assistance in dying.

A year ago, I was already writing on this subject to the Quebec Ministers of Health and Justice, in an open letter shared by The Press1. In this context, the Quebec law simply has to be harmonized with the federal law. This is what Bill 11 proposed by Minister Bélanger proposes, by integrating the concept of disability into the law. If this text passes, the semantic debate will therefore finally be resolved.

* Neurosurgeon and physician-assisted dying practitioner


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