End-of-life care | Medical assistance in dying at the funeral home will be supervised

(Quebec) At first uncomfortable with this emerging practice, the Legault government finally allows Quebecers who wish to receive medical assistance in dying in a funeral home, or in any other place that was not provided for by the law, to make the request to receive, if they respect new criteria, this ultimate care.

The Minister for Health, Sonia Bélanger, found a way through with her opposition counterparts on Tuesday, as the detailed study of Bill 11 draws to a close. This piece of legislation, which expands access to medical assistance in dying, reforms the Act respecting end-of-life care.

Currently, section 4 of this law provides that medical assistance in dying is provided “in a facility maintained by an institution, on the premises of a hospice or in the home”. However, by the very admission of the deputies in the parliamentary committee, the elected officials learned on May 19 by reading The Press that this care was also practiced in other places. This is the case, among others, at the Haut-Richelieu funeral complex in Montérégie, which has rented its showroom to clients so that they can receive end-of-life care at their request.

Challenged by this new practice which was not on their radar, Minister Bélanger and MPs Jennifer Maccarone of the Liberal Party, Christine Labrie of Québec solidaire and Joël Arseneau of the Parti Québécois, agreed on Tuesday to new rules to regulate it. It should be remembered that medical assistance in dying provided outside the places already provided for by law concerns less than 1% of cases.

What does the bill provide?

Thus, once the bill is passed, a patient who wishes to receive medical assistance in dying in a funeral home, in a chalet that is not his home, in a park or in any other place, will have to asks his attending physician. The latter will then obtain prior approval from his director of professional services (DSP) or the nursing care directorate (DSI), in the case of a specialized nurse practitioner. Management will ensure that the place requested by the patient is suitable for the rules and practices governing medical assistance in dying.

In addition, Bill 11 now provides that “no one may promote or advertise any good or service provided in the course of a commercial activity by associating it directly or indirectly with the to die, as well as to demand any amount directly or indirectly related to obtaining such assistance”. Solicited by The Press, Minister Sonia Bélanger’s office has confirmed that this new section of the law will prohibit companies or individuals from charging a fee to a patient who requests to receive medical assistance in dying on their property. In the case of the Haut-Richelieu funeral complex, for example, it will be prohibited in the future to charge fees for the rental of the room or to promote the service.

In addition, the bill provides that “anyone who contravenes the first paragraph is liable to a fine of $5,000 to $50,000 in the case of a natural person or to a fine of $15,000 to $150,000 in other cases. In the event of a repeat offence, the amounts of the fines are doubled. »

In parliamentary committee, Minister Bélanger affirmed that the amendments that were adopted make it possible to regulate this emerging practice, to document it, but also to avoid a certain form of commercialization of medical assistance in dying, while respecting the patients’ wishes.

The next steps

Throughout the parliamentary committee on Tuesday, the opposition MPs repeatedly pointed out that this new approach was an important development in the framework for medical assistance in dying in Quebec and that it had not been discussed during the consultations on the subject. Several physicians, including Dr.r Georges L’Espérance, a retired neurosurgeon and president of the Quebec Association for the Right to Die with Dignity, testified in The Press over the past few days so that the government does not prohibit patients from receiving medical assistance in dying outside the places already provided for by law.

The Legault government wants to adopt Bill 11 by the end of the parliamentary session, on June 9. This legislative text has been discussed and debated in a cross-partisan approach by the various political parties.

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