Expanding Assisted Dying | “We must stop pushing this debate away”, plead the medical specialists

The Federation of Medical Specialists of Quebec (FMSQ) says it is “disappointed” that Quebec is pushing back to an indefinite date the reflection on the extension of medical assistance in dying for people with mental disorders. For the organization, which represents 10,000 medical specialists throughout the province, it is “discriminatory” that these patients are excluded from this care offer.

Ariane Lacoursiere
The Press

“We have to stop postponing this debate and have the discussion, even if we are aware that it is a sensitive issue to be addressed with sensitivity,” says the president of the FMSQ, Dr.^r Vincent Olive.

For the FMSQ, “there is no distinction between mental health and physical health”. And therefore excluding from medical assistance in dying people whose only diagnosis concerns a mental disorder is “discriminatory”.

“Our position is based on the suffering of patients. And not on the diagnosis. Not on the status of the disease, ”says the D^r Olive. The latter specifies that it is obviously necessary that “there are criteria” and that medical assistance in dying for these patients “is well marked out”. “But patients with mental illness can have suffering that is irremediable and chronic,” he says.

Hurry up

Quebec has been studying Bill 38 in recent days, which notably aims to allow people with degenerative diseases, such as Alzheimer’s, to make an advance request for medical assistance in dying. But for lack of time, parliamentarians had to postpone its study until the next session, after the elections.

In the office of the Minister of Health, Christian Dubé, it is mentioned that the intention is to “resume work where we left off” and that there are therefore no plans for the moment to add the question of mental health in the discussions “even if this important debate will have to be done one day”. Minister Dubé’s press attaché, Marjaurie Côté-Boileau explains that the issue of medical assistance in dying is “very complex at the legal, social and legislative level” and that the objective is to “build on the whole path that has been done to date” this fall.

The FMSQ supports Bill 38, but emphasizes that “a major issue is left unresolved, that of mental disorders”. And Quebec will not be able to postpone the debate on this subject forever, notes the D^r Olive. On March 17, 2023, an amendment to the Canadian Criminal Code will come into effect and will allow people “whose only medical condition is a mental disorder to be eligible for medical assistance in dying”.

If Quebec has not adapted its law at this time, “it would create a void”, notes the D^r Oliva, who fears that citizens will again have to carry the legislative fight on their shoulders to assert their rights.

To avoid this situation, the government should, according to him, announce now that discussions will resume quickly in the fall around this subject.

The D^r Oliva recognizes this: the perception of medical specialists with regard to medical assistance in dying, and also to the accessibility of people with mental disorders, has changed a lot in recent years. “Today, society and physicians are moving further and further away from the concept of ‘life at all costs’ in favor of an objective of an acceptable quality of life for the individual”, writes the FMSQ in its memory.

Medical specialists are not the stakeholders who administer the most medical assistance in dying in Quebec. But more and more of them are taking part. “And we are in the front row to realize the importance of the suffering that patients experience”, underlines the D^r Olive.