(Quebec) Advance requests for medical assistance in dying will be permitted in Quebec as of October 30. Faced with Ottawa’s refusal to amend the Criminal Code, Minister Simon Jolin-Barrette is intervening to protect doctors from possible prosecution.
“To respect the choices of Quebecers and the specificities of Quebec, [le gouvernement du Québec] made his own choice to move forward,” the Minister of Justice said in an interview with The Press.
More than a year after the adoption of the bill to expand medical assistance in dying, Quebec will announce this Saturday that people suffering from a serious and incurable illness leading to an inability to consent to care, such as Alzheimer’s, will now be able to request this ultimate care. This is the last provision of the recent law to come into force.
“We carried out the work in a serious and rigorous manner, […] “We adopted a law and there are patients waiting,” said the Minister Delegate for Health and Seniors, Sonia Bélanger.
Advance requests will be permitted thanks to the intervention of Minister Simon Jolin-Barrette, who gave direction to the Director of Criminal and Penal Prosecutions (DPCP) to protect doctors and specialized nurse practitioners (SNPs) – the only two professions authorized to provide medical assistance in dying – from possible prosecution.
A directive will also be sent to all prosecutors on Monday and the minister’s guidance will be published in the Official Gazette Wednesday.
The DPCP clarified that The Press that “this instruction will indicate that it would not be in the public interest to authorize the filing of a criminal prosecution in connection with a death occurring in the context of medical assistance in dying […] if the analysis of all the evidence confirms that this care was provided in compliance with the relative wishes” expressed during an advance request.
It must be understood that advance requests are not part of the exceptions included in the Criminal Code to administer medical assistance in dying without contemporaneous consent. During the study of the bill, the Barreau du Québec and the Collège des médecins had also raised concerns, fearing that certain provisions of the Quebec law were “inapplicable.”
Trudeau “insensitive”
For months, the Legault government has been up against the federal government’s refusal to amend the Criminal Code. Last February, the Legault government increased the pressure on Ottawa by organizing an outing by ministers Simon Jolin-Barette, Sonia Bélanger and Jean-François Roberge (Canadian Relations). Their efforts were in vain.
The Criminal Code could have been amended by the federal government. […] This is a lack of sensitivity on the part of Justin Trudeau towards the wishes of Quebecers who suffer from this type of illness.
Simon Jolin-Barrette, Minister of Justice of Quebec
“The best way forward was to ensure that the Criminal Code was amended,” admits Minister Simon Jolin-Barrette. However, the publication of an orientation to the DPCP is a “tool that has always been [la] provision” of the minister, he acknowledges. If Quebec could move forward without Ottawa, why not have done so when the law was adopted in June 2023?
Mr. Jolin-Barrette replied that it was necessary to do “things in order” and first prepare the health network to accommodate anticipated requests and implement clinical protocols. “That’s why we are taking the direction today […]”As long as we are completely ready, we do not delay anything and we move forward according to our skills and the powers we have,” he maintains.
At the time the law was passed, Minister Sonia Bélanger was criticized for setting a 24-month deadline for the advance requests to come into effect. Suffering from early-onset Alzheimer’s, Sandra Demontigny, who campaigns for access to advance requests, expressed her surprise and dismay.1She has since tried to convince Ottawa to modify the Criminal Code, notably by travelling to the federal capital.
“When there is human suffering and science shows that a diagnosis has been made and that […] there will be an eventual end, I think that we in Quebec must evolve within that, with respect, and we have everything we need in our law to do things correctly,” argues Mr.me Belanger.
The direction given to the DPCP is a “very robust” path that does not lend itself to contestation mechanisms, explains Mr. Jolin-Barrette. Quebec had also used this same procedure when adopting the first law on end-of-life care in 2014. At the time, however, the context was different since the case was before the courts.
Former Justice Minister Marc-André Bédard also used it in 1976 to prevent doctors who performed abortions from being exposed to prosecution.
The story so far
May 2022 : Health Minister Christian Dubé tables his bill to expand medical assistance in dying. The legislative text dies on the order paper.
February 2023 : Minister Sonia Bélanger, elected in the 2022 elections, is taking up the matter again and tabling a new bill.
June 2023 : Sonia Bélanger’s bill is adopted by the National Assembly. Quebec gives itself 24 months to implement all the provisions, including advance requests.
October 2024 : Despite Ottawa’s refusal to amend the Criminal Code, Quebec will authorize advance requests for medical assistance in dying thanks to an intervention by the Minister of Justice.
1. Read “Deadlines for Advance Requests for MAiD: “I Started to Cry,” Says Sandra Demontigny, Who Has Early-Onset Alzheimer’s”