Medical assistance in dying must be offered in a former church

The St-Raphaël Palliative Care Home, installed in a former Catholic church and financed by the Archbishop of Montreal, will have to offer medical assistance in dying for the moment, even if this contravenes the principles of the Christian faith. The religious institution had requested that the recent article of Quebec law which obliges all care homes to administer it be suspended, pending the trial which will evaluate this case in all its aspects.

In his judgment dated 1er March, Judge Catherine Piché of the Superior Court refused the request for a stay, as well as that seeking an exemption from the law for the St-Raphaël house, located in the Montreal borough of Côte-des-Neiges.

“Despite the significant interest of the applicants in protecting their religious beliefs, this interest has less weight compared to the right of Quebecers to access the care of their choice, including medical assistance in dying, at Maison St- Raphael. »

This litigation is obviously not over, but it may take years before a judgment is rendered on the validity of this article of the Act concerning end-of-life care..

On Tuesday, Quebec was delighted with the decision rendered:Medical assistance in dying is care and all Quebecers must have access to it, regardless of their environment. The law is clear, palliative care homes must make this care available. Asking people at the end of their lives to travel elsewhere to receive medical assistance in dying does not correspond to a practice that we want to see,” the Minister responsible for Seniors and Minister for Health responded by email, Sonia Bélanger.

A closed and converted church

Under the leadership of former parishioners, donors and Catholic volunteers, the archbishop had accepted that the former Saint-Raphaël-Archange church, closed in 2008, be converted into a project that could benefit the community, namely a house palliative care.

To carry out this multi-million dollar project, a non-profit community organization was created, and Maison St-Raphaël was created in 2019. It has 12 beds and end-of-life care is provided without charge. costs. The organization was granted a 100-year lease — for an annual rent of $1 — with a series of conditions, including one very clear: medical assistance in dying cannot be administered there.

Everything was going smoothly until 2023, when the CAQ government amended the law to require all palliative care homes to offer medical assistance in dying.

This plunged the Archdiocese into an “insoluble dilemma”, its lawyer, Ms.e Jacques Darche.

The Archbishop does not want palliative care to be stopped there, but he cannot accept that “the property, a former church, is used to commit acts that are morally unacceptable to it.” “Catholic beliefs are that euthanasia constitutes a morally inadmissible act, a “murder” in which it is forbidden to collaborate in any way, the Church considering life to be sacred and inviolable from conception to natural death. »

He therefore appealed to the Court to continue his work and keep Maison St-Raphaël open for patients — but without medical assistance in dying. Those who decide to request it can be transferred to another establishment, with the agreement and supervision of the CIUSSS, it was explained to the judge.

He invokes his freedom of religion and conscience, protected by the Charters.

The request for suspension

Anyone who demands that a law duly adopted by the National Assembly be suspended has a high climb to climb, and must meet demanding legal criteria.

Stays are only granted “exceptionally” and “in obvious cases”, recalls the judge in her decision.

Here, she agrees that there is a serious question to be “decided”: in short, the matter is not frivolous.

The magistrate specifies that the legislative modification “harms in a more than negligible way” the Archbishop’s ability to conform to his beliefs: “The insoluble moral dilemma is real. »

And if only one patient receives medical assistance in dying within the walls of Maison St-Raphaël, the “moral stain” invoked by the Archbishop constitutes irreparable harm “which the judgment on the merits cannot remedy. »

Once these findings have been made, the judge indicates that she must now assess “who” will suffer the greatest harm if the article of law is suspended or not.

Most of the time, it is presumed that the legislative provision serves a public interest objective. But this presumption can be rebutted.

Here, the judge rules that in the balance, the Archbishop’s “moral dilemma” is of lesser importance compared to the public interest in respecting the right to choose one’s care and medical treatment, including the right to benefit from medical assistance in dying.

This dilemma is that of a restricted group — composed of the Archbishop and donors, volunteers and former parishioners — and not that of an identifiable and significant group such as the English-speaking community of Quebec or the Catholic community of Quebec, she notes.

For this reason, the balance of convenience does not favor suspending the section of the Act for all hospices. Judge Piché also rejects the request for exemption for this single healthcare establishment.

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