A protocol must be put in place to guide caregivers when dealing with patients who refuse to receive medical assistance in dying after having requested it in advance, and when they are no longer deemed fit to make an informed decision.
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That’s what several groups said Tuesday during consultations on expanding medical assistance in dying for people with neuromotor disorders.
In the morning, the co-chair of the group of experts on the question of incapacity and medical assistance in dying, Jocelyn Maclure, expressed that the notion of refusal is in his eyes “too vague” in the current form of the project. of law.
“If the person is not lucid, it is not a refusal, it is a resistance”, specified Mr. Maclure.
“If we allow advance requests for medical assistance in dying, it is to respect the will of people when they were able to make the decision,” he also argued.
As this is a sensitive issue, Mr. Maclure suggested that parliamentarians provide for the development of a protocol to guide healthcare personnel in assessing a person’s ability to reconsider their decision to receive medical assistance in dying when the time comes.
If it turns out that the person is “resisting” more than “refusing”, for example showing signs of agitation before the procedure, the provision of medical aid in dying should be postponed rather than cancelled. If the request is made in a moment of lucidity, Mr. Maclure is of the opinion that it could be otherwise.
The research director of the Quebec Federation of Alzheimer Societies, Nouha Ben Gaied, agrees with the expert group’s findings.
“We must not stop at this resistance to care, and continue with the process of medical assistance in dying,” she said, stressing however that this care must be “a last resort” and not be considered only under “conditions of advanced and irreversible decline”.
Involvement of relatives
The co-chair of the group of experts on the question of incapacity and medical assistance in dying, Me Nicole Filion, for her part expressed that “greater involvement of relatives” could be provided for in the event that a person patient would express the wish “explicitly or tacitly”.
According to Mr. Maclure, too narrow an interpretation of the bill could lead healthcare staff to speak only with a person who has been designated as a “trusted third party”.
A trusted third party, according to what is proposed, must inform the medical team that the sick person is overdue in order to carry out a medical examination, which will eventually lead to the provision of medical assistance in dying.
If the nursing staff considers that a person’s condition has deteriorated sufficiently, medical assistance in dying could be given, despite the unfavorable opinion of a trusted third party, believes the group of experts, in order to respect the person’s wishes when they were able to make their decision.
Consultation
Remember that Bill 11 proposes to allow people with a neuromotor disability to have access to this “end-of-life care”.
In a scrum with the press a few moments before the start of the commission’s work, the Minister for Health and Seniors, Sonia Bélanger, stressed the importance of clarifying the notion of handicap, when asked why circumscribe the access to medical aid in dying for neuromotor disabilities.
“The notion of disability is an extremely broad concept (…). I think it’s extremely important that we can bring in the nuances and mark out, as a precautionary principle, and that’s why we bring in the notion of “neuromotor” disability, she said.