It is clear that the progress of the last 10 years, in Quebec as in Canada, in the field of medical assistance in dying (MAiD), will not have paved the way for Ottawa’s consent to explicitly recognize the Quebec government’s right to proceed at its own pace.
With its requests to this effect having been ignored for six months now, Quebec is preparing to expand its MAID regime on its own to allow for advance requests. A welcome decision, but one which, through Ottawa’s fault, risks causing anxiety among new patients who have been waiting a long time for this ultimate gesture of compassion.
Quebec once again became the sole pioneer of medical assistance in dying last year by expanding the eligibility criteria to people with a cognitive neurodegenerative disease whose condition will not allow free consent at the end of life. The Minister responsible for Seniors, Sonia Bélanger, had given herself a period of at most two years to formalize the entry into force of this important change. It will begin this fall, her office confirmed last week.
However, the Quebec government demanded that Ottawa, in the meantime, enshrine an exemption in the Criminal Code confirming that Quebec will have the flexibility to deviate from it in matters of MAiD on its own territory. Because the Quebec expansion will overstep the boundaries set out in federal criminal law. Ottawa, however, would not listen. Federal Justice Minister Arif Virani defended his pan-Canadian “unitary system” and retorted that he did not want “province-by-province exceptions.”
The federal Liberals categorically reject the revival of a patchwork MAiD regime. They themselves have decided to postpone any expansion of medical assistance in dying for three years, thus carefully avoiding such a heartbreaking debate between now and the next federal election. That is their choice. That of the people of Quebec and the near-unanimity of its National Assembly, who are for their part ready to move forward, is however just as right. Whatever some of Justin Trudeau’s ministers think.
That his government is refraining from advancing the federal MAID regime is one thing, as regrettable as it may be for Canadian patients. That it is making Quebec’s own choice in this regard precarious by refusing to eliminate all legal uncertainty for its doctors and other health professionals is pure stubbornness that ignores Quebec’s social consensus.
Yet last year, the special joint committee of senators and MPs that looked at the aftermath of access to medical assistance in dying recommended that the federal government allow these same advance requests. Even another pan-Canadian advisory group, this time made up of provincial and territorial experts, was of the same opinion, as were the majority of witnesses heard by the committee who said they were in favour of it. The same goes for 86% of the Canadian population.
Regardless—and despite the fact that provincial flexibility is granted in other areas such as cannabis or lotteries, Quebec ministers point out—the Trudeau government remains entrenched in its position, without explaining it further.
Quebec will therefore have to, as it did during the very first legalization of MAiD in 2015, rely on asking Quebec prosecutors not to initiate proceedings against anyone who administers medical assistance in dying requested by advance directive. An entirely possible avenue, according to constitutional experts, but one that is not without risk, since MAiD is now regulated within the Criminal Code. A lawsuit brought by a citizen or a religious group is therefore not to be ruled out. Enough to cool nurses and doctors, worried about getting 14 years in prison, as evidenced by the fact that six Quebec professional orders have also called on Ottawa to amend the Criminal Code to reassure them.
This is a relief that one might have thought the federal government would be anxious to provide… By acting differently, it is above all the alleviation of the suffering of people who fear one day being prisoners of their bodies and who wish to die with dignity that Ottawa is threatening to paralyze. An intransigence that Quebec’s sick do not deserve.