Medical assistance in dying: yes to advance directives, no for mental disorders

A cross-party report recommends that Quebec allow it to dictate in advance its wish to obtain medical assistance in dying in the event of a serious and incurable disease leading to incapacity. However, the committee rejects the idea of ​​extending this option to people whose only medical problem is a mental disorder.

• Read also: Doctors and the public in favor of physician-assisted dying

The Special Commission on the Evolution of the Law on End-of-Life Care made these two main recommendations in a report tabled Wednesday in the National Assembly.

Thus, a recipient who receives a diagnosis of Alzheimer’s disease, for example, could write an advance request for medical assistance in dying (AMM) via a form provided for this purpose and notarized. Currently, a person who has become incapacitated due to an advanced stage of the disease cannot apply for MAID.

“The Commission recommends that the person clearly indicate the manifestations of his state of health which should give rise to his anticipated request,” said elected officials among their recommendations.

A trusted third party would be responsible for determining when medical assistance in dying should be administered, based on criteria determined in advance by the patient.

In addition, the mention of an advance request for medical assistance in dying would be written on the back of the health insurance card.

However, the government must first table a bill before such changes come into effect.

A press conference will take place around 1: 0 pm today to support the decisions of the members of the commission, made up of the four main political parties represented in Quebec.

No for mental disorders

Elected officials, on the other hand, spoke out against extending the MA to people with only a mental disorder, such as schizophrenia.

In a detailed argument, the commission argues that a diagnosis is more difficult to establish than for a physical illness.

“We note, at the end of our work, that there is no clear medical consensus on the incurability of mental disorders and the irreversible decline of capacities which would be associated with it. The positions of specialists diverge. As legislators, it is difficult for us to comment on this subject, ”the report states.

Quebec will therefore have to open up the current law at a minimum to exclude this avenue. Following a court ruling in the Truchoet Gladu case, the “imminent end of life” criterion has become inoperative.

This opened the way for people with a serious and incurable mental disorder, previously excluded automatically.

Enlargement

In September 2019, the Superior Court of Quebec ruled in favor of Nicole Gladu and Jean Truchon, suffering from neurodegenerative diseases, by ruling that the impending end of life criterion was restrictive and discriminatory.

Since then, 19 people have obtained permission from the Court of Quebec to receive MAID even if they were not considered to be at the end of their life.

“A majority of them were suffering from a neurodegenerative disease and had a vital prognosis of a year or more”, specifies the report of the commission.

More details will follow …

SEE ALSO


source site-64