From the outset, I would like to congratulate Minister Sonia Bélanger for her political courage in the area of medical assistance in dying (MAID). Some of the reactions that followed the tabling of the bill demonstrate the extent to which MAID, although permitted since the entry into force of the Act respecting end-of-life care in 2014, remains a debate in society. divisive, and whose complexity goes beyond the mere question of knowing in what circumstances a person is entitled to ask for assistance to end his or her life.
It should be remembered that the AMM mobilizes questions relating to the accessibility of health care, criminal law, the division of powers, and of course this thorny question which consists in knowing when is a life worth the pain of ending to be lived. It is a matter of public policy, of course, but it is first and foremost an eminently personal question, which brings into play a host of contradictory emotions and values. At least, it is for me.
In September 2017, I lost an incredible father who helped shape the person I have become. My father was a gentle, generous man who was always outgoing. He spared no effort to help his friends and colleagues. He was of that caliber of man who exists too little: those who broke cycles and who devoted their lives to being of service to others. And, first and foremost, he loved his family.
This is why, when the diagnosis of recurrence of prostate cancer fell, he immediately expressed the desire to continue living as long as he could find joy in his existence, but above all that they let him go the day when this joy would be tinged with the feeling of having become too great a burden for his loved ones. In short, my father did not want to disappear behind the disease. He was more afraid than anything of hurting us.
And yet. When the day came to ask for medical assistance in dying, my father no longer had the capacity to consent to it. The cocktail of drugs allowing him to somewhat appease the suffering that tormented him had also cost him the presence of mind necessary to ask that this same suffering end. The irony was not lost on me then, and I still feel it today.
Out of breath, devastated by pain and out of touch with reality due to an ultimate toxic psychosis, my father passed away in the circumstances he feared. Surrounded by his loved ones and benefiting from a last minute flash of lucidity, certainly, but bitter. Our mourning will have been all the more difficult.
Flaws to be corrected
Through the creation of an advance request for medical assistance in dying, Bill 11 corrects a major flaw in the system currently in place by allowing patients suffering from a disease that would eventually render them incapacitated to consent to provide for their rights in advance by submitting a request to a health professional covered by PL-11 (a doctor or a qualified nurse).
The safeguards against abuse remain very present, in the sense that the patient must be fit at the time of the anticipated request and will be accompanied throughout the process. However, this mechanism has major flaws that there is still time to correct. By specifying that eligibility for the advance request is reserved for patients who suffer from an illness that will eventually render them incapacitated, the government is closing the door to a significant number of people who, rendered incapacitated during their illness without this be the main cause, would have expressed the anticipated desire to end their life once a certain point of no return has been reached.
This is the case of the person who, like my father, would become incapacitated as a result of his treatment, but also of him or the one who, while suffering from an incurable disease, but not at risk of render incapacitated, would become so as a result of an unrelated accident. In short, by limiting the advance request to only the patient suffering from an illness that will render him incapacitated, the PL-11 does not allow a real request for advance medical aid. I submit that the legislator must withdraw this requirement, and thus base itself on what already prevails in terms of advance consent to care other than MAID (think of mandates in the process of incapacity or advance medical directives, for example) .
Similarly, always with the aim of guaranteeing full accessibility to medical assistance in dying, PL-11 must be an opportunity to allow other health professionals to receive a request for MAID. Although this makes it possible to take a first step in the right direction by putting an end to what was hitherto a preserve of doctors, the sole addition of qualified nurses is not enough. It is surprising, for example, that social workers cannot receive requests for MAID, even though they are better qualified than many other professionals to receive a patient contemplating this fundamental choice.
This position, although motivated in part by my experience and that of my family, is not limited to a heartfelt cry aimed at addressing the injustices of the past. Rather, I hope it will serve as a call to action. PL-11 is a progressive, fair, and solid initiative which, I am convinced, will receive the support of parliamentarians and the majority of the Quebec population. Let us therefore seize the opportunity it represents in order to perfect it and guarantee that, as my father would have wished, a human death is within everyone’s reach.