Madam Minister Sonia Bélanger, first of all, we would like to thank you for having implemented Bill 11 following your colleague Christian Dubé, and for having shown openness by not hesitating to expand the possibilities of places to obtain medical assistance in dying (MAID). However, the delay you introduce for advance requests is very worrying.
This new postponement will create anxiety among all the people who had found a certain serenity knowing that they had a light at the end of their progressive darkening: this unnecessarily long delay has just plunged them back into the anguish of a tomorrow without meaning. Let us think of Sandra Demontigny, emblematic figure of this fight, but of all the other citizens whom we have encouraged to be patient…
As service providers, we all have several people waiting on our lists: these are individuals who live in daily fear of their progressive loss of identity and who will have to resign themselves to requesting MAID now, while they are fit. They will thus lose precious months of serene life.
Allow us to remind you:
That these anticipated demands are the subject of a broad consensus in society: 78% of the population agrees with this proposal;
That this question was the subject of a symposium bringing together 200 participants from various health backgrounds on January 27, 2020, in Montreal, and that the conclusions were very clearly in favor of advance requests;
That the deadline for the implementation of the law on medical assistance in dying was 18 months in June 2014, when we started from a blank page;
That the 24-month delay is unnecessarily long and only aggravates the anxiety of these patients;
That a period of 6 months to draw up a guide to practice seems quite reasonable, especially since many briefs have been submitted to the attention of parliamentarians and already make it possible to draw the outlines of a guide to practice.
The report of the joint committee submitted to the federal government in February 2023 to pave the way for the expansion of MAID suggests to see what Quebec’s legislation will be regarding advance requests: such a long delay in Quebec will harm everyone, while there is a broad consensus.
In your media interventions of Wednesday, May 31, you mentioned certain objections which seem to us to be difficult to reconcile with what we experience daily. So is the assertion that it will take time for NPs (Specialty Nurse Practitioners) to know how to fill out a death certificate. However, the computer manipulation of this form (SIED) can be learned in 15-20 minutes, and it is often the administrative assistants of the hospital who fill it out perfectly. Moreover, in the vast majority of institutional cases, it is the nurses who certify the deaths.
MA learning by IPSs? Several of us already perform MAID with the support of a nurse, the latter are generally (all the time) much more skilful than us doctors in installing the venous lines necessary for treatment, and their training leads them to almost universal way to be very empathetic towards patients and loved ones. The technical training of a doctor in MAID is done in a single session observing a colleague and there is no reason to believe that it is any different for an IPS.
Madam Minister, it is with all respect and appealing to your empathy that we urge you, for our patients (Sandra, Mrs F, Mrs C, and all the others) to modify your last amendment in the following direction: article 55, paragraph 2: […] which come into force on the date set by the government, January 1, 2024.
This reasonable start-up time will restore hope and serenity to all our current and future patients. In addition, several service providers are offering you our services now in order to create a guide and a form based on the drafts that we have already offered in recent months.