(Quebec) Yes to an expansion of access to medical assistance in dying for incapacitated people, such as those suffering from Alzheimer’s, but not for people whose only medical problem is a mental disorder, decides the special commission on the evolution of the law concerning end-of-life care.
In its eagerly awaited report, tabled in the National Assembly on Wednesday, this commission bringing together deputies from all parties recommends that “a person of full age and capable can make an early request for medical assistance in dying following a diagnosis of serious and incurable illness leading to incapacity ”.
When drafting such an advance request, the physician must ensure the “free” and “informed” nature of the person’s decision.
“The Commission recommends that the advance request remain valid unless the person indicates otherwise; that it can be changed as long as the person is able to do so, ”says the report.
In addition, “the Commission recommends that the person designate on the form a trusted third party responsible for making known his anticipated request for medical assistance in dying and for claiming on his behalf the processing of the request at the appropriate time; that the trusted third party consents in writing to the role assigned to him ”. In the absence or impediment of a designated trusted third party, “the responsibility to protect the patient’s will and to act is assumed by a member of the care team”.
According to the recommendations of the commission, “when the trusted third party files the request on the anticipated request”, the doctor must examine “both the request and the anticipated request, take them into consideration and act on them without delay”.
Under the End-of-Life Care Act passed in 2014, only a person able to give consent, who has an incurable disease and whose decline is advanced and irreversible, can obtain medical assistance in dying. A person with Alzheimer’s or dementia who finds themselves in the same situation cannot obtain it now because they are unable to express their consent.
In addition, “the Commission recommends not to extend access to medical assistance in dying to people whose only medical problem is a mental disorder”.
This cross-party “Dying with Dignity” 2.0 commission was launched at the end of 2019 to study an expansion of medical assistance in dying. An expert report tabled at the time recommended that it be extended to disabled people, such as those with Alzheimer’s, under certain conditions. The deputies are therefore moving in the same direction.