Two weeks ago, I told the story of Yves Bélair in three parts in The Press : the story of his unusual life, his decline and his death by medical assistance in dying1.
Yves had always lived with cerebral palsy, a condition that always weighed him down and slowed him down, but never brought him down.
A generous man, he launched a scholarship program for handicapped students at UQAM. In 30 years, nearly $150,000 has been paid out to dozens of students.
And he died on May 16 as he had lived: well surrounded.
To say that you were touched by the story of Yves Bélair is an understatement. I received hundreds of reactions. I passed on several of them to his relatives. It did them a lot of good. THANKS !
I am writing these lines the day after the adoption of Bill 11, which outlines the expansion of the Act respecting end-of-life care, led by Minister Sonia Bélanger. I want to come back to these new frontiers of medical assistance in dying.
I have been writing about medical assistance in dying for more than 10 years, which I wished for with all my heart before the Quebec law, followed by that of Ottawa (which had its hand forced by the Court supreme).
I see medical assistance in dying as ultimate care and as an ultimate gesture of freedom. To have the right to choose the moment of one’s death rather than going to the end of the ordeal of illness, I find that it is civilized.
And that’s exactly the choice Yves Bélair made: as a free man, he decided that his physical and moral suffering had lasted long enough. And he chose, after months of reflection, that he left this earth on May 16, under the good care of Dr.r Georges L’Espérance, a doctor who campaigned for medical assistance in dying from the 1980s.
I have always understood that medical assistance in dying is a sensitive and complex issue despite the support in principle2 of a large majority of Canadians3. There are legal, ethical, moral and medical issues related to physician-assisted dying that could not – and still cannot – be settled on the table.
Quebec took the time to carry out extensive consultations a decade ago to probe the hearts of citizens. There have been laws, and the courts have since imposed on parliaments the fate of those left out of our laws on medical assistance in dying, I mean those who are not necessarily doomed by an incurable disease such as a cancer or amyotrophic lateral sclerosis.
This expansion of the boundaries of medical assistance in dying is complex, more complex than the first drafts of the Quebec and Canadian laws. Just on dementia, for example Alzheimer’s, there is a consensus to allow advance requests for medical assistance in dying for people who have it.
But how do we manage this, down to the legal, ethical, moral, medical and logistical detail? It is complex, as the study of Bill 11 demonstrated.
There are very good reasons to be very careful, to choose the right words and the right protocols at the end of the debates posed to frame the medical assistance in dying administered to people who wanted it when they were lucid, but who will receive it when they are no longer…
The compromise: the law is adopted, but for dementia of the Alzheimer’s type, it will be necessary to wait some time, the time that the infrastructure to properly supervise this care is put in place.
Quebec talks about a two-year period. But I know that Minister Sonia Bélanger has the ambition to make care available to people with Alzheimer’s much more quickly. This is the wish of Sandra Demontigny, who lives with early Alzheimer’s. We wish her, too, to have quick access to this option.
Moreover, I note that the study of Bill 11 was after all done in the Quebec tradition in matters of medical aid in dying: with a calm head, without hysteria, in a respectful and non-partisan manner.
Summon the Nazis…
I have just said that the debates around the bill were carried out without hysteria. I note one deplorable exception: The dutythere Montreal Gazette and Noovo published a letter from opponents of provisions of Bill 11 in recent days.
Dissent is healthy because it advances debate and improves legislation. But this letter4entitled “Hurry to kill before you live”, is totally out of whack: it establishes a link between the provisions of Bill 11 in Quebec in 2023 and Nazi Germany in the 1940s.
I quote the author of the letter, Professor Pier-Luc Turcotte, of the University of Ottawa, supported by 17 co-signatories:
“Many doctors and nurses are unaware that ‘competent professionals’ like them killed 200,000 disabled people in the euthanasia program during World War II. Although extreme, this measure was seen as medical care, because according to those involved, we could not claim to take care of these people by keeping them alive. They were given death on the pretext that their life “was not worth living”. In the eyes of the medical staff, these people were not really people, because they could not carry out even the least basic activity without requiring the assistance of others.
“In Germany, the euthanasia program was installed gradually, in a context of financial constraints, after the First World War, which called into question the ability to care for these people. Such eugenic measures have also been implemented in Canada and Quebec.
“Although very uncomfortable, this dark part of the story absolutely had to be found in the expert panel’s report, beyond a simple footnote. »
Do you know why metaphors, parallels and analogies invoking Nazism are almost never used by credible people in contemporary debates in democracy? Because nothing, or almost nothing, justifies invoking the horrors committed by Hitler and his henchmen.
Invoking the slippery slope of the extermination of the most vulnerable under the Hitler regime to discredit the expansion of medical assistance in dying in Quebec in 2023 is an ignominy that insults the memory of the victims of Nazism. This is generally the rhetorical weapon of the trolls that plague internet forums.
It’s surreal to have to write it, but let’s get to it: the victims of Nazism were exterminated against their will in the name of a totalitarian ideology that advocated superiority and racial purity.
It has nothing to do with medical assistance in dying in Quebec in 2023, an issue that has been the subject of a very broad debate in society. It has nothing to do with a care that people choose in a lucid and voluntary way to put an end to their suffering at the end of a very, very broad democratic debate.
Quite the opposite of Nazi exactions.