Quebec is moving to allow euthanasia for people deemed by doctors and nurse practitioners as no longer able to give consent, without consequence for the medical professionals, if those people had advanced directives in place. The lack of consequence for practitioners would remain, even if those requesting death changed their minds later.
Justice Minister Simon Jolin-Barrette issued a statement saying that they are taking “necessary steps” to ensure doctors and nurse practitioners who commit euthanasia on patients unable to give consent will be protected from criminal charges.
“The issue of advance requests for medical assistance in dying is widely supported in Quebec,” Jolin-Barrette said. Sonia Bélanger, the minister responsible for seniors, added that there had been a “constant increase” in Medical Aid in Dying (MAiD) requests since it had been legalized. Far from being concerned, Bélanger downplayed it. “That’s normal because it’s new,” she said in an interview with Radio-Canada on Saturday. “What we’ve noticed over the past year is that there has been a certain stabilization.”
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Dr. Georges L’Espérance, a retired neurosurgeon, applauded the development, giving the example of a 59-year-old lawyer who was physically healthy, but whose “mind was in decline,” and could be eligible for MAiD now. “With that [advance request], she will be able to say: ‘I want to keep on living with my boyfriend, with my dog. And then, I will have medical aid in dying when I will not be apt anymore,'” L’Espérance said.
The federal government has refused to change the criminal code, but the Quebec government will allow the change to be instituted beginning in October 2024.
Quebec already has the highest euthanasia rate in the world, despite similarly liberal laws in countries like Belgium and the Netherlands. “We have no sociological explanation, apart from the aging of the population,” Michel Bureau, president of the Commission on End-of-Life Care, said earlier this year.
One geriatrician suggested that the issue is not one of fearing a painful death, but of elderly people not wanting to spend their final years in nursing homes, known as long-term care centers (CHLSD) in Quebec.
“As a geriatrician, the fear of being in CHLSD, I hear it a lot and so it concerns me,” Dr. David Lussier said. “It’s sad, but I don’t see it as a failure. What people don’t want is to be in this state of dependence and severe loss of autonomy.”
The commission also warned that some euthanasia deaths were not in compliance with the law, such as someone wanting to die simply because they are elderly, not ill. Alex Schadenberg, president of the Euthanasia Prevention Coalition, said at the time that because Quebec has a self-reporting system for euthanasia, the true number of illegal euthanizations was likely much higher.
“The reporting procedure requires the doctor who carried out the euthanasia death to also report the euthanasia death. This self-reporting system enables doctors to ‘cover-up’ controversial euthanasia deaths,” Schadenberg said. “Why [have] none of the doctors been sanctioned for killing patients outside of the law?”
Now, with the euthanasia laws being liberalized even further, MAiD doctors will be all the less likely to be held responsible for wrongly killing their patients.
