Our communication this week focuses primarily on the new work of the Special Joint Committee (House of Commons and Senate) on Medical Assistance in Dying (AMAD). You will find a reflection on the first testimonies heard and, above all, a call for briefs, that are to be submitted before… this Thursday, November 16, 2023 (!). Indeed, we learned last week that experts and the public had only a few days to prepare their documents. The AMAD committee will continue its work until November 28, 2023 and must produce a report by January 31, 2024; regarding “the degree of preparedness attained for a safe and adequate application of MAiD in cases where mental disorder is the sole underlying medical condition.” You will also find a short press review and the link to the final version of Bill 11, An Act to amend the Act respecting end-of-life care and other legislative provisions, as adopted on June 7, 2023 at the National Assembly of Quebec.
Have a great week,
Living with Dignity citizen network
Testimonies at the AMAD Committee
Testimonies at the AMAD Committee Testimonies resumed on November 7, 2023 to “verify the level of readiness reached for a safe and adequate application of MAiD (in cases where mental disorder is the sole medical issue invoked).” The list of invited witnesses can be found here.
It included several professional associations (the Canadian Psychiatric Association, the Canadian Bar Association, the Association of Psychiatrists of Quebec, and the Federation of Medical Regulatory Authorities of Canada) and Dr. Mona Gupta, who chaired the expert group on MAiD and mental illness. The witnesses invited were convinced that Canada is ready to offer MAiD for cases of mental disorders as early as March 17 next year.
Here is a video excerpt (in French) of the exchange between MP Luc Thériault and the president of the Association of Psychiatrists of Quebec in response to the question: why does Quebec refuse to follow suit on the issue of mental disorder?
Complete excerpt at 20:07:03 of the committee meeting video (with English translation).
Extrait comité 🇨🇦 #AMAD 7/11 aide médicale à mourir.— Vivre dans la Dignité / Living with Dignity (@Vivredignite) November 8, 2023
Échange @luctheriaultbq Association des médecins psychiatres du Québec:
Pourquoi QC refuse-t-il d’emboîter le pas sur la question du trouble mental?
Désolé Dre Claire Gamache, ce n’est pas par stigmatisation, mais précaution 1/ pic.twitter.com/baTp6SUGgE
No, Dr. Claire Gamache, it is not through stigmatization that Quebec law forbids MAiD in cases of mental disorder, but through prudent caution. The reasons cited by the Quebec Select Committee on the Evolution of the Act respecting end-of-life care are numerous (read on pp. 57-59 of its final report, in English):
– The lack of consensus among psychiatrists and other specialists on the incurability of mental disorders and the irreversibility of the decline in capabilities associated with them;
– The lack of social acceptability
– Difficulty in making the correct diagnosis;
– Negative impact on the therapeutic relationship.
We will closely follow the committee’s work via their web page
How to submit a brief to the AMAD committee?
Here is the information shared last week on the AMAD Committee’s website:
The Special Joint Committee on Medical Assistance in Dying is calling for briefs of no more than 1,000 words regarding the degree of preparedness attained for a safe and adequate application of MAID in cases where mental disorder is the sole underlying medical condition. Briefs must be submitted to the committee no later than Thursday, November 16, 2023 at 5:00 p.m. All text contained in the submission, including but not limited to graphs, quotes, images and footnotes, count towards the 1,000 words limit. Your brief can be sent electronically to the committee using the committee’s email address AMAD@parl.gc.ca, personal contact information (address, email address, phone number) should be provided in your email.
If you are concerned about this expansion, we invite you to take the time to express yourself. Your submission can be up to 1,000 words or much shorter.
The members of the Joint Committee will benefit from your perspective.
Journal of Palliative Medicine
Response to Medical Assistance in Dying, Palliative Care, Safety, and Structural Vulnerability
A report signed by Romayne Gallagher, Ramona Coelho, Philippe D. Violette, K. Sonu Gaind, Harvey Max Chochinov, and >170 scholars, clinicians, and researchers in palliative care and related field.
TVA Estrie Report
In distress: seniors end their lives after being denied medical assistance in dying.
Open letter from Dr. Stéphane Lemire in Le Devoir
Social geriatrics to avoid a “geriageddon”.
Journal de Montréal
Article: Medical Assistance in Dying: a study to understand the increase in requests.
The press release from the Cabinet of the Minister responsible for Seniors and Deputy Minister of Health confirming funding of $920,750 for the launch of a call for proposals to the scientific community to better understand the use of medical assistance in dying (MAID) in the Quebec context (and our reaction via X, in French).
Finally, as we were asked for the link to the complete text of Bill 11 adopted on June 7, 2023, here it is.
The next expansions planned for the law will take effect on December 7:
– Palliative care homes in Quebec will be required to offer MAiD;
– Specialized nurse practitioners (SNP) will be able to assess requests for access to MAiD and administer it.