Public Interventions 2017-2018

A second year marked again by abuse

Montreal, October 30, 2017 – Covering the period between July 1, 2016 and June 30, 2017, the government of Quebec published the second activity report of the Commission sur les soins de fin de vie (CSFV) on October 26.

The report reveals that the number of cases of euthanasia continues to rise dramatically in Quebec: in total, 638 euthanasia cases were reported between July 1, 2016 and June 30, 2017, out of a total of 992 requests. This corresponds to roughly 1% of deaths in Quebec in 2016 and is almost double the number of deaths on our roads in the same year.

What’s more, while the first year of euthanasia in Quebec saw 21 cases of transgressions of the law remaining without consequence, the most recent report from the CSFV shows 31 new cases where the Act Respecting End-of-Life Care was not observed before a euthanasia (referred to as “medical aid in dying” in the Act):

• In 20 cases, the physicians performed the euthanasia while the second physician, consulted to confirm that the conditions for admissibility for MAiD were present, was not independent from the patient; contrary to the requirements of article 29 of the Act.
• In 7 cases, the reports submitted to the CSFV did not demonstrate that the physician who performed the euthanasia had personally interviewed the patient to ensure the patient’s request was voluntary,  his suffering persistent and his desire to die repeated; contrary to the requirements of sections 29 (1) (b) and 29 (1) (c) of the Act
• In 2 cases, the physician performed the euthanasia without the request having been countersigned by a health professional or social service worker; contrary to the requirements of article 26 of the Act
• In 1 case, the report sent to the CSFV did not demonstrate that the person had a serious and incurable illness despite this being a mandatory requirement of section 26 (4) of the Act
• In 1 case, the physician performed the euthanasia while the patient was no longer insured by the RAMQ.

In addition, the number of cases transgressing the Act could be much greater because 55 cases are still under review, and the Commission was “unable to conclude on the compliance with the act in 19 [other] cases.” (CSFV Report 3.1.1). Note that “in four cases, the Commission did not receive the additional information, or the details requested, and in three other cases the physician (…)notified the Commission of his/her decision not to respond to the request made [by the Commission]” (CSFV Report 3.1.1), in defiance of the legal Act framing the practice of euthanasia in Quebec.

It should be noted that the physician who performs the euthanasia must declare it to the Commission within 10 days of the euthanasia. However, “the Commission found that about 38% of the forms were received past this deadline – sometimes by several weeks or even months after the euthanasia.” (CSFV Report 4.1.1). In addition, there is no way of knowing whether all cases of euthanasia were reported by the physicians to the Commission, let alone whether all unreported cases were performed in accordance with the Act.

According to article 47 of the Act, every failure to respect article 29 of the Act – noted by at least 2/3 of the members of the Commission – must be reported by the Commission to the Collège des médecins du Québec or the establishment so that they “take the appropriate measures.” However, neither the Collège des médecins nor any healthcare establishment has reported any action whatsoever in response to cases of transgression of the Act. On the contrary, this year again, Dr. Yves Robert, secretary of the Collège des médecins, mentioned that “there was no case that justified a punitive measure” since, in his opinion, it is a question of “administrative errors.”

In the same vein, Living with Dignity learned with consternation that that, since February 2017, “the Commission has adapted its assessment of the criterion concerning the independence of the second doctor from the patient (…), and that these cases are now considered compliant, so long as the other criteria are met (CSFV Report 3.1.2).” This decision to change the evaluation criteria was made in disregard of a fundamental requirement of article 29 of the Act, without the law being amended!

Faced with the facts reported by the Commission, Living with Dignity deplores the lax attitude of the Government of Quebec, which, from one year to another, loses more and more control of the situation: the statistics increase at a tremendous rate, the transgressions of the Act multiply without any consequences for the offending physicians, and the Commission is unable to process all the euthanasia forms sent to it.

Living with Dignity continues to affirm that the population of Quebec has the right to access to other solutions than death on demand in the case of suffering.

Living with Dignity’s requests to the Government of Quebec

1. Mandate a coroner to shed light on the circumstances surrounding the 31 deaths by euthanasia that did not respect the criteria established by the Act. This responsibility is essential to prevent the recurrence of other similar criminal abuses that threaten the security of people made vulnerable by illness, old age, disability, and other health conditions.

2. Honour its commitment to make palliative care accessible in Quebec. At present, priority is given only to euthanasia and no effective follow-up is done on access to palliative care. Thus, the Commission mentions in its report that the “variability of reported information with respect to the number of individuals at the end-of-life who received palliative care does not allow for the processing of these data at this time” (CSFV Report 3.2.1).

About Living with Dignity

Living with Dignity is an autonomous, non-profit organization in Quebec with no religious or political affiliation. Its mission is to promote the protection of the life and inherent dignity of people made vulnerable by sickness, old age or disability, by ensuring an end to their lives that is natural and respectful of the person and their dignity, through compassionate accompaniment.

For more information, please contact:

Aubert Martin, Executive Director

Living with Dignity

438.931.1233

info@vivredignite.org