"Not recognising your children"
"Not being able to eat, go to the toilet or walk alone"
"Appearing distressed"
Where will we draw the line?
Montreal, September 9, 2024 – Our citizen network is reacting to the introduction of medical assistance in dying by advance request as of October 30 in Quebec:
The announcement of the forthcoming introduction of a system of advance requests for medical assistance in dying in Quebec highlights a number of problems associated with this extension of the Act respecting end-of-life care.
One of the main issues will be the list of possible reasons to be included in an advance request for medical aid in dying for a person diagnosed with a major neurocognitive disorder (such as Alzheimer’s disease). We have not yet seen any protocols for assessment and administration of MAID. However, if the discussions that took place during the parliamentary study of Bill 11 (An Act to amend the Act respecting end-of-life care and other legislative provisions) adopted in 2023 are to be believed, there will be no list of inadmissible motives.
It will be left to the good judgement of the various parties involved (the patient diagnosed with a neurodegenerative disease, a competent professional, a trusted third party and, for those who so wish, a notary).
In an interview on Saturday 7 September, Sonia Bélanger, Quebec Minister for Health and for Seniors, gave an idea of the acceptable reasons to include in advance requests for MAID (our translation):
“When, for example, I no longer recognise my children, when I am no longer able to feed myself, when I am no longer able to walk alone or go to the toilet, when I am in physical pain and appear distressed, then I would like to be assessed for medical assistance in dying.”
Living with Dignity is concerned that the possible inclusion of such a broadrange of impairments will contribute to stigmatising all people who lose their ability to recognise someone close to them, to feed themselves, to wash themselves, to walk (etc.) at some point in their lives. What they need is help to live, not medical aid in dying under a veneer of compassion.
As a guideline, we are promised that the two competent professionals who will assess the patient’s condition before proceeding with medical assistance in dying will have to observe signs of suffering in the patient.
In the absence of objective criteria, it seems clear to us that the door remains wide open to the administration of MAiD even in cases of happy dementia: some doctors have already stated their opinion that this condition of apparent happiness conceals inner suffering.
Awaiting essential clarifications
Before this new extension of the law on medical aid in dying is implemented, many clarifications will be essential. Here are three examples of outstanding questions:
– Will private prosecution of a practice prohibited by the Canadian Criminal Code really be impossible?
– What will be the protocols for giving lethal injections to incapable persons who do not expect their lives to be ended?
– Will there be any prior studies on the expected impact on families and care staff?
Instead of advance requests for MAID, the recommendation of the Living with Dignity citizen network is simple:
“Rather than crossing the line of incapacity to access medical aid in dying, it would be preferable to invest extensively in geriatric care and support for people living with a neurocognitivedisorder.“.
Reminder of recommendation 1 of our brief presented in 2023 during the
study of Bill 11, An Act to amend the Act respecting end-of-life care and other
legislative provisions.
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For interviews :
Jasmin Lemieux-Lefebvre
Coordinator
Living with Dignity Citizen Network
info@vivredignitaire.org
438-931-1233
SEP
2024