{"id":14873,"date":"2023-02-18T12:42:08","date_gmt":"2023-02-18T17:42:08","guid":{"rendered":"https:\/\/vivredignite.org\/?p=14873"},"modified":"2023-02-19T15:45:17","modified_gmt":"2023-02-19T20:45:17","slug":"reaction-bill-11-amad-report","status":"publish","type":"post","link":"https:\/\/vivredignite.org\/en\/reaction-bill-11-amad-report\/","title":{"rendered":"Reaction to the tabling of Bill 11 and Federal AMAD Committee Report"},"content":{"rendered":"\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t\"\"\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t

The Mirage of Advance Requests
<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t

What kind of society administers death\n to those who have lost their
<\/h4>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t

A look at the many ethical and moral pitfalls of expanding access to MAiD in: <\/b>

– Quebec: Decision-making incapacity, disability and the obligation of hospices to offer MAiD

– Ottawa: Decision-making incapacity, mature minors and mental disorders<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t

Montreal,\nFebruary 18, 2023<\/span><\/b> – After the successive tabling\nof the report of the <\/span>Special\nJoint Committee on Medical Assistance in Dying (AMAD)<\/span><\/a><\/span>\nin Ottawa (on February 15th<\/sup>, 2023) and <\/span>Bill 11<\/span><\/a><\/span>\nin Quebec City (the following day), the citizen network Living with Dignity<\/i> and the Physicians’\nAlliance against Euthanasia<\/i> would like to shed light on the many problems\ninherent in the proposals to expand access to medical assistance in dying that\nare now on the table in Canada. Both organizations will certainly be making\nsubmissions to the specific consultations on Bill 11 and wish to testify on\nthat occasion.<\/o:p><\/span><\/p>

The common\ndenominator: the mirage of Advance Requests<\/o:p><\/span><\/b><\/p>

Both\nQuebec and Ottawa are proposing to offer MAiD through advance requests to\npersons who are at risk of losing their decision-making capacity (to consent to\nMAID).<\/o:p><\/span><\/p>

Quebec\n(Bill 11):<\/o:p><\/span><\/p>

The Bill allows people with a serious and incurable illness\nthat could make them incapable of consenting to medical care to make an advance\nrequest for medical assistance in dying so that they can have MAiD\nadministered, should such a loss of capacity occur.<\/o:p><\/span><\/i><\/p>

Ottawa\n(AMAD recommendation 21):<\/o:p><\/span><\/p>

That\nthe Government of Canada amend the Criminal Code to allow for advance requests\nfollowing a diagnosis of a serious and incurable health problem, disease or\ndisorder leading to loss of decision-making capacity.<\/o:p><\/span><\/i><\/p>

Only\none other country in the world gives death to individuals who have lost their\ncapacity to consent, but who are still conscious, the Netherlands. We endorse\nthe words of Dr. Trudo Lemmens, Professor of Law and Scholl Chair in Health Law\nand Policy at the University of Toronto, in his submission to the AMAD\nCommittee, which illustrates the mirage of advance requests (<\/span>essential\nreading<\/span><\/a><\/span>):<\/o:p><\/span><\/p>

Advance requests for MAID further raise insurmountable ethical and\nhuman rights concerns. This is reflected in this: Belgium only allows MAID\nbased on advance requests when persons are permanently unconscious, to avoid\neuthanizing people who still enjoy life and may resist. The Netherlands\noriginally had difficulty with MAID based on advance requests, since it was\nconsidered impossible to defend this practice on the basis that persons \u2018suffer\nunbearably\u2019, when they were no longer able to confirm this. It now has\npermitted it for persons even when they appear to resist.<\/span><\/i><\/o:p><\/span><\/i><\/p>

Health\ncare for major neurocognitive disorders and geriatric heath care is making\ngreat strides every year. We should be investing more substantially in\nsupporting individuals in the aforementioned groups and reassuring the public\nthat a dignified life in the advanced stages of Alzheimer’s and other dementias\nis possible! More difficult stories of personal experiences exist, but they are\nnot the norm. They are even rarer with adequate care and support.<\/o:p><\/span><\/p>

\u00a0<\/span><\/p>

Quebec:\nBill 11<\/o:p><\/span><\/b><\/p>

The\nconfirmation that access to MAiD for mental disorders is still not envisaged in\nthis legislative project is excellent news. We hope that this choice can\ninspire the rest of Canada. <\/o:p><\/span><\/p>

However,\nthere are two otherproposed expansions of access to MAiD that are highly\nproblematic:<\/o:p><\/span><\/p>

\u00a0<\/span><\/b><\/p>

Disability<\/o:p><\/span><\/b><\/p>

Without being explicitly stated in the explanatory notes of the bill (where only a reference to the removal of the end-of-life criterion is mentioned), serious and incurable neuromotor disability neuromotor disability would be an acceptable criterion for access to MAiD.* Members of Parliament\nsitting on the Parliamentary Committee that will study the Bill should expect a\nstrong reaction from groups representing individuals with disabilities.\nAlready, the Regroupement des activistes pour l’inclusion au Qu\u00e9bec (RAPLIQ)<\/i>\nhas\ncalled this expansion “very dangerous“<\/span><\/a>.<\/o:p><\/b><\/span><\/p>

The obligation\nfor hospices to offer medical assistance in dying<\/o:p><\/span><\/b><\/p>

According\nto the Alliance des maisons de soins palliatifs du Qu\u00e9bec<\/i>, <\/span>25 of\nthe 35 hospices offer medical aid in dying<\/span><\/a><\/span> (four hospices\nare in the process of doing so, and for another it is in consideration). In\nthis context, forcing palliative care facilities to offer MAiD by means of mandatory\nlegislation seems completely disproportionate. It should be remembered that at\nthe outset, facilities dedicated to the culture of palliative care will never\nbe primary destinations for obtaining MAiD, even though the majority of hospices\nnow offer it when a patient changes his or her mind. The rigidity of the Bill\n(lack of exceptions, unlike the previous version) is incomprehensible and\nQuebec should respect the fact that a small group of hospices prefer to offer\nonly palliative care, which is at the heart of their mission. As an example, the\u00a0<\/span>brief\npresented by Maison Victor-Gadbois<\/i><\/span><\/a>\u00a0<\/span>for\nstudy of the previous law clearlypresent the challenges of a palliative care\nhome.<\/o:p><\/span><\/p>

We remember\nthat access to MAiD is not a problem in Quebec. However, access to quality\npalliative care in the living environment of the patient’s choice deserves a\ngreat deal of improvement: the need is critical. <\/o:p><\/span><\/p>

The\nfollowing link for the Quebec National Assembly website allows you to read the Bill\nand comment on it <\/span>https:\/\/www.assnat.qc.ca\/en\/travaux-parlementaires\/projets-loi\/projet-loi-11-43-1.html<\/span><\/a><\/span>.\nThe citizen network Living with Dignity and the Physicians\u2019 Alliance against\neuthanasia invite active participation of the population in this consultation.
\n
\n<\/o:p><\/span><\/p>

Ottawa:\nThe AMAD Committee Report<\/o:p><\/span><\/b><\/p>

The\nreading of the 23\nrecommendations of the committee’s report<\/a> allows us to take a glimpse at\nthe new expansions of MAiD at the Federal level. <\/o:p><\/span><\/p>

The\n16th is the most troubling: <\/o:p><\/span><\/p>

Recommendation\n16<\/o:p><\/span><\/b><\/p>

That\nthe Government of Canada amend the eligibility criteria for MAID set out in the\nCriminal Code to include minors deemed to have the requisite decision-making\ncapacity upon assessment.<\/o:p><\/span><\/i><\/b><\/p>

There\nis no age limit, only “decision-making capacity”. While a young\nperson would not be able to vote or buy a lottery ticket, he or she could\naccess MAiD if natural death is reasonably foreseeable.<\/o:p><\/span><\/p>

Access\nto MAiDin cases where mental disorder is the sole medical condition is unfortunately,\nstill on the agenda. It will become a possibility on March 17, 2024 if the <\/span>Federal\nBill C-39<\/span><\/a><\/span> is passed.<\/o:p><\/span><\/p>

\u00a0<\/span><\/p>

Particular\nattention should be paid to recommendations 11 and 12 as Quebec elected\nofficials prepare to debate the issue of MAiD and disability in the context of\nBill 11:<\/o:p><\/span><\/p>

Recommendation\n11<\/o:p><\/span><\/b><\/p>

That\nthe Government of Canada, through the Department of Justice, and in\nconsultation with organizations representing persons with disabilities, explore\npotential amendments to the Criminal Code that would avoid stigmatizing persons\nwith disabilities without restricting their access to MAID. Options considered\nshould include replacing references to \u201cdisability\u201d in section 241.2(2) of the\nCriminal Code, with attention to the potential legal ramifications of such an\namendment across Canada. <\/o:p><\/span><\/i><\/b><\/p>

Recommendation\n12<\/o:p><\/span><\/b><\/p>

That\nthe Government of Canada convene an expert panel to study and report on the\nneeds of persons with disabilities as they relate to MAID, similar to the\nExpert Panel on MAID and Mental Illness.<\/o:p><\/span><\/i><\/b><\/p>

\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\nThere is a considerable\namount of work foreseen on the horizon, as across the country, various groups\nrepresenting people living with disabilities have been very unhappy with the\nimpact of access to medical assistance in dying since Track 2 became available\n(for individuals whose natural death is not reasonably foreseeable) since <\/span>Bill\nC-7 was passed in 2019<\/span><\/a><\/span>.

For Inclusion Canada, “The Committee’s\nfinal report is a discriminatory disaster”. <\/span>Their\npress release from the day before yesterday<\/span><\/a><\/span> and their moving video\nshow the obvious abuses of the system in place:\u00a0<\/span>
<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
<\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t

These words are echoed in the dissenting report of the Special Committee<\/a>.<\/o:p><\/span><\/p>\n

Note: Living with Dignity has indexed on this page<\/a> all the testimonies expressing reticence or opposition to the themes explored during the work of the AMAD committee. These testimonies demonstrate the great diversity and expertise of the groups and individuals questioning the merits of expanding access to MAiD.<\/o:p><\/span><\/p>\n

Two concluding observations<\/o:p><\/span><\/b><\/p>\n

Two days ago, Radio-Canada confirmed that <\/span>more than 7% of deaths result from medical assistance in dying in Quebec<\/span><\/a><\/span>: “Quebec is now well ahead of the Netherlands and Belgium in the use of medical assistance in dying. The article confirmed that the Commission des soins de fin de vie<\/i> has launched a consultation to understand the phenomenon. However, it should not be limited to physicians who provide MAiD. A multidisciplinary approach needs to be put in place as soon as possible. Another question is whether we should wait for the results of this consultation prior to embarking on a new Bill to expand access to MAiD.<\/o:p><\/span><\/p>\n

The views of other nations also invite us to reflect on the very rapid adoption of MAiD in Quebec. In the midst of the French debate on “active assistance in dying”, 13 organizations representing 800,000 caregivers published an opinion yesterday on the potential legalization of euthanasia. They state that this practice “cannot in any way be considered as care and alert legislators to the risks for vulnerable people”. A relevant reminder for Quebec and Canada.<\/o:p><\/span><\/p>\n

https:\/\/sfap.org\/system\/files\/avis_ethique_commun_-_160223.pdf<\/span><\/a><\/o:p><\/span><\/span><\/p>\n

Available in French only<\/o:p><\/span><\/i><\/span><\/p>\n

 <\/span><\/span><\/p>\n

Title translation:<\/span><\/b> <\/span><\/b><\/p>\n

Can providing death be considered<\/o:p><\/span><\/i><\/b><\/p>\n

be considered as care?<\/o:p><\/span><\/i><\/b><\/p>\n

Interprofessional ethical reflections
\non the prospects of legalizing assisted suicide and euthanasia and their
possible impacts on the practice of health care.<\/o:p><\/span><\/i><\/p>\n

 <\/span><\/i>16 February 2023<\/span><\/p>\n


<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t\"\"\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t

Living with Dignity is a Quebec non-profit citizen network 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.

The Physicians\u2019 Alliance against Euthanasia seeks to ensure quality medical
care and respectful decision-making for vulnerable patients, especially those at risk of pressure to end their lives prematurely through euthanasia or assisted suicide, and to protect the professional integrity of all health care workers.

-30- <\/b>

*Original version of the sentence: Without being explicitly stated in the text of the bill (where only a reference to the removal of the end-of-life criterion is mentioned), severe neuromotor disability would be an acceptable criterion for access to MAiD.<\/i> Clarification from February 19, 2023: it is indeed the explanatory notes that do not explicitly mention disability.
We also added “a “serious and incurable” as in article 14 of Bill 11.<\/span> <\/span><\/p>\n

 <\/span><\/p>\n

Media contacts :

<\/o:p><\/span><\/b><\/p>\n

Jasmin Lemieux-Lefebvre
Coordinator
Living with Dignity citizen network
<\/span>directionVDD@gmail.com<\/span><\/a><\/p>\n



Charmine Francis
Coordinator
Physicians\u2019 Alliance against Euthanasia
<\/span>info@collectifmedecins.org<\/span><\/a><\/p>\n

<\/p>\n

 <\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

\nThe Mirage of Advance Requests
\nWhat kind of society administers death
\n to those who have lost their
\nA look at the many ethical and moral pitfalls of expanding …<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[290],"tags":[],"class_list":["post-14873","post","type-post","status-publish","format-standard","hentry","category-blog"],"_links":{"self":[{"href":"https:\/\/vivredignite.org\/en\/wp-json\/wp\/v2\/posts\/14873","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vivredignite.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vivredignite.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vivredignite.org\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vivredignite.org\/en\/wp-json\/wp\/v2\/comments?post=14873"}],"version-history":[{"count":3,"href":"https:\/\/vivredignite.org\/en\/wp-json\/wp\/v2\/posts\/14873\/revisions"}],"predecessor-version":[{"id":14893,"href":"https:\/\/vivredignite.org\/en\/wp-json\/wp\/v2\/posts\/14873\/revisions\/14893"}],"wp:attachment":[{"href":"https:\/\/vivredignite.org\/en\/wp-json\/wp\/v2\/media?parent=14873"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vivredignite.org\/en\/wp-json\/wp\/v2\/categories?post=14873"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vivredignite.org\/en\/wp-json\/wp\/v2\/tags?post=14873"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}