The alleged murder of an ailing nursing-home patient by her spouse on Monday has renewed questions about Quebec’s law on medical assistance in dying, especially when it comes to those who might be suffering from dementia.
On Tuesday, Michel Cadotte was charged with second-degree murder in the death of Jocelyne Lizotte, a patient of the east-end Centre d’hébergement émilie-Gamelin. Lizotte was reportedly suffering from Alzheimer’s disease and was denied a request for assisted dying.
Under Quebec’s “end-of-life care” act, which came into effect on Dec. 10, 2015, a patient seeking medical assistance in dying must make the request “in a free and informed manner.” . . . [Full text]
Ontario will allow hospitals to opt out of providing assisted death within their walls, provoking charges from ethicists that conscientious accommodation has gone too far.
Elsewhere in the country, a divide is already shaping up, with half of voluntary euthanasia cases in Quebec reportedly occurring in Quebec City hospitals — and few in Montreal.
The situation highlights the messy state of the emotionally charged debate as the provinces wrestle with the new reality of doctor-assisted death, and as the Senate takes a proposed new law further than the governing Liberals are prepared to go. . . [Full Text]
Right to die: ‘We were grateful and honoured to be able to help her,’ says doctor
A Calgary woman who received a legal exemption for doctor-assisted death has ended her life in Vancouver with the help of two physicians.
It is believed she is the first person in Canada outside of Quebec to be allowed to legally end her life with help from a doctor.
The woman, who cannot be identified because of a court-ordered publication ban, died with her family at her side.
“My colleague and I were grateful and honoured to be able to help her,” Dr. W, a clinical professor at the University of British Columbia, said in an e-mail to The Canadian Press. The doctor also cannot be ID’d due to the publication ban. . . [Full text]
Fear of legal reprisal still widespread among health professionals
Two months after Quebec’s assisted-dying law came into effect, about 10 patients have chosen to end their lives with the help of a doctor.
Health Minister Gaétan Barrette says this is a sign that things are going well and there are no systematic obstacles.
“The information that I have from the ground and from the College of Physicians is that teams are in place and that access is there,” Barrette said.
“Problems, if there were any, were resolved quickly.”
Doctors and patient advocates tell a different story.
Jean-Pierre Ménard, a lawyer specializing in health law, says his clients have reported trouble obtaining medical assistance to die. . . [Full text]
Quebec physicians told to falsify euthanasia death certificates
Regulators support coverup of euthanasia from families
In the first week of September, the Canadian Medical Association (CMA) was reported to be “seeking ‘clarity'” about whether or not physicians who perform euthanasia should misrepresent the medical cause of death, classifying death by lethal injection or infusion as death by natural causes. The question arose because the Quebec College of Physicians was said to be “considering recommending” that Quebec physicians who provide euthanasia should declare the immediate cause of death to be an underlying medical condition, not the administration of the drugs that actually kill the patient.1 In fact, the Collège des médecins du Québec and pharmacy and nursing regulators in the province had already made the decision. In August, the three regulators issued a Practice Guide directing Quebec physicians to falsify death certificates in euthanasia cases.
The physician must write as the immediate cause of death the disease or morbid condition which justified [the medical aid in dying] and caused the death. It is not a question of the manner of death (cardiac arrest), but of the disease, accident or complication that led to the death. The term medical aid in dying should not appear on this document.2
Lawyer Jean Pierre Ménard correctly observed that Quebec’s euthanasia law does not require physicians to report euthanasia on death certificates.1 M. Ménard is an expert on euthanasia law consulted by the Quebec government and the CMA,3 but he seems unaware of guidelines relevant to the classification of deaths and medico-legal death investigations. . . [Full text]
For at least a few more months, the Canadian medical system will continue to be a safe space, free of assisted suicide and euthanasia. But all that is about to change. In order to ensure our hospitals and palliative care centres remain places where patients feel safe and secure, we must respect doctors’ conscience rights, rather than listen to activists who seek to impose their one-size-fits-all policy on the rest of us.
For instance, the palliative care centres in Quebec that refuse to have anything to do with euthanasia, for reasons of medical judgment and ethics, have apparently angered Jean-Pierre Menard, the lawyer who helped write Quebec’s euthanasia law, Bill 52. The act specifically states that palliative care centres are not required to provide euthanasia service — but maybe to Menard, those were just soothing words to get the bill passed. Now Menard says money should be taken away from palliative services that won’t provide euthanasia on their premises. And the minister of health, Gaetan Barrette, has threatened to revoke the hospital privileges of doctors who won’t comply. . . . [Full text]
As Canada inches closer to granting doctors the power to end the lives of consenting patients, medical leaders are grappling with a new dilemma: should deaths by lethal injection be classified “death by natural causes” on death certificates?
Quebec’s College of Physicians is considering recommending doctors list the underlying terminal disease as the cause of death in cases of “medical aid in dying” on public death records – and not euthanasia.
The college says it wants to ensure life insurance is paid to families in cases of euthanasia and says the province’s assisted-death law will require any doctor who administers euthanasia to report the death to a special oversight body. That information will be kept confidential or shared with the college and/or the doctor’s hospital.
Euthanasia opponents are denouncing the proposal as an attempt to conceal the truth. It is also creating unease among some doctors who worry misstating death certificates could make it difficult to track how often assisted death is occurring once the practice becomes legal in Canada in February, and whether it is being performed legally. . . [Full Text]
Canadian Medical Association Journal
Canadian doctors remain deeply divided over whether and how to provide medical aid in dying, and what is required of those who refuse to assist in ending a patient’s life.
Earlier this year, the Supreme Court of Canada unanimously ruled that patients who face intolerable suffering from a “grievous and irremediable medical condition” have a constitutional right to doctor-assisted suicide. The decision overturned a previous ban; now federal legislators must regulate the practice by Feb. 6, 2016.
Exactly how physicians should respond to this new legal reality dominated discussion at the Canadian Medical Association (CMA) General Council in Halifax on Aug. 25. . . (Full text)