Quebec Minister of Health Tables Bill to Expand Access to Medical Assistance in Dying

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The Minister of Health, Christian Dubé, tabled a bill on Wednesday that would allow, for example, people with Alzheimer’s disease to make an early request for medical assistance in dying (MAD).

The long-awaited Bill 38 incorporates most of the recommendations made last December by the multiparty special commission on the evolution of the Act concerning end-of-life care.

But it contains a provision which was not included in the work of the committee: the extension of the MA to people with severe neuromotor disorders, such as quadriplegics.

“With neuromotor disorders, there is also the question of suffering,” said Dubé in a press briefing, saying he wanted to harmonize Quebec legislation with that of the federal government.

Paraplegia, cerebral palsy and amputation after an accident are also serious neuromotor disabilities.

“TAKE A RABBIT OUT OF HIS HAT”

But this last-minute addition “tremendously complicated” the adoption of the bill, Parti Québécois (PQ) MP Véronique Hivon warned on Wednesday.

She believes that the minister is opening up “an entirely different area” that has never been debated in Quebec, and that it will be difficult to debate it properly with only nine days of legislature.

“It’s not a trivial choice for the Minister, and I must tell you that I really wonder why he did this.”

Minister Dubé should have stuck to the recommendations of the transparent commission, according to Vincent Marissal, MP for Québec solidaire.

“He pulls a rabbit out of his hat by adding neuromotor disability as a reason to apply for [MAID]while this condition was barely touched upon during the consultations,” he said.

If passed, Bill 38 will allow a person suffering from a serious and incurable disease resulting in a disability (dementia, Alzheimer’s, Parkinson’s in certain cases) to choose the end of their life.

They will be able to decide, with the help of a doctor or a specialized nurse practitioner, at what stage of the disease they wish to end their lives, even if they are no longer able to give their consent.

The request would be recorded on a form completed and signed in the presence of the health professional and countersigned by two witnesses or notarized. It would then be recorded in a register.

The person may designate one or two trusted third parties whose role is to inform a doctor or a specialized nurse practitioner when they believe that the person is experiencing the suffering described in the request.

A person who is alone and who does not have a trusted third party will be accompanied by healthcare personnel, but a person can modify or withdraw their prior MA request.

Approximately 140,000 Quebecers currently suffer from Alzheimer’s disease.

On the other hand, Minister Dubé sided with the Transpartisan Commission and refrained from extending MAID only to people with mental disorders.

“Are we going to come back to it later, when there’s maybe another update? But right now it really wasn’t the right thing to do,” he said.

Another change proposed in the bill is that a hospice will no longer be able to exclude MAID from the care it provides, with some exceptions. Currently, six of the 37 hospices in Quebec do not offer medical assistance in dying.

Finally, the bill removes the “end of life” criterion from the eligibility conditions for the procedure, since it is no longer applicable.

BLOCKING AT END OF SESSION

In order to be able to study Bill 38, Dubé said he was ready to scrap Bill 19 (health information).

In a press conference, he defended himself from being poorly organized, while he is currently piloting four health bills. However, he acknowledged that the agenda was “very tight”.

“We have a group of legislators who, until a few weeks ago, were still working on COVID and then on a lot of things… As soon as we received (Bill 38) from our people, we tabled it. “, did he declare.

According to the regulations of the National Assembly, a bill tabled after May 15 “cannot be adopted during the deliberations during which it was tabled”.

However, this rule can be circumvented if the government obtains the agreement of all elected officials.

— This report from The Canadian Press was first published in French on May 25, 2022.

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