Many doctors have denounced the intolerable situation in which they faced requests for medical assistance when their disabled patients died. Should they give them care as federal law allows, or refuse to comply with Quebec laws? For this reason, the College of Physicians welcomes Quebec’s desire to harmonize the two laws.

However, the bill does not resolve the situation. By stating that only people with disabilities neuromotor qualify, Quebec excludes other types of disabilities from the list. For example, those of a serious congenital nature.

However, the penal code and Supreme Court guidelines in Canada in no way qualify the concept of disability.

” We understand that the legislature wants to keep intellectual disabilities out of the law and that they seem to find disability, as worded without qualification in the Criminal Code, to be a vague concept that could be open to abuse. Why this would lead to a different situation or particular difficulty in assessing disability […] in Quebec than in the rest of Canada? »

dr Mauril Gaudreault wonders about this excessive caution and recalls that theMA is one of the most pronounced and monitored treatments. It is not important to us to indicate the origin of the disability. I’m not sure what falls within the definition of neuromotor. He believes that access should be offered equitably to all people with severe disabilities.

Remove qualifier neuromotor is the first of nine recommendations from the medical board.

The college had not officially responded to the submission of the new version of the Euthanasia Act (MAD). He will present his letter to parliamentarians on Tuesday. The copy received by Radio-Canada welcomes the progress but asks for clarifications.

Necessary reflection on mental illness

The professional code also believes that Quebec is on the wrong track in completely shutting down requests from people with mental illnesses. The college believes that this inevitable and sensitive issue should at least be discussed, since the penal code could allow it as early as next year.

In its report presented last December, the Special commission for the further development of the law of end-of-life care did not recommend expanding itMA People who have a mental disorder as their only medical problem. The draft law expressly follows this recommendation by specifying its inadmissibility.

It really felt rushed to do that. I think it takes time. This is an extremely sensitive issuesaid Sonia Bélanger, Minister for Health and Elderly. The idea is not to take away a right. […] Nothing prevents you from discussingshe added as she presented the bill, but without committing to a specific timeline.

It should be noted that this exclusion in the Criminal Code should initially be lifted by March 17, 2023. It has been postponed by a year to allow the federal government to follow up recommendations from an expert panel to ensure that the assessment and delivery of this care will be safe and labeled.

” With the current wording of the bill, which, contrary to the Criminal Code, excludes mental disorders without a time limit, doctors and patients in Quebec could face an overhang situation in the very short term with the coexistence of two non-harmonised legislative regimes that theMA. We perceive this exclusion as stigmatization […] And [elle] perpetuates the prejudice that people with mental illnesses are not capable of making decisions and need to be protected from themselves […] it is tantamount to abandoning and judging those very suffering people who can no longer take it. »

We will continue to argue that mental illness should also be part of all these severely disabled patients. There are people for whom the treatments have not been effective for years and who find themselves in similarly unfortunate situations as the severely physically disabled patients.adds dr Mauril Gaudreault added.

The second recommendation of the college is therefore to be understood as a request: to speed up reflection on eligibilityMA People with Mental Illnesses, in time for March 2024 to ensure consistency between federal and state laws.

requests in advance not applicable

The Chamber of Physicians sees a significant gain in the new regulation of the advance application. This would, for example, allow a person diagnosed with a serious and incurable disease leading to disability, such as Alzheimer’s, to apply before their condition worsens.

Quebec would be a precursor as it is not currently possible to make such a request in Canada as the penal code does not yet provide for it. A Senate and House of Commons committee has recommended the change, but it is not yet known if the government will act on it.

For this reason, the College considers that a pre-proposal would not be applicable. On the other hand, immediate legislation on this issue could quickly give people access to this option if the Penal Code allows for prior searchesMA.

Change for end-of-life care at home

However, the medical college welcomes the empowerment of specialist nurses (IPS) to assess and perform medical euthanasia, as is already the case in the country. He also advocates requiring all palliative care homes to provide this care immediately, as required by the bill.

As a whole it makes a clear progress that reflects the social acceptance very well. The College will use its platform before Parliamentarians to reiterate its desire to improve end-of-life care at home, including medical euthanasia.