Comprehensive access to medical care for dying | Opposition urges government to introduce legislation

(Quebec) The long-awaited and consensual expansion of access to medical care at the time of death is in danger of being “ruined” and postponed until after the general election, the opposition fears. She is urging the Legault government to table a bill as soon as possible, when there is very little time left to pass it by the end of the parliamentary session on June 10.

Posted at 2:26 pm
Updated at 3:01 PM

Tommy Choinard

Tommy Choinard
The press

On Thursday, MPs David Birnbaum (PLQ), Vincent Marissal (QS) and Véronique Hivon (PQ) made a joint public outing to pressure the Legault government to follow through on the cross-party commission’s report on medical assistance in the event of death , filed in Dec. They had an articulate guest by their side to shake things up.

“Hurry up. There are people like me, several thousand people, whose countdown has started and it doesn’t stop,” says Sandra Demontigny, who suffers from an early and hereditary form of Alzheimer’s disease. “I am expected to two to three more years of acceptable life,” she added, her throat clenched with emotion. She wants to be able to request an advance for medical assistance when dying, allowing her to leave “in serenity” and in “dignity” when the time is right. there is.


Sandra Demontigny suffers from early Alzheimer’s.

Precisely for people like her, the long-awaited bill would help.

In its report, the special and transparent commission for the evolution of Acting with respect for end-of-life care recommended expanding access to medical assistance at the time of death for unfit people, such as people with Alzheimer’s disease, by allowing them to make an ‘advance request’. David Birnbaum (PLQ), Vincent Marissal (QS) and Véronique Hivon (PQ) were members of this committee.

Below the End of life law submitted by Véronique Hivon and adopted in 2014, only a person who can give consent, who has an incurable disease and whose deterioration is advanced and irreversible, can receive medical assistance when dying. A person with Alzheimer’s disease or dementia who is unable to give consent will not be able to access it, even if they meet other criteria, such as advanced capacity reduction. It is not possible to request medical assistance in the event of death in advance.

The Legault government has pledged to submit a bill to follow up on the cross-party commission’s recommendation, but has still not done so. The parliamentary session ends on 10 June. “If we suspend” without passing a law, “it will be messed up”, and we will have to wait a year for the file to be settled, Vincent Marissal said at a news conference. “So yes, we are putting pressure on the government. Hurry up. There are still 4 weeks. That’s not a lot of sand in the hourglass. †


Vincent Marissal

“It really is midnight to one,” Véronique Hivon insisted. “It is important that the message is heard and that the bill is introduced now. […] By working long days, we can get there in a month” and adopt the legal text.

David Birnbaum clarified that there is no question of “a rigorous examination” of a bill to spare and that the opposition is ready to sit “day and night” to do the job.

The cross-party committee was chaired by CAQ MP Nancy Guillemette, who was noted for her absence on Thursday. Véronique Hivon clarified that “Mrs Guillemette, for reasons belonging to her, could not be there”, but that “she is informed and stands in solidarity with today’s approach”.

At the exit of the Blue Chamber, the Minister of Health and Social Services, Christian Dubé, confirmed that “the bill is in preparation and will be presented”. He has made no formal commitment to have it approved before June 10, the last day of the parliamentary session before the summer recess and after the election campaign. He already has three bills pending in the National Assembly.

In its report, the special committee recommends that “a person of age of majority and able to seek medical attention in advance when dying after a diagnosis of a serious and incurable illness leading to incapacity for work,” such as a neurocognitive disorder.

The committee proposes a framework for this expanded access to medical care at the time of death. Only a person who has been diagnosed with a serious and incurable illness that leads to his incapacity for work can apply for an advance. An adult in perfect health could not make one in anticipation of a possible incapacity for work after, say, an accident.

When preparing such an advance request, the doctor must ensure “the free” and “informed” nature of the person’s decision, without external pressure. The person can change the request as long as he is able to do so. It must “designate a trusted third party to be responsible for disclosing its anticipated request for medical assistance at the time of death and for requesting treatment of the request at the appropriate time on its behalf.” In the absence of a trusted third party or in the event of impediment, “the responsibility for protecting the patient’s will and actions should be borne by a member of the healthcare team.”

Still per the recommendations of the commission, “when the trusted third party submits the request for the advance”, the physician should “examine both the request and the advance”, consider it and respond to it without delay.

Before providing medical assistance in the event of death, the physician must ensure that the person meets certain criteria, such as “physical or psychological suffering, including existential, constant, unbearable suffering”. [ne pouvant] be appeased under conditions deemed acceptable”.

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