CMAJ Quebec Passes Right-To-Die

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Quebec passes right-to-die law

uebec has become the first groups have argued that assisted suicide of Sue Rodriguez, who suffered from Canadian province to legalize is an unethical alternative to redressing amyotrophic lateral sclerosis (ALS) dis- Q medically assisted death. Bill deficiencies in palliative care. ease. The British Columbia Civil Liber- 52, an Act respecting end-of-life care, Quebec’s International Relations ties Association recently asked the court passed in the National Assembly by Minister Christine St-Pierre, who voted to reconsider whether such prohibitions 94 votes to 22 in a free vote on June 5. against the bill, said she worries that violate the rights of the gravely ill. A Health Minister Gaétan Bar- ruling is expected in the fall. rette said the law will come into A private member’s bill to force within 18 months, as soon legalize physician-assisted as the province has established suicide nationally has been a commission on end-of-life- introduced in the federal par- care to oversee implementation. liament by Manitoba Conser- Quebec is the fourth juris- vative MP Steven Fletcher, diction in North America — but its low place on the order after Oregon, Vermont, and list makes it unlikely to be Washington — to allow what debated this session. The the bill describes as “medical House of Commons over- aid in dying.” Drawing heavily whelmingly rejected a bill on Belgian and Dutch models, legalizing physician-assisted Quebec’s law permits doctors dying in 2010. to prescribe and administer the During Quebec’s debate, substance that will cause the Premier Philippe Couillard death of the patient. told fellow legislators that in The bill’s language avoids his work as a neurosurgeon, describing this as euthanasia. he had never encouraged a By defining the act of hastening patient who explicitly asked death as a medical service, and to die. “But some said, ‘Doc- thus a matter of provincial tor, I don’t want this pain any competence, Quebec’s govern- more. I want to sleep.’ ” ment hopes to avoid friction Couillard said he would with the Criminal Code of Can- have voted against the bill had ada, which still defines all he held a seat last year, but assistance in dying as culpable was won over by recent homicide. changes that allow physicians Federal Justice Minister to refuse to provide medical Peter MacKay criticized this aid in dying if their conscience manoeuvre when Quebec’s new dictates. Physicians will still Liberal government tabled the have to transmit such requests bill in March, arguing that pro- to a colleague or superior, hibitions against assisted sui- Photodisc/Thinkstock however. cide “serve to protect all mem- A landmark law gives terminally ill and suffering Quebeckers Health Minister Barrette, a bers of our society, including the right to medical aid in dying. radiologist, said that he had the most vulnerable.” often heard patients demand A spokeswoman for the federal undue pressure from family members “the proverbial shot of morphine.” He justice ministry, Mary Ann Dewey- might lead some patients to feel it is added, “Canada will not be spared this Plante, said on Thursday that “it is for “their duty to die.” Under the new law, debate. At some point, they will have to the courts to decide if any province is it is the physician’s duty to verify that face it. But I believe that support for an legislating within its jurisdiction,” but patient consent is informed and free initiative like this one will not be uni- did not suggest that Ottawa would from such external pressures. form across the country.” — Owen mount a legal challenge. It is now 21 years since Canada’s Dyer, Montréal Several anti-euthanasia groups have Supreme Court narrowly upheld the said they will go to the courts. Such Criminal Code’s provisions in the case CMAJ 2014. DOI:10.1503/cmaj.109-4830