Québec debates bill to permit euthanasia for incompetent people.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Québec National Assembly has introduced Bill 38, a bill to expand Québec's euthanasia law. Bill 38 is Québec's response to Truchon court decision, the federal passage of Bill C-7 in March 2021 and the report of a Québec government committee that supported euthanasia for incompetent people but not for mental illness.

Article: Québec Committee supports euthanasia for incompetent people but not for mental illness (Link)

Bill 38 removes the requirement that a person needs to be at the "end of life" to die by euthanasia, it permits euthanasia for incompetent people who requested it in their advanced directive and it permits euthanasia to be done by nurse practitioners, among other changes. Bill 38 does not permit euthanasia for mental illness alone, as the federal legislation, Bill C-7 had done.

Bill 38 removes conscience protections that were in the original Québec regulations which will force all hospices to provide MAiD (euthanasia). Bill 38 is expanding the law in accord with the demands of the euthanasia lobby.

Bill 38 refers to euthanasia for incompetent people who had requested it in their advanced directive as a "contemporaneous request" where the “advance request for medical aid in dying” or “advance request” where it is made in anticipation of a person becoming incapable of giving consent with a view to an administration of such aid after the onset of that incapacity.

Permitting euthanasia by advanced consent creates several problems, even for people who believe in euthanasia. First, advanced request creates the problem of who will decide the time and place of the lethal injection. Secondly, since the person is deemed incapable of consenting, it denies the person the right to change their mind.

Further to the problems with advanced requests to be killed, Bill 38 will allow a "third" person to make the request in the presence of the person, when the person is unable to sign and date the request form.

To qualify for an advanced request for euthanasia the patient must:

29.2 With the assistance of that professional, the patient must describe in detail in the request the constant and unbearable physical or psychological suffering which cannot be relieved under conditions the patient considers tolerable that will determine, when the patient has become incapable and when a competent professional finds that the patient is experiencing such suffering due to their illness, the time from which the patient considers it appropriate to obtain medical aid in dying.

The reasoning for euthanasia is completely subjective. It states that the constant and unbearable physical or psychological suffering which cannot be relieved under conditions the patient considers tolerable. A person who is seeking death simply has to say that the suffering that they are experiencing is intolerable. People can be killed without objective criteria.

The medical professional in 29.3 only needs to:

(1) be of the opinion that the patient meets the criteria set out in section 29.1

A person is killed and the medical professional is only "of the opinion" that the person meets the criteria of the law.

Bill 38 is designed to protect medical professionals from being charged or sued for misconduct rather than ensure that the person who is being killed actually meets the criteria of the law.

The advanced request can one or two trusted "third persons" who would decide when the person, who has become incompetent, should die.

Once the advanced request for euthanasia is made the information will be maintained in a register of requests.

Section 29.9 allows a person to withdraw the advanced request at any time. The problem is that the person makes an advanced request because they anticipate that their condition will lead to becoming incompetent. Once a person is incompetent, they cannot legally change their mind.

Section 29.15 states that before administering medical aid in dying following an advance request, the competent professional must

(1) be of the opinion that the patient meets the following criteria:

It doesn't matter what the criteria states, the medical professional only needs to be of the opinion. To be of the opinion means that if someone complains that something wrong has happened, the medical professional is protected since they only need to be of the opinion...

At least the Québec government recognized that someone who changes their mind might resist and indicate that they don't want to die. Bill 38 states at the end of section 29.15:

Any refusal to receive medical aid in dying expressed by a patient must be respected and it is prohibited to disregard it in any manner.

The Euthanasia Prevention Coalition recognizes that Bill 38 does not extend euthanasia to people with mental illness alone, nonetheless, the federal government extended euthanasia to people with mental illness alone with the passage of Bill C-7.

It is interesting that Bill 38 describes the process that the committee examining the euthanasia reports must go through to determine that a euthanasia death did not fit the criteria of the law and yet the medical professional must only be of the opinion that the person who was killed fit the criteria of the law. Once again, the law is designed to appear to provide effective oversight of the law, whereas, in reality the law lacks any effective oversight.