Monday, August 7, 2023

Media Release: Memo to Quebec physicians practising medical aid in dying.

For Immediate Release: Link to the original release (Link).

Memo to Quebec physicians practising medical aid in dying

The Commission on End-of-life care had to act

A welcome intervention that unveils some important issues

Montreal, August 7, 2023 – Over the past few days, the Commission on End-of-life care has issued a memo to the hundreds of Quebec physicians who provide medical aid in dying. This information comes from the work of journalists Davide Gentile and Daniel Boily in a text published Saturday in French by Radio-Canada information, then adapted to English by CBC News’ Rowan Kennedy. Living with Dignity citizen network welcomes this intervention by the Commission on End-of-life care and its president, Dr. Michel Bureau. Living with Dignity invites political decision-makers to support the reminders contained in the memo, which highlight important issues that need to be taken very seriously.

The memo addresses three themes, as seen in these excerpts (in quotation marks, our translation) from the e-mail sent by the Commission on end-of-life care:

1) Non-compliance of a growing number of medical aid in dying procedures
"...a growing number of MAiD procedures with very borderline compliance with the conditions contained in the law, and a growing number of non-compliant MAiD procedures administered";
2) The importance of a second physician's opinion and doctor-shopping for a favourable opinion
"...the opinion of a second independent physician confirming the admissibility of MAiD is not just a formality; it must be critical and contemporaneous with the MAiD application";

"Doctor-shopping for a favourable second opinion is not an acceptable practice";
3) Advanced age is not a criterion for MAiD eligibility
"...advanced age and age-related problems do not constitute a serious and incurable disease, and do not justify MAiD".
Comments from Living with Dignity

By Jasmin Lemieux-Lefebvre, coordinator of the Quebec citizen network:

These warnings confirm the information we are receiving on the ground. To avoid refusals, people applying for medical aid in dying may be tempted to turn to MAiD providers who have a broader vision of MAiD access. Doctor-shopping for a favourable second opinion is also a well-known problem in this country. In his essay, No other options, published in The New Atlantis last winter, journalist Alexander Raikin explores the subject in depth in the section Easy to die.

At a conference of the Canadian Association of MAID Assessors and Providers, it was said that “you can ask as many clinicians as you want or need” and that "disagreement doesn't mean you must stop".

It should also be borne in mind that this memo comes at a time when the situation is probably more serious than that described by the Commission on End-of-Life care, which refuses to acknowledge any abuses for the time being. The scientific article The realities of Medical Assistance in Dying in Canada, published by Cambridge Press this summer, addresses the issue of inadequate data collection on MAiD in Canada:
The data are acquired from the MAiD providers via self-reporting. There is no mechanism for objectively, prospectively, or retroactively identifying or uncovering any errors or abuses of the process. Providing assisted suicide and euthanasia outside the parameters of the law remains prohibited. MAiD providers filling out the forms know that any deviation of the key criteria may result in criminal prosecution, making self-declarations of error or deviation unlikely. (see the Inadequate data collection section of the article by Ramona Coelho, John Maher, K. Sonu Gaind and Trudo Lemmens).
On March 7, 2024, medical aid in dying will be available in Quebec to people living with a serious physical impairment (a term adopted by the Act to amend the Act respecting end-of-life care and other legislative provisions and suggested by a group of experts on disability). As of December 7, 2023, it will be required in all palliative care hospices. The revelations of the Commission on end-of-life care must lead to concrete action to avoid the abuses that can be expected.

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Media contact:

Jasmin Lemieux-Lefebvre
Living with Dignity citizen network
438 931-1233

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