On May 25, more than 200 people gathered at Place des Aînés for a forum on end-of-life care, which contained public reflection on topics such as euthanasia, assisted suicide and the arrest or refusal of further treatment and palliative care.

This debate, which is the third leg of a process implemented by the Association de défense des droits des personnes retraitées et préretraitées de Laval (AQDR), in collaboration with the Association québécoise pour le droit de mourir dans la dignité (AQDMD), will help prepare a memoir which will be given to the Quebec government’s Select Committee on Dying with Dignity when it will stop in Laval as part of a public consultation.

This event was emceed by journalist Ariane Émond and counted on the participation of panellists Marcel Melançon, associate professor and bioethics researcher at Université du Québec à Chicoutimi, Dr. Yves Robert, Secretary of the Collège des médecins, and Me Jean-Pierre-Ménard, a lawyer specialized in medical rights, all of whom shared their thoughts and concerns regarding end-of-life care and the right to die with dignity.

“We all wish to die with dignity,” Melançon said. “However, will the law protect that right? For the time being, Québec is supporting palliative care after it turned down (Bloc Québécois MP Francine) Lalonde’s assisted-suicide bill (Bill-384), but it’s not a definite choice. It will be a societal choice where individuals can make an individual choice.”

Over the past three and half years, the Collège des médecins has been studying the issue of euthanasia and medically-assisted suicide. Even though this analysis has yet to result in a clear solution, it has led to several findings. The Collège is in favour of euthanasia with certain clear conditions, and strongly encourages Québec to carry out a public reflection.
“The Collège is not claiming or asking for anything, we are simply laying out the issues and the dead ends doctors must deal with when facing death,” Dr. Robert explained. “The current legal situation in Québec puts doctors in a deadlock.”

A doctor`s main priority is to act in a way to preserve a patient`s dignity when death seems inevitable. A doctor does not have to keep the patient alive at all costs, and must prevent unduly suffering. As such, stopping treatment or “pulling the plug” is not considered euthanasia.

“We (Collège des médecins) have turned down the option of assisted suicide because it is often a situation where the patient must determine themselves whether their quality of life is poor. We cannot be judge of another person`s quality of life – this is a social consideration, and not a medical one,” Dr. Robert added.
As for the Barreau du Québec, no decisions have been made regarding euthanasia and assisted suicide.“These decisions will be important for doctors, but mainly for patients and their families. To what point can a person decide on their fate with regards to end-of-life care,” said Me Ménard.

Currently, a person’s right to inviolability protects all citizens against any intrusion by a third party, unless the individual gives his or her consent. Therefore, a patient can refuse medical care. Furthermore, the right to autonomy grants any person the right to dispose of their own body and to make an unreasonable decision, even if this decision may cause death. However, individuals are not allowed to consent that death be inflicted by a third person, and such a consent does not affect the third party’s criminal responsibility.
“A doctor’s omission to comply with a patient’s will is not criminal, and to stop providing care that will unduly prolong the patient’s suffering and agony is not sanctioned. A patient cannot demand to pursue care that has become obsolete,” Me Ménard said.
At this time, there are no rights to palliative care. The decision to provide such care to a patient is made on a case-by-case basis and is often based on accessibility and budgetary criteria. The Barreau du Québec is studying this issue. “I believe we need to review the current laws to better reflect society’s choice, and to do it now, while there are no crisis situations, to carefully study this issue,” Me Ménard said.