QUEBEC — A landmark report suggesting Quebec legalize doctor-assisted euthanasia could rekindle the national debate on the controversial issue.
The report introduced at the provincial legislature Thursday recommended the Quebec government make it legal for doctors to help the terminally ill die, if they want to, under “exceptional circumstances.”
The non-partisan commission made of nine members from all political parties studied the sensitive issue for two years before making its 24 recommendations.
The group said it rejected legalizing assisted suicide — performed by a family member — to recommend “medical aid to die,” which amounts to euthanasia.
“We chose those words because we’re talking about a medical environment only,” said commission co-chair Maryse Gaudreault, a Liberal.
Euthanasia and assisted suicide are illegal in Canada. But the committee believes Quebec could introduce such legislation because of its provincial jurisdiction over health and the administration of justice.
If Quebec were to go ahead with this, it would be the first province to do so.
“We want to elevate the debate and we know that this report will have an impact on the rest of Canada,” Gaudreault said.
Jocelyn Downie, an ethicist and health law professor at Halifax’s Dalhousie University, expects other provinces to draw inspiration from this report.
“I think that Quebec has shown extraordinary leadership in this area,” she said.
“That’s a very solid foundation for other provinces to build upon. This is such a difficult issue for people, it touches people very close to the heart, and it’s important that the report was done very carefully,” she added.
The report of the commission, entitled Dying with Dignity, suggests the government improve significantly its end-of-life care and make it available at home as well.
But the commission noted palliative care has its limits and Quebec should offer its citizens a legal option for medical assistance for dying.
“Some sufferings can’t be relieved satisfactorily and the seriously ill who want to put an end to their sufferings, they deem senseless, come up against a refusal that isn’t in line with Quebec’s values of compassion and solidarity,” the report says.
Commission co-chair Veronique Hivon stressed several people who testified before them likened this type of medical help to a “spare wheel” or an “insurance policy.”
“This can bring serenity and calmness to people who fear suffering at the end of their life,” said Hivon, a Parti Quebecois member.
“Palliative care and medical aid to die don’t clash, they are part of the same intention to encourage a good death,” she added.
The commission recommended strict criteria be met before offering medical help to a dying person wishing to end their life.
The person would notably have to be an adult, suffering from an incurable disease and unable to endure physical and psychological pain anymore. The patient would have to make the request in writing and have it certified by two physicians.
Hivon noted they drew inspiration from Belgium, where voluntary euthanasia has been legal since 2002. The commission travelled to that country and the Netherlands last summer and Hivon said they found medical assistance to the dying did not lead, as some feared, to an increase in elder abuse or instances of non-voluntary euthanasia of seriously ill patients.
Recent polls show 70 per cent of Quebecers and a majority of the province’s doctors support the decriminalization of euthanasia.
However, the Euthanasia Prevention Coalition criticized the report Thursday for ignoring strong voices during the hearings against euthanasia and assisted suicide.
“The committee claims to be responding to the changes in social values in Quebec and yet they ignore the fact that the majority of the 271 briefs that were presented before the committee were opposed to euthanasia and assisted suicide,” the coalition wrote in a statement.
Former Bloc Quebecois MP Francine Lalonde, who introduced without success two bills at the House of Commons to legalize medical aid to die, applauded the report.
“It’s a great day for Quebec and Quebecers,” she said, noting the recommendations are very similar to what she proposed in her legislation.
“Quebec now has the tools to go ahead with this until changes happen in Ottawa,” Lalonde said.
Ghislain Leblond, who has been at the forefront of the debate in the province, also hailed the report as a major step forward.
“Today I feel more serene,” said the 67-year-old former deputy minister, who suffers from a degenerative neurological illness.
“The scenario that terrorizes me the most is to become totally paralyzed, dependent on others and a prisoner of my body for a very long period. I don’t think that’s a life that makes sense and I want to have the freedom to decide to seek assistance to put an end to my misery,” said Leblond, who is uses a wheelchair.
The report also recommends Quebec walk in British Columbia’s footsteps and refrain from prosecuting doctors who medically assist people to end their life, an area that falls into provincial jurisdiction.
Following the case of Sue Rodriguez — a terminally ill patient who fought for years for the right to die, and took her own life in 1994 with the help of a doctor — B.C. enacted new prosecution guidelines that laid out the strict conditions under which it will lay charges in cases of assisted suicide.
The Quebec report is not binding, but the panel urges the government to adopt a bill by June 2013.
The provincial government declined to comment on the report Thursday before reading it fully, but Health minister Yves Bolduc has already said the province is “open” to the proposed changes.
67% of Canadians support legalizing assisted suicide: poll