In a historic vote in the National Assembly, Quebec has become the first province to legalize doctor-assisted death as part of comprehensive end-of-life legislation.
The Bill was adopted by a wide margin Thursday afternoon with support from all parties in the National Assembly. Liberal Premier Philippe Couillard invited his caucus to vote according to their conscience. A total of 22 Liberal MNAs voted against the Bill including 10 ministers. Members from the other political parties voted in favour of the legislation. The final vote was 94 in favour and 22 against.
Parti Québécois MNA Véronique Hivon, who spearheaded the Bill when she was a minister in the recently defeated PQ government, argued the Bill should not be viewed as “medical aid-to-die” but rather as “end-of-life care.”
The difference, she said, is significant because the Bill is dedicated to those who suffered intolerable pain knowing that their situation was irreversible.
Premier Couillard, who was a practicing neurosurgeon before entering politics, agreed with Ms. Hivon. His numerous encounters with death in treating patients convinced him that people don’t want to die – but they also don’t want to suffer excruciating pain.
“Not once did patients ask that they wanted to die. But they often told me that they no longer wanted to endure the pain and wanted to go to sleep,” Mr. Couillard said.
He applauded changes to the Bill adopted during committee hearings, especially those allowing doctors to freely object to administering medications that would lead to a patient’s death.
“Without such changes I would not have been able to support the Bill,” Mr. Couillard said.
The legislation outlined the conditions needed for a terminally-ill adult patient who is able-minded to request continuous palliative sedation that would lead to death.
Anyone requesting medical aid in dying would need to be suffering from an incurable illness and from an advanced state of irreversible decline in capacities. The patient would need to suffer constant and unbearable physical and psychological pain that would be viewed by doctors as being impossible to relieve through medication. The procedure whereby a patient would make such a request would be supervised by the attending physician and approved though consultation with the hospital’s medical team.
Under the law any patient making a signed request for medical aid in dying could at any time withdraw that request.
The Bill also defines a policy for palliative care, which will require each hospital to define its own policy on medical treatment of terminally-ill patients.
The legislation was the result of more than four years of public consultations in which the vast majority of Quebeckers expressed the need to resolve the emotional issue of euthanasia. A non-partisan committee produced a report called Dying with Dignity which served as the foundation for the Bill tabled last June by the former PQ government.
The federal government has said it could challenge the legality of the legislation.
Assisted suicide and euthanasia are illegal under Canada’s Criminal Code and Ottawa has insisted it has no intention of changing that.