Joanne of Arc's blog

By Joanne of Arc for Quebec Life Coalition— Photo : Unsplash.com

QUEBEC — Euthanasia is being expanded again for quebecers, this time for those suffering with Alzheimer’s disease. 

“Quebec's Minister of Health and Seniors, Sonia Bélanger, will table a new version of the bill that aims to expand medical assistance in dying (MAID)” in 2023, reported CTV News.

Bélanger is taking over the bill from Christian Dubé, Health Minister, who failed last year to pass Bill 38 that would allow people with Alzheimer's disease to make an early request for “MAID” should they want to apply for it before they are unable to. 

Patients with severe Alzheimer's are usually incapable of offering clear and informed consent and are therefore prohibited under law from accessing “MAID”.

Quebec's “MAID” law requires that patients give written consent to euthanasia within 90 days of the euthanasia procedure, this Bill would allow for them to apply earlier. 

The National Assembly of Quebec’s official pdf document from 2022 on the bill explains: 

“The purpose of this bill is mainly to amend the Act respecting end-of-life care as regards eligibility for medical aid in dying.

The bill makes eligible for such aid persons suffering from a serious and incurable neuromotor disability who meet the other criteria set out in that Act.

The bill also allows persons suffering from a serious and incurable illness leading to incapacity to give consent to care to make an advance request for medical aid in dying so that they can receive such aid once they have become incapable. The bill prescribes the applicable rules regarding the content and form of such advance requests and establishes the responsibilities of the various resources that participate in making or implementing such requests. Furthermore, it determines the criteria to be complied with in order for medical aid in dying to be administered to a person who has become incapable of giving consent to care, in particular the criteria regarding observation of the suffering the person is experiencing. The Commission sur les soins de fin de vie is also given the function of overseeing the application of the requirements specific to advance requests for medical aid in dying. (...)” 

Meanwhile, a group of five Quebec geriatricians, from The Physicians Alliance against Euthanasia including José A. Morais, Pierre J. Durand, Félix Pageau, Donald M. Doell and the president of the Physicians’ Alliance, Catherine Ferrier, shared a brief with the Committee on Health and Social Services in reaction to Bill 38.

In the brief they argued that “Advance consent can never be fully informed.”

Amongst their other valid points, their brief stated : 

“Our prediction, if this Bill is adopted, is that geriatric care will be disrupted by the demand for MAiD, just as palliative care is now. The extensive counselling and reflection required by the Bill will only detract from the already limited resources available. They will be stretched past their limit to include MAiD consultations. Assessments will be rushed. Decisions will be made based on fear and stigma. Patients will suffer and will die prematurely.

When the patient becomes incapable of decision-making, MAiD will be performed, not upon the autonomous request of the patient, but because a third party assesses their suffering as intolerable.

Is that what you want?”.

The Physicians Alliance against Euthanasia concluded their brief by saying: 

“The Netherlands, the only country in the world that allows euthanasia of conscious patients by advance request, is mired in controversy over the practice.

To cause the death of a person with dementia, who is not asking for it, in the absence of adequate consent, is contrary to autonomy and beneficence, and should not be permitted in a civilized country.”

The President of Citizen Network Living with Dignity, Mr. Alex King co-wrote another open letter in September 2022 with the President of Physicians’ Alliance against Euthanasia, Dr. Catherine Ferrier. In this letter titled "The Bill that no party wants to talk about" they state that "A society like ours should never give death to incapable people, no matter what the circumstances."

They also raise the following questions in regards to Bill 38: 

"Do you really want to force palliative care homes to offer medical aid in dying? Whether one is for or against offering MAiD in these places (a majority of them now choose to offer it), it is always counterproductive to impose an act of such magnitude in palliative care homes whose primary mission will always be palliative care until natural death.

Do you really want neuromotor disorders to be studied in the next Bill on MAiD? Disability as a criterion for access to medical aid in dying has never been the subject of parliamentary debate in Quebec. Despite the opposition of national disability rights associations (please click the following links for examples: Inclusion Canada and Disability without poverty), the federal Bill C-7 (March 2021) takes this criterion into account in certain circumstances, but it is not regulated in the Quebec legislation. A discriminatory view of the situation of disability underlies this vision. Disability alone would be sufficient to want to die. This is unacceptable in a liberal democracy that seeks to protect those who are most vulnerable to discrimination, such as those with dementia."

One of the largest organizations studying the disease, Alzheimer’s Disease International, released a Global Report in 2022 where a Quebec geriatrician, Dr. Félix Pageau on page 186 states that euthanasia for people with dementia is not a preferred option.  

Moreover, opening the door early to apply for euthanasia for patients suffering with Alzheimer could remove their motivation to treat the illness and choose hope. 

The United States recently declared that it authorized a new treatment for Alzheimer, according to Journal de Montréal. 

"The new treatment, which will be marketed under the name Leqembi, is now recommended by the US Food and Drug Administration (FDA) for patients who have not yet reached an advanced stage of the disease."

It represents "an important advance in our battle to effectively treat Alzheimer's disease", the FDA said in a statement.

Euthanasia being proposed and expanded for patients suffering from Alzheimer would reduce their motivation to seek treatment and feel pressured to stop being a burden on the system or their family. 

The case of Roger Foley is an example of a patient being pressured into assisted dying by the hospital and Government while they prevent his access to care options. 

"I am continuing to be attacked through my care, being denied basic necessities of life, and being denied proper and dignified health care. I am very scared, and the Government and the Health Care systems want to end my life rather than help me to live with dignity and compassion." wrote Foley in one of his blogs. 

"The Hospital is currently billing me $1800 dollars per day and continuing to coerce me to Assisted Dying during the Covid-19 pandemic when they threatened me with that and offered me Assisted Dying. Instead of protecting the lives of the elderly, the disabled and the vulnerable, the Hospital and Government are taking advantage, by further exploiting and abusing persons who are vulnerable before and during Covid-19 and not protecting their lives across the Country. So many persons are dying unnecessary deaths, when robust self-directed home care would make all Canadians safer in their own homes." wrote Roger. 

"I have seen and heard of so many vulnerable persons being pressured into wrongful assisted deaths, I feel a responsibly to speak out about the truth of what is really happening. The public is being mislead. MAiD doesn't truly mean Medical Assistance in Dying, it's true meaning is Mislead Answers in Dying" concluded Foley.