Medical Aid in Dying: What is it and how are hospices in Quebec reacting to the legislation?

Today, the Quebec National Assembly passed the proposed Bill 52, which among other recommendations will legalize “medical aid in dying.” Medical aid in dying is described as:

Although the term “euthanasia” is used in Belgium and the Netherlands, we noted during the public hearings that this term is emotionally charged, and not everyone agrees on its use. But more importantly, it does not evoke the idea of support, which is central to our proposal. Over the course of the Committee’s work, “medical aid in dying” is the expression that gradually emerged on its own. The word “aid” refers to the fundamental value of support, while “medical” indicates the type of support and implies the intervention of a physician and health professionals. We therefore opted for the expression “medical aid in dying”. P. 76

Pre-emptively to the passing of this bill, some hospices in Quebec have taken a definitive stance on providing “medical aid in dying” within their facilities.

In Quebec City, staff of the 15-bed Maison Michel-Sarrazin have refused to perform medical aid in dying within their facility. They maintain that palliative care aims to relieve pain and suffering to the best extent possible through medication and support, with death occurring naturally. In an article published last week in Le Soleil, Executive Director Dr. Michel L’Heureux stated that, “medical aid in dying is not a part of palliative care. It’s euthanasia. This position is a part of our history and we will not change it even though we expect there will be pressure to do so.”

In Montreal, the West Island Palliative Care Residence continues to focus on delivering high-quality hospice palliative care to their patients, with the goal of neither hastening nor prolonging death. Teresa Dellar, Executive Director, shared with us: “it is important that we continue to provide the best care to our patients, and have the choice to not provide medical aid in dying. Our goal is to provide comfort and care to patients and families through their end of life journey, and we would inform patients before admission that we do not provide medical aid in dying.”

Worried about this legislation? Why not talk about your fears with your team and patients? The CHPCA created the Let’s Talk about Hospice Palliative Care First campaign to raise awareness on the terminology and questions frequently asked about end of life choices. The campaign also includes key terminology and clarifies the definition of palliative sedation therapy. Please visit www.chpca.net/hpcfirst to access these resources.