Quebec MDs to be issued euthanasia kits
Quebec doctors will soon be given standardized kits with which to end the lives of patients seeking euthanasia — including drugs to calm the nerves and stop the breathing — along with detailed instructions as the province prepares to usher in legalized aid in dying.
The Collège des médecins du Québec has developed a new guideline for doctors unlike any in the history of Canadian medicine: a step-bystep guide to follow before, during and after administering euthanasia to an eligible patient, including the type of drugs to be used, the dose, the injection site and what to do in the event of complications.
The guideline, which was developed in collaboration with the Order of Pharmacists of Quebec and the Order of Nurses of Quebec, will be available to doctors, nurses and other health professionals on a secure area of the college’s website. “We don’t want these recipes made too easily available to everyone,” college secretary Dr. Yves Robert told the National Post.
In December, Quebec will become the first jurisdiction in the country to allow competent adults experiencing intolerable suffering at the end of life to request “medical aid in dying.”
Bill 52 allows doctors to administer lethal injections to mentally fit patients suffering an incurable illness and in constant and unbearable physical or psychological pain. He or she must also be in an advanced state of irreversible decline and be at the end of life.
“It is clearly not euthanasia on demand,” Robert said. “It is clearly not that.”
While the Supreme Court of Canada did not define “physician-assisted death” when it threw out the century-old Criminal Code prohibitions against the practice in February, legal experts say the court opened the door to both euthanasia and physician-assisted suicide — where the doctor writes a prescription for a life-ending overdose the patient then takes himself.
The Quebec guideline could become a model for all of Canada once the Supreme Court ruling comes into effect in February.
Modelled on a formula used in the Netherlands, the Quebec protocol calls for a three-phase approach to assisted death via lethal injection.
First, a benzodiazepine, a type of sedative, would be injected to help control anxiety and “help calm the patient,” Robert said.
Next, a barbiturate drug would be injected to induce a coma. The third step would be a neuromuscular block, a derivative of curare that acts on the respiratory muscles to cause “cardiorespiratory arrest.”
The whole process, from beginning to death, “would probably take something around 15 minutes,” Robert said.
The standardized euthanasia packages, specially prepared by pharmacists, will contain two complete treatments, in case a backup should be needed. Unused drugs must be returned to the pharmacy.
The guideline will be posted on the college’s website in French on Sept. 10, followed by an English version one month later. It will also be made available to every provincial doctors’ college in the country.