Be prudent, regulator warns quebec mds

While Quebec i nsists it is ready now to let people die by lethal injection, the big question is: are doctors?

With confusion surrounding the legal standing of the province’s assisted death legislation, which came into effect Thursday, its physicians are being urged to tread carefully. And legal experts warn that while the risk of prosecution may be “infinitesimal,” it is not inconsequential.

“It’s a risk not of a parking violation — it’s a risk of what, for the time being, is still considered by the Criminal Code to be an act of criminal homicide,” said Daniel Weinstock, a professor in the faculty of law at Montreal’s McGill University.

Weinstock said it would be “shocking” if any doctor were prosecuted on the basis of Criminal Code provisions the Supreme Court of Canada has ruled constitutionally invalid.

Weinstock said it would be “shocking” if any doctor were prosecuted on the basis of Criminal Code provisions the Supreme Court of Canada has ruled constitutionally invalid. However, “with all of the uncertainty of the last few days, I would be very surprised if any physician or health institution were to say, ‘ You know, as far as we’re concerned, this (Quebec) law is a go and we’re going to start acting today,’” he said. “The situation is just too up in the air.”

The registrar of Quebec’s college of physicians is also urging caution.

While there likely would be little criminal risk to any doctor who agrees to euthanize a consenting patient before the province’s appeal of an injunction against its medical-aid-in dying act is heard next week, “we cannot say there is no risk of prosecution,” Robert said in an exclusive interview Thursday.

“Our message right now (to doctors) is, be prudent.”

Quebec’s Act Respecting End-of-Life Care makes it legal for doctors to administer lethal injections to mentally competent, consenting adults who are at the end of life, have an incurable illness and experience “constant and unbearable” suffering.

Wednesday, the province declared its historic law would come into effect Thursday, as scheduled, after its highest court agreed to hear the government’s appeal of a Superior Court decision suspending key articles of the act. But some are questioning why Quebec pushed ahead before the appeal is heard on Dec. 18.

Even if a doctor were willing to euthanize a patient, it might be logistically impossible in the next seven days for a doctor to comply with the process the Quebec law requires.

Two doctors have to agree to the request. “We have to prepare the drugs ( for the lethal injection),” Robert said. “Usually it will take probably a few days before it can actually be implemented.

“We are not aware of a number of requests that may be pending right now in the health network, and we don’t know how the physicians will react to this legal confusion that is going on,” he said.

Given that, “we can wait a few days or a few weeks,” Robert said. “This is not such an emergency.”

Quebec had sought leave to appeal a Superior Court ruling that found Quebec’s legalization of euthanasia clashed with the federal Criminal Code prohibiting physician-assisted death.

Last February, the Supreme Court of Canada struck down the federal law and gave Ottawa one year to come up with new legislation, but Prime Minister Justin Trudeau has requested a six-month extension.

Although assisted dying came into force in Quebec as of midnight Thursday, “This is still a criminal act in all of Canada,” said Dr. Catherine Ferrier, president of the Physicians’ Alliance Against Euthanasia.

“If I were a doctor contemplating euthanasia — which I’m not — I would be a little bit nervous about doing it in these circumstances.”

Ferrier works in geriatric medicine at the McGill University Health Centre. She said doctors were told at a recent MUHC physicians’ council meeting four doctors among the five teaching hospitals are willing to euthanize patients seeking assisted death. “Nobody knows who they are,” she said. “It’s a big secret. It’s like it’s ‘normal,’ but kind of shameful at the same time.”

Quebec Health Minister Gaétan Barrette insists the province’s health system “is ready” to help people access assisted death.

Ghislain Leblond, of Quebec City, has long been vocal in his support for euthanasia. Leblond, 71, has a neuromuscular disease similar to Lou Gehrig’s. His first symptoms appeared when he was 20. He has been confined to a wheelchair for 13 years and requires help with most of his daily activities.

“I lose a bit every year, and I’m worse than I was a year ago, but the trigger line for me will be if I ever become a prisoner within my own body,” Leblond said. “That’s when I would want to get help ( dying), but I’m not there yet.”

Leblond said he has heard of “some possible cases” of people hoping to access doctorhastened death. “Let’s suppose that you’re suffering from Lou Gehrig’s. For us, waiting for eight days is no big deal,” he said.

“But when you’re in pain, and unbearable pain, eight days is an eternity.”