QUEBEC — A Quebec committee of elected officials says anyone diagnosed with Alzheimer's disease should be able to sign an advance request for medical aid in dying.
That is the main recommendation in a multi-party committee report tabled Wednesday looking at expanding the province's law on end-of-life care, one that is expected to revive a debate that has divided politicians and the public.
The current law, adopted in 2014, set out strict criteria that include informed consent of a patient until their death, meaning people who had been diagnosed with Alzheimer's and could no longer provide informed consent do not have access.
If the legislature follows the committee's recommendation, the law would allow any adult diagnosed with a serious and incurable disease and facing incapacity to make an advance request for medical aid in dying.
However, the committee did not recommend expanding access to those whose only medical problem is a mental disorder. It says experts testified that in many cases with mental illness, it can be difficult to make the proper diagnosis.
It will now be up to Health Minister Christian Dubé to decide whether to table a bill responding to the recommendations quickly if he wants the changes to be adopted before the end of the government's mandate next fall.
At a news conference, Nancy Guillemette, the chair of the committee and a member of the Coalition Avenir Québec government, said the committee agreed a bill should be tabled in the legislature as soon as possible.
According to the committee made up of a dozen elected provincial politicians, its position reflects "the main trends" of opinions observed in Quebec society on this subject in recent years. They say there is a "social consensus" in favour of a widening of the law.
Véronique Hivon of the Parti Québécois, a member of the committee who shepherded the original legislation, said the key is ensuring any expansion of the law is "extremely well framed."
That means doctors will play a decisive role in managing requests and ensuring the request is free and informed. They must also ensure that the patient understands the nature of the diagnosis and the expected course of the disease.
The applicant could identify at what stage they would want to die and name a third party responsible for alerting medical authorities. The committee recommends the form be signed in the presence of two witnesses and a doctor. It would be up to medical authorities to decide whether the request meets the established criteria.
Currently to be eligible for medical aid in dying in Quebec, a patient must be of legal age, suffer from a serious and incurable disease and experience intolerable physical or mental suffering. They must also be able to consent up until death, although the law has been relaxed to allow for a period of 90 days between consent and medically assisted death if the patient has become incapacitated in the meantime.
The committee carried out consultations last spring and in August, hearing from 77 people and consulting 75 written briefs.
Experts urged elected officials to broaden access to the procedure, saying that some seriously ill patients had given up taking their medications, exposing themselves to horrible suffering, for fear of losing consciousness and no longer being entitled to medical aid in dying.
Since the adoption of the law, more than 7,000 people have received a medically assisted death, including 2,270 last year. The average age of patients is 73, and three out of four suffered from cancer.
This report by The Canadian Press was first published Dec. 8, 2021.
The Canadian Press