Introduction

Webcast archive: Nine months of euthanasia in Québec

This week, we review the first nine months of euthanasia in Quebec.

Webcast archive: Nine months of euthanasia in Québec

In this episode of Euthanasia & Disability, Amy Hasbrouck and Christian Debray discuss:

  • Nine months of euthanasia in Québec: the Commission reports
  • The assisted suicide bill is adopted by the Washington DC city council

Please note that this text is only a script and that our webcast contains additional commentary.

NINE MONTHS OF EUTHANASIA IN QUÉBEC; THE COMMISSION REPORTS.

  • Québec’s Commission on End-of-life care has issued a nine-month report on the province’s euthanasia program that came into effect on December 10, 2015.  As of August 31, 262 euthanasia have been reported by doctors in Québec, and 263 terminal palliative sedations were reported by institutions as of June 30.
  • The number of requests and completed euthanasia is three times higher than the original estimate given by Québec’s health minister, Gaetan Barrette, who believed there would be about 100 euthanasia in the first year.  At the current rate there will probably around 350 euthanasia by the end of the first year of the program, not counting the terminal palliative sedations.
  • The document consists of reports from institutions, as well as the forms filled out by doctors each time they perform euthanasia.  The institutional data, which was issued on June 9, showed 167 euthanasia at that time.  However as of June 30 only 161 doctors’ forms had been filed.  This leads us to question whether doctors are reporting every instance of euthanasia.
  • According to the report, 85 cases were examined in time for the June 30 report, while another 113 cases were handled before the end of August.  That means that only 198 of the 262 euthanasia records have been examined.  Of those, only 148 have been ruled on in terms of compliance with the law.
  • Of the 21 cases in which the commission found a failure to comply with the law, 18 concerned the lack of independence of the second physician.  Health Minister Barrette stated in media interviews that he is considering making some adjustments to simplify the paperwork and ease the obligation of seeking a second opinion from an objective and independent doctor.
  • Of the remaining three cases, the Commission believed, based on the information received, that two of the people were not at the “end of life” as defined by the law.  In the other instance, the Commission felt the person did not have a serious and incurable illness.
  • The 21 cases that did not conform to the law represent 14.2% of the total of 148, while the three found with eligibility violations represent a 2% error rate.
  • 114 cases have not been ruled on; 64 were not examined, and 50 others were not decided.
  • The report says euthanasia wasn’t administered for 87 requests: 36 of the people did not meet the criteria set out in the law, 24 people changed their minds, 21 died before being euthanized, one person asked for a delay and five requests are still being processed.
  • The report includes no information about the underlying cause of the request, the nature of the “intolerable suffering” or any demographic information about the people making the request, or the doctors who are granting them.
  • The report does include the number of people from each region who requested, received, or did not have euthanasia, but only through June 30.
  • This report raises many questions.  First, is the commission equipped to examine and rule on the number of euthanasia cases it will face if it already has a backlog before the end of the first year?
  • Second, how do we know that doctors are actually reporting when they perform euthanasia?  This is a chronic and serious problem in Belgium; who’s to say it won’t become a problem here in Canada?
  • Third, if the government’s response to the 14% error rate is to remove the requirement that the second doctor be independent, how will it respond to the 2% of cases where serious errors of eligibility occurred?  What penalties will those doctors face who do not comply with the eligibility requirements of the law?  Who will enforce the law?
  • Fourth, the information furnished in the report is not enough to enable the reader to know if those who received euthanasia were eligible, and if all safeguards were followed.  Without detailed information, researchers will not be able to study the demographics and reasons people request euthanasia, to understand the public policy impact of this law.

ASSISTED SUICIDE BILL APPROVED BY DC CITY COUNCIL

  • In an 11 to 2 vote, the City Council of the District of Columbia voted on November 1 to approve a bill allowing assisted suicide.
  • The Council must still hold a final vote on the bill, possibly as early as November 15.
  • The bill was opposed by disability rights activists, the Catholic church, and many African-Americans who make up nearly half of the District’s population and are the demographic least likely to support medical aid-in-dying. Advocates attribute this to a historic distrust of the medical profession and fears of poor blacks who lack access to health care being steered to early deaths.