Québec: 50 euthanasia deaths in 5 months. No new commitment to palliative care.

Amy Hasbrouck

Amy Hasbrouck

This story is written by Amy Hasbrouck. It includes quotes and sections translated from that an article by Davide Gentile of Radio Canada that appeared in the Huffington Post online on May 4, 2016. Link to the original article.

Amy Hasbrouck - is a lawyer and the founder of the disability rights group Toujours Vivant - Not Dead Yet and is the EPC Vice President.

Five months after Québec’s euthanasia law went into effect, about fifty people have been euthanized according to health Minister Gaetan Barrette, according to an article by Radio Canada that appeared in the Huffington Post website. 

Health Minister Barrette said the rate is normal. "Many people were waiting for the implementation of the law," said Gaétan Barrette. "I do not think we are headed to unbridled growth," he said.

Some doctors who work in palliative care are concerned that more emphasis has been placed on the roll-out of the euthanasia program than toward providing palliative care. 

"We do not feel the same mobilization to increase access to palliative care," says Christiane Martel, president of the Quebec Society for Palliative Care. "The majority of people still want to just comfort care at end of life."

Martel recalls that access to quality palliative care was the primary objective of the Act concerning the end of life care adopted in June of 2014. 

"In palliative care, we do not see much improvement in resources. But we see a lot of resource mobilization for medical help to die."

Dr. Martel is concerned that meagre hospice care in some regions will affect the number of requests for euthanasia. "I think we must ensure that no one requests medical help to die because we did not have the proper care," she said.

Martel’s colleague Marjorie Tremblay believes that there is a serious problem. 

"What I see in my field every day are patients who don’t have palliative care in their area. I find it appalling!"

She believes that patients whose pain is relieved overwhelmingly reject medical help to die.

She believes Québec should develop an information campaign on palliative care. "Have you seen palliative care promoted since the implementation of the law? I have not even heard the term ‘palliative care’!"

Tremblay also deplores the confusion among some people between physician assisted dying and palliative care; they simply want to avoid suffering in the dying process. "Some people are afraid they will be given the lethal injection if they come into palliative care,” she said.

Health minister Barrette believes their findings are exaggerated. "I do not think people say, ”If I don’t get a palliative care bed, I will ask for medical help to die!" I am convinced that it does not happen," insists Barrette.

He says that with few exceptions, the number of palliative care beds in institutions is sufficient. Improvements need to be made, for example, in the Shawinigan area and in eastern Montreal.

However, the minister admitted that home-based palliative care services must be improved. Currently, about 11% of Quebecers end their days at home. Quebec wants this number to increase to 22% within 5 years.

EPC needs you to contact Members of Parliament

The House of Commons Standing Committee on Justice and Human Rights will be hearing interventions concerning Bill C-14, the bill that will legalize and “regulate” euthanasia and assisted suicide in Canada.

The Euthanasia Prevention Coalition (EPC) will be presenting to the committee next week. We will be represented by: Amy Hasbrouck (EPC – VP), Hugh Scher (EPC – Legal Counsel) and Dr Will Johnston (Chair of EPC – BC). 

Several MP's have said that they are receiving more communication from members of the euthanasia lobby than from our supporters. 

EPC needs you to contact members of the House of Commons Standing Committee on Justice and Human Rights with your concerns about Bill C-14.

Resources for your communicating with committee members:

Link to the article on Bill C-14 by Alex Schadenberg.
Link to the article on Bill C-14 by the Physicians Alliance Against Euthanasia.
Link to the article on Bill C-14 by Dr Will Johnston (EPC - BC).
Link to the article on Bill C-14 by Charles Lewis.
Link to the article on Bill C-14 by Andrew Coyne.
Link to the article on Bill C-14 by Amy Hasbrouck (Toujours Vivant - Not Dead Yet).

Committee Chair: Anthony Housefather (Lib) - Anthony.Housefather@parl.gc.ca
Committee Vice Chair: Ted Falk (CPC) - Ted.Falk@parl.gc.ca
Committee Vice Chair: Murray Rankin (NDP) - Murray.Rankin@parl.gc.ca
Committee Member: Chris Bittle (Lib) - Chris.Bittle@parl.gc.ca
Committee Member: Michael Cooper (CPC) - Michael.Cooper@parl.gc.ca
Committee Member: Colin Fraser (Lib) - Colin.Fraser@parl.gc.ca
Committee Member: Ahmed Hussen (Lib) - Ahmed.Hussen@parl.gc.ca
Committee Member: Iqra Khalid (Lib) - Iqra.Khalid@parl.gc.ca
Committee Member: Ron McKinnon (Lib) - Ron.McKinnon@parl.gc.ca
Committee Member: Hon. Rob Nicholson (CPC) - rob.nicholson@parl.gc.ca

EPC also encourages you to send letters to your Members of Parliament. Link to contact your Member of Parliament.

You can mail letters to Members of Parliament (Postage Free) by sending letters to:

(Name) Member of Parliament
House of Commons
Ottawa Ontario K1A 0A6

Euthanasia Prevention Coalition: the design of the euthanasia law will either discourage or enable abuse

Media Release
April 14, 2016

The Euthanasia Prevention Coalition (EPC) opposes giving anyone, the power in law, to cause the death of another person. We oppose any form of euthanasia and assisted suicide. 

In all jurisdictions where assisted death is legal, the laws lack effective oversight stated Alex Schadenberg, EPC executive director. Even the need for consent from the patient may often be ignored.

A study concerning assisted deaths in Belgium published in the NEJM (March 2015) found that more than 1000 deaths were intentionally hastened without request in the Flanders region of Belgium in 2013. The same study determined that many assisted deaths were not reported.

EPC legal counsel, Hugh Scher, urges the government to ensure effective oversight of the law. 

Prior approval by the court or an expert panel is essential to any assisted suicide regime that Parliament introduces. It is the only way to ensure compliance with legislative criteria established to identify vulnerability and prevent abuse of the law before people are put to death.

EPC VP Amy Hasbrouck,  a lawyer and disability leader, works in coalition with many groups.

Effective oversight based on a court approved or expert panel is endorsed by multiple stakeholders across the country including from the disability community, the medical community and legal experts.

Dr. Will Johnston, EPC – BC Chair stated that Euthanasia is not a form of health care. 

Defining euthanasia as health care would mean that lethal injections become a form of medical treatment. Not only is this an Orwellian concept, but may leave Canadians without a safe space within the healthcare system.

Dr Johnston continued: 

Forcing doctors to participate in killing their patients is paternalistic. To require doctors to refer patients to a doctor who will lethally inject them undermines conscience rights and my oath that I will “Do No Harm.”

EPC urges the government to protect people at the most vulnerable time of life.

For more information contact: 

Alex Schadenberg, Executive Director (London) 519-851-1434, info@epcc.ca
Hugh Scher, EPC Legal Counsel (Toronto) 416-816-6115, hugh@sdlaw.ca
Dr Will Johnston, Chair EPC – BC (Vancouver) 604-220-2042, willjohnston@shaw.ca
Amy Hasbrouck, EPC – VP (Montréal) 450-921-3057, tigrlily@gmail.com

Joint Parliamentary Committee on Assisted Suicide Refuses to hear from leading experts on the need for effective oversight to protect Canadians

TORONTO, Feb. 3, 2016 (GLOBE NEWSWIRE

Hugh Scher

Hugh Scher

Fundamental to keeping Canadians safe in the operation of a state-sanctioned assisted dying regime is the need for rigorous before the fact oversight by an independent judge or tribunal stated Hugh Scher, Toronto constitutional lawyer and disability rights advocate. Scher stated:

Before the fact judicial oversight is essential to any assisted suicide regime that Parliament may seek to introduce. It is the only way to ensure compliance with legislative criteria established to identify vulnerability and prevent abuse before people are put to death.

EPC VP Amy Hasbrouch stated that:

This position is endorsed by multiple stakeholders across the country including from the disability community, the medical community and legal experts.

In all jurisdictions where assisted death is legal, the laws lack effective oversight. Consequently, safeguards, including the need for consent from the patient are routinely ignored.

A study published in the NEJM (March 19, 2015) found that 1.7% of all deaths in the Flanders region of Belgium in 2013 were assisted without request. Therefore more than 1000 deaths were intentionally hastened without request. The same study determined that nearly half of the assisted deaths went unreported states Alex Schadenberg, EPC executive director.

Dr. Will Johnston states that adoption of a Belgian-style euthanasia regime in Canada, such as has been adopted in Quebec, without effective before the fact judicial oversight to ensure compliance with legislative requirements would be a recipe for disaster that is certain to put Canadians at risk.

Euthanasia is not a form of health care. Defining euthanasia as health care would mean that lethal injections become a form of medical treatment. Not only is this an Orwellian concept, but it is one that would certainly leave Canadians without a safe space within the healthcare system, states Dr. Johnston, Chair of EPC – British Columbia.

Despite more than 15 years of extensive experience with the legal, medical and practical challenges associated with assisted suicide practices in other jurisdictions, the Joint Parliamentary Committee has deliberately refused to hear from leading constitutional, medical and sociological experts, who have previously advocated against the adoption of euthanasia or assisted suicide in Canada because of the risks that it poses to all Canadians and our healthcare system.

Failure to hear particularly from those who are experts who raise concerns about euthanasia practices in other jurisdictions represents a fatal flaw to the committee's deliberations and an intentional attempt to silence those with differing viewpoints while embracing those who promote unbridled euthanasia. Such an approach runs completely contrary to the Government's stated objective of conducting a comprehensive consultation with all relevant stakeholders in order to implement a safe and measured response to the Supreme Court's ruling.

The Supreme Court's conclusion that assisted suicide could be legalized safely in Canada is predicated on the notion of strong federal regulation. The court concluded that a legislative response would require a "carefully designed and monitored system of safeguards." It was only the possibility of crafting a scheme with such effective oversight and safeguards that led the court to reject the argument that weakening the prohibitions will inevitably lead to the casual termination of life including the lives of individuals who do not wish to die, notes Scher. 

The Committee's exclusion and refusal to hear from leading national experts on the subject call into question its motives and actions and greatly undermines the conclusions it may draw as a consequence of its limited and self-selected inquiry.

For more information contact: 
Alex Schadenberg, Executive Director (London) 519-851-1434, info@epcc.ca
Hugh Scher, EPC Legal Counsel (Toronto) 416-816-6115, hugh@sdlaw.ca
Dr Will Johnston, Chair EPC – BC (Vancouver): 604-220-2042, willjohnston@shaw.ca
Amy Hasbrouck, EPC – VP (Montréal): 450-921-3057, tigrlily@gmail.com

Is the Québec law euthanasia or assisted suicide

By Alex Schadenberg, Executive Director, Euthanasia Prevention Coalition

Those who follow the Euthanasia Prevention Coalition (EPC) newsletters and blog will know that in June 2014 the Québec government legalized euthanasia, not assisted suicide in a manner that is similar to the Belgian euthanasia law, by claiming that lethal injection is a form of medical treatment.

Many Canadians remain confused about the Québec euthanasia law. Graeme Hamilton, the National Post's Québec corespondent, explained in his December 11th article what Québec's "Medical-aid-in-dying" law (Bill 52) actually says. Hamilton wrote:

Is it euthanasia or assisted suicide that Quebec has legalized? 
Under the Quebec law, physicians will administer lethal injections to consenting patients. Quebec calls this “medical aid in dying,” but it is more commonly known as euthanasia. Assisted suicide, which is currently legal in three American states, occurs when a physician provides a patient with lethal medication that the patient uses to end his or her own life. Quebec considered but rejected the legalization of assisted suicide, concluding that it was preferable to have the physician administer the medication. 
How might a federal law differ from what Quebec has done? 
Ottawa has been spurred to action by last February’s Supreme Court of Canada ruling, which invalidated the Criminal Code prohibition of physician-assisted death. The high court gave the federal government and provinces one year to come up with new legislation, but Ottawa has requested a six-month extension and it has not indicated whether it will opt for euthanasia or assisted suicide.

Clarification: The dangerous Supreme Court decision struck down Canada's assisted suicide law (Section 241b of the Criminal Code) and offered limited reasons as to when euthanasia could be legal.

Therefore, "medical-aid-in-dying" in Québec is euthanasia. The Québec government published euthanasia guidelines, that disability rights leader, Amy Hasbrouck, explains are clear as mud.

On December 4, Canada's federal government requested a six-month extension to enable them to legislate on the issues of euthanasia and assisted suicide. 

EPC intervened in the Carter case at all levels and has submitted its legal analysis to the Supreme Court whereby EPC agrees with the six-month extension and we oppose the request by the Québec government that they be exempt from the six-month extension.

Status of Québec Euthanasia Law Remains in Flux

Press Release - December 10, 2015


On December 9, 2015 the Québec Court of Appeal granted permission for Québec to appeal a declaration rendered by the Québec Superior Court on December 1, 2015, which rendered inoperable the euthanasia provisions set out in the Québec euthanasia law, finding that they were in conflict with existing Criminal Code prohibitions against homicide

The Court of Appeal made it clear that it was not making any decision on the merits of the case, but did note that the issues raised by the case are of significant public importance and should be addressed swiftly. A hearing has been scheduled for December 18, 2015 to address the appeal, putting in flux the status of the Québec law, which was to come into effect on December 10, 2015.

As such, a doctor in Québec can still be prosecuted if they participate in an act of euthanasia.

In February 2015, the Supreme Court of Canada in Carter v. Canada (Attorney General), found that existing laws against homicide and assisted suicide to be unconstitutional, but kept those laws in effect and gave Parliament one year to enact a new law that provides for a regime of effective oversight and safeguards.

The Euthanasia Prevention Coalition (EPC) was an intervenor at all levels of court in the Carter case and is also an intervenor before the Québec Court of Appeal in D’Amico c. Procureure générale du Québec.

EPC's position in the D'Amico litigation is that Québec's euthanasia law goes beyond the jurisdiction of the Province of Québec and falls under the jurisdiction of the Parliament of Canada. The intentional killing of patients by doctors is not medical treatment or health care, and the lack of before the death oversight represents a fatal flaw in the proposed Québec law that puts the safety of the public at risk, contrary to s.7 of the Charter.

EPC Counsel, Toronto Constitutional Lawyer, Hugh Scher states:

A national approach to the regulation of assisted suicide is the only way to avoid an inconsistent patchwork quilt of regulation of assisted suicide laws across Canada, which could leave Canadians at risk.

EPC Executive Director, Alex Schadenberg states:

The Federal Government could take a very different approach to regulation than the much riskier regime of euthanasia that has been endorsed in Québec, which is similar to the Belgian regime, where deaths without request have occurred, and where a lack of compliance with the enacted safeguards is evident.

EPC Vice President, Amy Hasbrouck notes that:

The Supreme Court’s conclusion that assisted suicide could be legalized safely is predicated on the notion of strong federal regulation. The lack of a comprehensive national response to these issues risks sowing incoherence, an approach that would put all Canadians at risk.

The Federal Government has indicated its intention to hold all-party Parliamentary Committee hearings to study and respond legislatively to the Supreme Court’s ruling in Carter.

For more information contact:

Hugh Scher (Toronto), EPC Legal Counsel (416) 816-6115 or hugh@sdlaw.ca
Alex Schadenberg (London), EPC Executive Director (519) 851-1434 or info@epcc.ca
Amy Hasbrouck (Montreal), EPC Vice President (450) 921-3057 or tigrlily61@gmail.com

Québec euthanasia regulations are clear as mud

By Amy Hasbrouck

When Québec passed its euthanasia law in 2014, we pointed out many problems, hoping that these would be remedied before the law came into effect.

Eighteen months later we are on the verge of entering the euthanasia era in Québec, with many issues still unsettled. Thus far, Québec has:

  • Issued a set of regulations governing a narrow slice of the euthanasia process;
  • Offered a “five year plan” for palliative care which proposes “equitable” but not “universal” access to palliative care;
  • Through the college of physicians, issued guides to performing euthanasia and continuous palliative sedation, and offering care “at the end of life.”

The government of Québec has also threatened hospices which refuse to perform euthanasia with loss of funding, in direct violation of § 72 of the law. The government is also requiring doctors who refuse to kill their patients to provide a referral for euthanasia.

Despite these actions, many standards and procedures remain unclear:

  • The application process still lacks any provision for accessibility to people who have communication disabilities. Nor are there guarantees that people with mobility impairments will receive medical care in a timely manner on equipment which is accessible to them.
  • There are still no protections against family members with financial interests who witness or fill out the forms on the person’s behalf.
  • There are no procedural barriers to serial applications in case of refusal, or “doctor shopping.”
  • Neither a psycho-social evaluation, nor a home visit is required to verify capacity to make decisions, that the decision is free and informed, or to ensure the person is not being abused or coerced.
  • The competency determination does not appear to involve the judicial process already used for determining capacity in Québec.
  • There is no requirement that the person receive palliative care or other support services to enable him or her to live well until natural death occurs. The “choice” to die remains an illusion where the person does not have a choice in where or how to live.
  • The definition of “end of life” is entirely subjective, and can range from two months to eight years.

Link to the full article