Project comment on Quebec euthanasia statistics

News Release

For immediate release

Protection of Conscience Project

LifeSite News has published an article concerning Quebec euthanasia statistics collated by the Project.

During the interview that led to the publication of the article, the Project Administrator expressed concern that a significant increase in the volume of cases in the last half of 2016 could increase pressure on physicians and other health care workers who do not wish to participate in the procedure.  Such pressure was generated across Canada by the exponential increase in the number of abortions following liberalization of the abortion law in 1969, from under 300 in eleven years[1] to over 11,000 in the first year after the change in the law.[2]  The number of euthanasia and assisted suicide cases in the first year of legalization seems unlikely to exceed 20%  of that number, but this is still sufficient to warrant concern about pressure on objecting health care workers.

The statistical returns disclose some wide differences between different regions or reporting agencies, and sometimes between reporting agencies in the same administrative region.  For example: the number of euthanasia requests per 100,000 population is reported to be much higher in the Quebec City area than in the rest of the province, while the number of euthanasia requests per 100,000 palliative patients reported in Lanaudiere and Laval is much higher than in the Montreal Region.  Euthanasia is reported to be provided per 100,000 population in the Quebec City area at a rate three times that of Montreal.

The Administrator explained that the statistics were primarily useful in raising important questions about the reasons for such variations or trends, such as differences in the quality or accessibility of palliative care or the nature of patient illnesses.

Note

1. Waring G. “Report from Ottawa.” CMAJ Nov. 11, 1967, vol. 97, 1233 (Accessed 2016-06-15).

2. In 1970, the first year under the new rules, there were more than 11,000. In 1971 there were almost 39,000. “Therapeutic abortion: government figures show big increase in ‘71.” CMAJ May 20, 1972, Vol. 106, 1131 (Accessed 2016-06-15)

[Release revised 2017-03-14]

Quebec euthanasia statistics

10 December, 2015 to 9 June, 2016

Introduction

Quebec passed An Act Respecting End of Life Care (ARELC) in June, 2014, purporting to legalize euthanasia in the province.  In February, 2015, the Supreme Court of Canada effectively ordered the legalization of physician assisted suicide and physician administered euthansia in Canada by striking down the criminal law to the extent that it prohibited the services (Carter v. Canada).  The Court suspended the ruling for a year and later extended the suspension to give governments the chance to enact new legislation.  Amendments to the Criminal Code were finally passed in June, 2016.

ARELC did not come into effect until 10 December, 2015.  It is more restrictive than the Supreme Court ruling and the Criminal Code provisions in that it does not permit assisted suicide and imposes some limits on euthanasia not found in the Supreme Court decision.

Health and social services agencies established by the government throughout the province are the state agencies responsible for responsible for the delivery and coordination of health care in the province administrative regions.  These are called Centres intégrés de santé et de services sociaux (CISSS) and Centres intégrés universitaires de santé et de services sociaux [CIUSSS).  Some administrative regions (like Montreal and the Quebec City region) have more than one CISSS or CIUSSS.

In June, 2016, these agencies sent reports to the commission established by ARELC to monitor the administration of euthanasia in Quebec (Commission sur les soins de fin de vie).

The Project has compiled the statistics in tables and charts to make them readily available.  An Excel file with all tables and charts and links to the original reports can be downloaded here.

Euthanasia requests

Response to euthanasia requests

Euthanasia requests fulfilled

Reasons euthanasia requests not fulfilled

Frequency of euthanasia requests

Frequency of euthanasia

Mortality rates

Quebec, Belgium and Netherlands

MUHC’s assisted death policy repealed: Barrette

Montreal Gazette

Caroline Plante

QUEBEC — The McGill University Health Centre has repealed its policy exempting the palliative care unit from offering medical aid to die, said Health Minister Gaétan Barrette on Wednesday.

“This morning, I met with Mr. (Normand) Rinfret and he told me that as of this very moment, the policy has been repealed,” Barrette said, referring to the MUHC’s executive director. “As we speak today, no patient can be transferred out of the palliative care unit at the MUHC, and medical aid in dying will be made available in the unit itself.” . . . [Full text]

Barrette chastises MUHC over policy not to provide medically assisted death

Montreal Gazette

Caroline Plante

QUEBEC — The McGill University Health Centre is being forced to backtrack on a policy that exempts its palliative care unit from helping patients die.

Health Minister Gaétan Barrette issued a strongly worded letter to the MUHC’s director general Wednesday, urging him to change the policy, which he says does not respect the law.

“To say that medical aid to die will not be offered in a particular unit … poses a serious problem when it comes to respecting patients’ lawful right to receive end-of-life care,” the minister wrote. . . [Full text]

MUHC to allow medically assisted dying in palliative care unit

Montreal Gazette

John Meagher

The McGill University Health Centre said Monday it will change its policy and allow medically assisted dying in its palliative care unit after coming under fire from Health Minister Gaétan Barrette last week.

The uproar came about after a patient at the Glen site had to be transferred out of the palliative care unit to receive medical aid in dying in April.

Barrette sent a letter to the MUHC’s director general last week, asking the hospital network to change its policy, because it does not respect the new law. . . [Full text]

Ontario hospitals allowed to opt out of assisted dying, raising conscientious accommodation concerns

National Post

Sharon Kirkey

Ontario will allow hospitals to opt out of providing assisted death within their walls, provoking charges from ethicists that conscientious accommodation has gone too far.

Elsewhere in the country, a divide is already shaping up, with half of voluntary euthanasia cases in Quebec reportedly occurring in Quebec City hospitals — and few in Montreal.

The situation highlights the messy state of the emotionally charged debate as the provinces wrestle with the new reality of doctor-assisted death, and as the Senate takes a proposed new law further than the governing Liberals are prepared to go. . . [Full Text]

 

Let’s not become Belgium when it comes to assisted suicide

Imagine . . .  being the first hospital in human history to be closed for refusing to kill patients in its care.

National Post

Barbara Kay

In February, the archbishop of Edmonton announced that in the event of legalized euthanasia, physicians and other health-care workers of Covenant Health Hospital would not be participating in the active termination of patients’ lives.

In response last month, Alberta’s associate health minister Brandy Payne stated that Covenant Health’s conscientious objection would be respected, and that patients requesting life termination there would be transferred. That seems reasonable. After all, when conscripted soldiers refuse to go to war for reasons of conscience, they are not asked to provide their own combat replacement.

In Quebec, by contrast, where euthanasia is already in effect, any Christian institution that refuses to comply with the legislation will be shut down. (Imagine the dubious distinction of being the first hospital in human history to be closed for refusing to kill patients in its care.)

Ethics-based tension in the medical community is but one of many concerns we must acknowledge to be inherent in Bill C-14. . . [Full  Text]

 

The intersection of freedom of conscience and assisted dying

One MP’s views on balancing the needs of patients and doctors who have personal issues providing assisted dying

Macleans

Garnett Genuis

Garnett Genuis, the Conservative MP for Sherwood Park—Fort Saskatchewan in Alberta, has served on the Physician-Assisted Dying Committee.

Parliament will imminently be dealing again with the issue of physician-assisted suicide / euthanasia. If government legislation follows the direction given in the report of the Liberal-dominated joint committee, we are in for (among other things) a significant change in the way Canadian law treats freedom of conscience.

The court was clear in Carter that nothing in their decision would require anyone to be involved in euthanasia or assisted suicide if they did not wish to be. In this respect, I think the court got it right. Freedom of conscience is protected by the Charter itself. Euthanasia and assisted suicide were considered murder until just this year; it’s understandable that many healthcare providers remain uncomfortable with it. . . [Full text]

 

Some Quebec doctors let suicide victims die though treatment was available: college

National Post

Graeme Hamilton

MONTREAL  –  Quebec’s College of Physicians has issued an ethics bulletin to its members after learning that some doctors were allowing suicide victims to die when life-saving treatment was available.

The bulletin says the college learned last fall that, “in some Quebec hospitals, some people who had attempted to end their lives through poisoning were not resuscitated when, in the opinion of certain experts, a treatment spread out over a few days could have saved them with no, or almost no, aftereffects.”

It goes on to spell out a physician’s ethical and legal duty to provide care, even to patients seeking to end their own lives.

Yves Robert, the college’s secretary, told the National Post that an unspecified number of doctors were interpreting suicide attempts as an implicit refusal of treatment. They “refused to provide the antidote that could have saved a life. This was the real ethical issue,” he said. . . [Full text]

 

Quebec’s new assisted-dying law leaves doctors struggling to adapt

Fear of legal reprisal still widespread among health professionals

CBC News

Two months after Quebec’s assisted-dying law came into effect, about 10 patients have chosen to end their lives with the help of a doctor.

Health Minister Gaétan Barrette says this is a sign that things are going well and there are no systematic obstacles.

“The information that I have from the ground and from the College of Physicians is that teams are in place and that access is there,” Barrette said.

“Problems, if there were any, were resolved quickly.”

Doctors and patient advocates tell a different story.

Jean-Pierre Ménard, a lawyer specializing in health law, says his clients have reported trouble obtaining medical assistance to die. . . [Full text]