End-of-Life, Social Work/Helping Profession/Mental Health

End-of-life Rules to be set out in New Quebec Law

In the province of Quebec in Canada, Véronique Hivon, the Quebec minister responsible for implementing a report on dying with dignity, said this past Tuesday she hopes to present legislation setting out the rules for medically assisted end-of-life procedures in the province before the National Assembly adjourns for the summer.

Jean-Pierre Ménard, a lawyer specializing in patients’ rights cases, called Quebec’s approach “a small evolution,” setting the rules for patients who are incurably ill, have no chance to recover and are suffering intolerable pain. Hivon explained Quebec is dealing with death as a medical issue, falling within provincial jurisdiction over health care, and said palliative care and offering medications to ease the pain “is the best solution for most people.”

But Quebec will set the rules for patients, who must give their consent before refusing medical treatment, interrupting medical treatment or seeking medical assistance to die. There must be an agreement with a doctor, who must be willing to offer such assistance. Ménard and his panel suggest a 15-day period of reflection once such a decision is made, offering the patient a chance to reverse the decision, along with a second doctor in the field to review the case.

The recommendations follow a landmark report in Quebec from last March  that  suggested doctors be allowed in exceptional circumstances to help the terminally ill die if that is what the patients want. It’s a debate that Canadians have grappled with for nearly two decades.

I shared the newest article to discuss euthanasia in Quebec on social media to get opinions from professionals in other areas of the world, below are 2 responses:

“Opponents fear changing the law could be the start of a slippery slope that would see some people killed without their explicit consent or people suffering from depression or other psychological pain helped to die, even though they are not terminally ill.”

Although I understand the spirit of the proposed legislation, I do not believe it should be put into practice. As a social worker, I work with hospice in helping patients transition from active to palliative or hospice care. Patients are kept comfortable and the natural progression is for the body to basically shut down in its own time. The dignity and comfort of the patient is top priority. Healthcare providers are to do everything possible to treat the patient and when that fails, comfort should be the focus. Never should we be in the business of ending lives. – Oncology Social Worker

As social workers, we are constantly being asked to support clients in situations where they are making choices that are in opposition to our values. These difficulties are part of our professional lives and I see the choice to end one’s life in the same light. I believe that government should stay out of personal decisions as much as possible. We also must admit that many of the palliative care measures that are used to control pain, do inhibit respiratory function and therefore, to some degree, hasten death.  -Social Worker

This is not an easy topic and there will be many opinions regarding what should and should not be allowed. I always think in terms of what would I want. It is difficult to know what I would want thirty or more years from now (I hope). In listening to clients, I hear about the horrible, daily persistent pain that they are subjected to. It is hard to be motivated, hard to be in a good mood, hard to leave the house or bed for that matter and they are taking strong prescription pain medications with side effects. Is there quality of life? Should the decision rest with the provincial government, with physicians, with other helping professionals or the patient themself as long as they are being deemed to be of sound mind?

Written by Victoria Brewster, MSW

 

First posted at: http://www.socialjusticesolutions.org/2013/01/17/end-of-life-rules-to-be-set-out-in-new-quebec-law/

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