Medically-assisted suicide will be legal in Quebec later this year, but many palliative care centres want nothing to do with it.
Euthanasia for incurable patients will be legal as of Dec. 1, and the provincial College of Physicians is recommending procedures and medications to sedate a patient, induce a coma, and stop their breathing.
A person choosing to die must be mentally fit, in unbearable physical or psychological pain, and in an advanced state of irreversible decline.
But doctors will not be forced to help someone end their life.
"We cannot and we cannot even think of forcing doctors, it's not about that at all," said Quebec's Health Minister Gaetan Barrette.
Caregivers at the West Island Palliative Care Centre say they, like their counterparts at 28 -- other non-profit end-of-life centres in Quebec, have no wish to speed up someone's death.
Teresa Dellar said the doctors at the facility instead do their best to make people comfortable at the end of their lives.
"Good system management, good palliative care -- which is a word that is important here, care -- does allow a person to live comfortably right to the end of their life. And that's what we're doing," said Dellar.
She added that if any patients do wish to end their lives, they would be transferred to another facility, but she thinks that will be exceedingly rare.
"You know, generally people don't want to hasten in any respect. We have people that are living their days very, very comfortably," said Dellar.
She added that most patients only remain at the West Island facility for 10 to 18 days.
Palliative care physician Dr. Celine Dupuis tends to patients living out their last days there said she will always try to make every death as beautiful as possible - and always in its own time.
“I think it's an illusion to think that you can control death. It takes time – it takes time to get there,” she said.
The bill gives doctors the right to opt out of ending someone's life, but patients have the right to make their own decisions.
That means patients may need to find doctors willing to perform euthanasia, a tricky situation, said Dr. Catherine Ferrier, of the Physicians’ Alliance Against Euthanasia.
“I think it's going to be chaos and patients will be saying, ‘It's my right’ and I and other doctors will be saying, ‘You don't need this!’” she said.
The framework will be ironed out to help patients, said Barrette.
"The system has to make itself sure that it can provide this kind of treatment with dignity in the proper setting, when the patient decides that. It's not for us to decide," said Barrette.
The MUHC's director of palliative care said the hospital centre will discuss the law this fall before it goes into effect, though it's clear the definition of palliative care in the law does not hasten death.
Quebec is the first province to legalize the right to die.
A detailed set of guidelines will be made available for healthcare professionals online in the coming weeks.