Quebec’s College of Physicians has released a guide on how health professionals should handle Quebec’s law on medically-assisted death.
The guide will be available in English in October and is meant to be a reference manual.
“It's a tool and as any tool if you want to build something you need something else, and the something else is the training sessions that we give on request,” said Dr. Yves Robert, the college’s secretary.
There will also be a public awareness campaign to eliminate what Robert says are misconceptions about medically assisted death in Quebec.
He says it's not euthanasia on demand, but rather the law frames the request to die and the physician’s consent within a continuum of care.
“The treating physician already has a relationship with the patient. They have to discuss about that there has to be for the physician a medical reason to do that, one of which is having an incurable disease and having an uncontrollable suffering,” and be mentally fit, he said.
The guide does detail the choice of drugs and possible doses that could be used in three steps, to first sedate the patient and then bring about death.
Aside from the fact that bioethicist David Roy does not think medically assisted death should be legalized or decriminalized at all, he also has some specific concerns about the guidelines.
“If the patient does not want family to know that he or she has requested assisted death, it will be kept confidential. In principle that's right, but in practice, we're going to have to be ready for possible extreme tensions between members of the family,” he said.
The other problem, Roy says, is with the declaration of death – the guide is recommends the official cause of death be noted as the patient's underlying disease, such as cancer or neurodegenerative diseases.
“They explicitly said medically assisted death is not to be listed as the cause of death. That sounds a bit like deceit to me,” he said.
Roy said he wonders if this is because insurance companies will view the act as assisted suicide, even though it's not, and believes there is drama brewing between the law, medical practice and life insurance providers over the law.
The college decided not put the document online, but it is available on demand for anyone who wants to read it. The new law on medically-assisted death comes into effect Dec. 10.
