Canada's newly minted Liberal government is unlikely to challenge a Quebec law allowing terminally ill patients to end their life with a doctor's help months before the federal ban on medically assisted suicide is lifted, a national advocacy group said.
Quebec was the first province to pass right-to-die legislation last year, arguing it is an extension of end-of-life care and thus a health issue, which falls under provincial jurisdiction.
The law takes effect Dec. 10, while the Supreme Court of Canada ruling that struck down the federal ban on doctor-assisted suicide has been stayed until Feb. 6 of next year.
A palliative care centre in Sherbrooke, Que., announced Tuesday it would provide the service starting Feb. 1. La Maison Aube-Lumiere said it is the first palliative care facility to adopt such a policy.
Since medically assisted suicide remains illegal until the ban is overturned, Quebec will be operating in a legal grey zone, but it is unlikely doctors will face any repercussions, said Wanda Morris, CEO of Dying With Dignity Canada.
"While the Criminal Code is set by the federal government, the decision whether or not to prosecute rests with the provinces' attorneys general and so if an attorney general doesn't want to prosecute, they won't," she said.
"So Quebec, looking forward, is going to have health-care legislation and presumably their attorney general will be on side not to prosecute any doctors who would perform it.
"And we also have the fact that we have a (federal) government in power who has stated their support for assisted dying and they don't really have any tools...to force Quebec to comply, so there's really no repercussions Quebec would face if they proceeded."
Morris said Quebec's law goes beyond the scope of the Supreme Court decision, in that it requires publicly funded health-care facilities to provide assisted suicide and states that patients must be given information about it and a referral.
Neither Ottawa nor the remaining provinces have regulated doctor-assisted death yet, but a federally appointed panel is looking into legislative options to govern the practice.
As a private facility, La Maison Aube-Lumiere — which provides care to those with terminal cancer — is not required under the Quebec law to give its patients access to assisted death.
Though it initially decided not to provide the service, the centre had a change of heart once the parameters of the law were made clear, its director said.
"Our mission...is to accompany a person at the end of their life, while respecting their choices, so that they have the easiest end possible," Marie Bercotte said, adding a palliative care centre is the best place to do that.
"It's an exceptional measure. In a palliative care centre, our doctors are end-of-life specialists and it's very very rare that they aren't able to alleviate suffering. When you alleviate a person's suffering, they don't want to die, they want to live for whatever time they have left."
Provincial rules state that eligible patients who have gone through the process receive a lethal injection of three medications, Bercotte said.
Very few people will be eligible for the service and Bercotte predicts the centre will only see two or three cases a year. People from outside the province cannot seek help in Quebec to end their own life, she said.
Should its doctors object on moral grounds, the centre will bring in a doctor from the nearby hospital, she said.
Government-run training sessions are being held at the end of the month and the centre is waiting until February to provide the service so that staff and volunteers have time to learn the new regulations, she said.
Patients seeking a doctor's help to die must be terminally ill and in an "advanced state of irreversible decline in capacities."
They must also demonstrate they are in constant physical and psychological pain which doctors could not treat with medications.
The attending physician would have to supervise the request, in conjunction with a hospital medical team, and patients could change their mind and withdraw or postpone the request at any time.
The Supreme Court of Canada ruled in February that Canadians with unbearable and irremediable suffering could be eligible to end their lives with a doctor's aid, but the justices stayed their decision until February 2016 to give Parliament time to replace the existing law if it so chooses.
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