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Quebec’s Bill 52: An “Act respecting end-of-life care”

On June 12, 2013 Junior Health Minister Veronique Hivon tabled a bill in the Quebec National Assembly that ostensibly focuses on improving end-of-life care. Bill 52 would permit, in certain circumstances and under strict procedural protocols, the medical use of “terminal palliative sedation” for those individuals with prescribed illnesses and symptoms who wish chose their moment of death. Only Quebec residents will qualify for treatment under Bill 52.

The Globe and Mail reports:

Social Services Minister Véronique Hivon insisted that the bill was compatible with the federal Criminal Code because the proposed end-of-life treatment was part of a “continuum” of health care.

“I want to repeat that euthanasia, for example, is not provided for…is not forbidden in the Criminal Code. There are general provisions and there is something specific about assisted suicide but nothing on euthanasia,” Ms. Hivon said, insisting the bill was a health measure that falls under provincial jurisdiction.

The CBC reports that the bill will be reviewed by the government:

Federal Justice Minister Rob Nicholson says the government will review the implications of Quebec’s proposed legislation.

“The laws that prohibit euthanasia and assisted suicide exist to protect all Canadians, including those who are potentially the most vulnerable, such as people who are sick or elderly, and people with disabilities,” said Nicholson in a statement.

He said the Supreme Court of Canada upheld the constitutionality of the existing law against assisted suicide in the Sue Rodriguez case in 1993, and three years ago, parliament voted not to change the law.

“This is a sensitive issue for many Canadians, with deeply held beliefs on both sides of the debate,” said Nicholson.

It is unclear how this Bill accords with s. 241(b) of the Criminal Code, which prohibits the giving of assistance to commit suicide. It may be relevant to note that the Supreme Court of Canada was split in its 1993 decision in Rodriguez v. British Columbia (Attorney General), which upheld the constitutionality of s. 241(b). That case was brought by Sue Rodriguez, a woman with ALS who wished to terminate her life when her symptoms became unbearable. However, because of her physical symptoms, Ms. Rodriguez required assistance in doing so. She argued s. 24(d) unnecessarily infringed her section 7 Charter rights (personal autonomy). The majority dismissed her appeal, but Justices L’Heureux‑Dubé, McLachlin, Lamer and Cory dissented. Justice Cory wrote:

Section 7 of the Charter, which grants Canadians a constitutional right to life, liberty and the security of the person, is a provision which emphasizes the innate dignity of human existence. Dying is an integral part of living and, as a part of life, is entitled to the protection of s. 7. It follows that the right to die with dignity should be as well protected as is any other aspect of the right to life.

It will be interesting to read the appellate decisions in respect of palliative terminal sedation that seem inevitable if Bill 52 is passed.

Read more:

Globe and Mail article

Toronto Star article

CBC.ca article

Link to the Rodriguez v. British Columbia (Attorney General) case is here

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