Good afternoon, ladies and gentlemen. Thank you for this invitation.
My name is Georges L'Espérance, and I am president of the Quebec Association for the Right to Die with Dignity.
As a retired neurosurgeon, I provide medical assistance in dying and am part of a private discussion group in Quebec. The group consists solely of physicians who provide that last compassionate and ethical care. This enables highly judicious and educational exchanges. The following remarks enjoy a strong consensus among us and inform the association's reflections for our fellow citizens.
I use this opportunity to thank Minister Lametti and his team for listening to patients and practicians in the development of this latest bill.
The bill proposes highly relevant adjustments, more specifically for people who are alone. First, the bill allows there to be a request for medical assistance in dying in writing with a single independent witness. In addition, someone whose job is to provide health care or professional care now has the ability to act as an independent witness. What is more, the 10-day reflection period has been shortened, and this adjustment is the fruit of simple clinical logic. Finally, the waiver of final consent immediately prior to care is, once again, a response in line with the clinical reality we are all experiencing.
We completely agree with the previously drafted opt-out provision, as well as with proposed new sections (3.3) and (3.4) concerning manifestations through words, sounds or actions of refusal for the substance to be administered. However, we suggest this last safeguard measure, in section (3.4), must be revised in two years. Based on experience acquired, it could eventually be shortened.
We feel there are still three major points to Bill C-7 that should be improved.
First, we are asking that the concept of “reasonably foreseeable natural death” as a safeguard measure be pulled from Bill C-7. The other criteria set out in Bill C-7 have proved in Canada that the most vulnerable individuals don't need any other protection to guarantee their fair and safe access to medical assistance in dying. Otherwise, our patients and us, the physicians on the ground, will once again remain stuck with a vague and non-medical concept. Life expectancy is actually a notion that affects the average, and not specific individuals.
If, despite everything, the legislator wants to hold on to this measure, they should at least remove the 90-day minimum assessment period for the same reasons as those mentioned regarding the 10-day period. That so-called period of reflection is an insult to our patients' intelligence and suffering.
The removal of that criterion will also make more seamless access across Canada possible, since the decision in terms of medical assistance in dying will be subject to a strict objective medical process.
As far as mental illness goes, with all due respect for those Canadians and because those issues are complex, we suggest removing that exclusion provision and keeping a 12-month legal non-application period, during which the regulatory colleges within each province will have to work together and be under the legal obligation to define a common clinical framework.
Finally, any capable individual who has been diagnosed with a cognitive neurodegenerative disorder of the Alzheimer type should be able to indicate in their advance medical directives, with a supporting witness, that they wish to obtain medical assistance in dying at a time they deem appropriate, according to their values and regardless of their cognitive state at the time.
In closing, I would like to reiterate that the Quebec Association for the Right to Die with Dignity firmly and unwaveringly defends the absolute prohibition on using medical assistance in dying, under threat of criminal penalties, in the case of individuals who have always been incapacitated—here we are talking about mental deficiency—or individuals who became incapacitated before providing advance medical directives.
Thank you for your attention.