Justice committee  I would like to add a final word, if I may. As you can imagine, these patients don't show up at their doctor's office one day asking for medical assistance in dying. That is not how it works at all. Many stakeholders are involved, including social workers and nurses, who are with patients 24 hours per day.

Justice committee  There are two kinds of diseases we're talking about here. There are terminal diseases, which are usually very clear, such as cancer, etc., and non-terminal diseases, which are chronic and debilitating diseases. That's why I think there should be both terms, because it's really not the same clinical reality.

Justice committee  First of all, a 15-day waiting period is problematic. Why not 13 or 18 days? For a patient who is very close to death, this makes no sense. Secondly, the vast majority if not all patients with a terminal illness have had plenty of time to think about their problem. It is not a decision that is made in 15 days.

Justice committee  Absolutely. On the first question, no, there's no problem in Quebec with— conscientious objection. It's something that is absolutely natural and it's perfect. Whatever the reasons for conscientious objection, it is perfectly normal. In Quebec, a physician who refuses to provide medical assistance in dying has a duty to refer the patient to the administration of an institution, which must in turn find a physician to provide that assistance.

Justice committee  If I may say so, I am happy to let the legal experts decide whether conscientious objection should be included in the amendment of the Criminal Code. I am not a lawyer, but it should not, to my mind, be part of the Criminal Code. It should certainly be part of the legal framework though.

Justice committee  I would like to address one final point. The term “reasonably foreseeable” is very vague in medicine. Physicians, even those in palliative care, who claim they can predict how much time a patient has left are always or very often mistaken, unless the patient is at death's door.

Justice committee  There is also a difference between a minor who is 14 and one who is 16. These are very difficult concepts and problems, and we should engage in more reflection here.

Justice committee  There are two parts to your question. The first part of your question pertains to persons eligible for medical assistance in dying who have a specific illness and who have been suffering from psychological problems of some kind. In Quebec, these patients must be evaluated by a psychologist and/or a psychiatrist.

Justice committee  As I said, I think there should be a very clear-cut way of doing things and that it should be written somewhere that assisted suicide in our view is not a good thing, because the frontier with suicide is too short. That's why I strongly feel, and I'm not alone, that medical aid in dying should be medical, as said.

Justice committee  There is no place for assisted suicide in Quebec. It is a medical matter. It's strictly medical, and I think that is important.

Justice committee  Under Quebec law, practical nurses are not included. That is why we are stressing that it depends on each province's legislation, because in the federal law there's the perspective of a nurse clinician. That's why.

Justice committee  Finally, I have one more thought on assisted suicide. The Association is concerned about section 241.1b) of BillC-14, which in our opinion opens the door to a type of assisted suicide. In our view, it must be very clear that medical assistance in dying is and must remain a strictly medical act, administered by a physician, nurse clinician or pharmacist, according to the legislative provisions of each province.

Justice committee  Merci beaucoup. On behalf of Dr. Faure, myself, and the Association québécois pour le droit de mourier dans la dignité, we are very pleased to be here and thank you very much for this opportunity to discuss this very important bill. My name is Georges L'Espérance. I am a neurosurgeon and president of the Quebec Association for the Right to Die with Dignity.