Quebec's assisted dying law in effect

It is now legal in Quebec for terminally ill patients to choose to die but that may not last for long.

The province's end-of-life care bill, which was adopted in the National Assembly in June 2014, went into effect on Thursday.

"People in this province have made the debate. They have concluded. There is a law.the principle of having the choice is something that people want to have," said Quebec Health Minister Gatan Barrette.

But patients may only have that choice for the next eight days, due to pending legal hearings.

On Dec. 18, the Court of Appeal will hear arguments from all sides. This comes after last week's decision by the Quebec Superior Court which suspended key aspects of the new law, stating it conflicts with the federal Criminal Code.

• Quebec's assisted dying law will proceed as scheduled, pending Appeal Court hearing
• Quebec end-of-life law contradicts Criminal Code and can't take effect, court says
• Doctor-assisted death in Quebec could face delay: Health Minister Gatan Barrette

Barrette said that until then, Quebec's health system is ready to implement doctor-assisted dying.

"I want to assure the population and [professional medical staff] that all the steps are in place for it to happen," he said.

"I want to reassure the population that in terms of access on all kinds of end-of-life care, we're ready."

Doctors who are against Bill 52 are holding out hope that on Dec. 18, the Court of Appeal will stop doctor assisted deaths in Quebec.

"Nobody should be euthanized. What they call medical aid in dying, well, is shortening somebody's life. The way of treating somebody's life is not by ending life, but palliative care," said Dr. Paul Saba, a family physician and president of the Coalition of Physicians for Social Justice.

While Quebecers wait for the Court of Appeal to make a ruling next week, some experts say doctors and patients are in legal limbo.

Dr. Eugene Bereza, the director of the medical ethics program at the McGill University Health Centre, said there are many grey zones.

"We want to respect the law but we need to know what the law is so we have to adapt very quickly to those changing circumstances," said Bereza."So, for example, physicians will say, 'Well, if I were to be involved in [assisted dying] does that mean I'm legally liable? Could I be prosecuted criminally?' The answer may change week to week. That's really tough."

Legal risks?

The Quebec Justice Ministry has already instructed Crown prosecutors not topursue under the Criminal Codeany doctors who perform medically assisted death operations.

Still, Quebec's College of Physicians worriesits members do face some legal risk.

"It's a message of caution to our members ...Follow the law, follow the guidelinesfrom the College, but know that there's a minimal risk of prosecution," saidDr. Yves Robert, secretary of theQuebec College of Physicians

Individual doctors can refuse to help a patient die, but a hospital cannot opt out of providing the service.

The Health Ministry said a system is in place for physicians to find a colleague willing to perform the procedure in their place.

Patients' rights

Patients have to meet strict criteria to be eligible for medicallyassisted dying and undergo an assessment by two doctors. The law does not dictate how long that process should take.

"Conceivably, it could take a relatively short period of time, maybe even a few days. We're not meant to drag things out and increase the psychological burden on the patient and family," Bereza said.

But he said doctors will not speed up the process, just to perform the procedure before the next court hearing on Dec. 18.

"We're not going to rush it. There's too much at stake here."

Information only in French

Earlier in the day, the HealthMinistry's websitehad informationavailable onlyin French, promptinga coalitionof English-speakinggroups to speak out.

"I don't know how one can say that we have access to health and social services in the English language if we can't get the information about those services," saidEric Maldoff,a lawyerand the chair of the health and social services committee for the Quebec Community Groups Network.

Health Minister Gatan Barrette said he was surprised and called for the situation to be fixed immediately.

"For such a sensitive issue, I would agree that the information should be made available in both languages," Barrette said.

Information was made available in English by Thursday afternoon.