Tuesday, October 31, 2017

Québec Euthanasia data from the Commission on end-of-life care


This article was written by Amy Hasbrouck and published by the Euthanasia Prevention Coalition on October 31, 2017.

The number of euthanasia deaths continue to increase, compliance with the law remains questionable.

Link to the euthanasia report that was submitted to the Québec’s National Assembly on Thursday, October 26, 2017
Summary of information:
  • 37% of forms/reports from doctors, and an unnamed percentage of reports from institutions, needed more information. Some doctors openly refused to provide the additional information requested by the Commission.
  • The most frequent compliance problem is a lack of independence of the second doctor. Québec solved this problem by eliminating the requirement that the second doctor be independent. Footnote a. of table on page 22 (translated) reads: “Since February 2017, the Commission has adapted its assessment of this criterion in the light of ongoing work in partnership with the MSSS [Ministère de santé et services sociaux] and the CMQ [Collège des Médecins du Québec]. These cases would now be considered compliant, as long as the other criteria are met.”  
  • The Commission on End-of-life care has a backlog of 138 cases that have not been examined or ruled on.  
  • Forms/reports are not submitted in a timely manner by doctors.  
  • Confusion and inconsistency exists between euthanasia figures offered by the various sources; the “number of forms received and examined“ by the commission, the reports of the institutions, and the reports from the Collège des médecins du Québec.
  • A 5% or 7% error rate (with 3% undetermined) would not be acceptable where lives depended on the effective application of safeguards (e.g. the airline industry).  
  • The three cases in which the safeguards were clearly violated (two where the person did not have a “serious and incurable illness” and one where the person was not at the “end of life”) were not addressed as the crimes that they are. 
  • If people are not given information necessary to make a “free and informed” decision, this is another serious breach of the safeguards.
Data for the period of June 10, 2016 to June 9, 2017   
Statistics from institutions and the College des médecins
  • Continuous Palliative Sedation - (817)
  • Euthanasia requests - (992)
  • Euthanasia administered - Institutions (618)
  • Euthanasia administered - College des médecins (638)
    [June 10, 2016 - June 27, 2017]
  • Euthanasia not provided - (377)
Reasons why euthanasia was not done
  • Person not eligible/no longer eligible - (159)
  • Person died before euthanasia administered - (107)
  • Person withdrew request - (79)
  • Person was still in the process of being evaluated - (15)
  • Person returned home or transferred to another institution - (10)
  • Person was in distress and had a rapid decline - (5)
  • The request was suspended pending the person's choosing date - (2)
Number of forms/reports Examined - (634)
  • More information was needed on 37% of the forms - (237) 
  • Decisions were rendered on (579) forms  
  • Unexamined and undecided cases – (55)  
  • 92% of cases respected the law.
19 cases (3%) where Commission couldn’t reach a decision on compliance with the law,
  • 12 cases – supplemental information was still insufficient 
  • 4 cases – the commission did not receive the supplementary information requested  
  • 3 cases – the doctor refused to provide the supplementary information requested.
Non-respect of the law = 5% of the cases (31)
  • 20 cases – second physician wasn’t independent 
  • 7 cases – doctor who administered euthanasia did not have a conversation with the person to verify:
    • That the request was free and informed 
    • That suffering was persistent  
    • The consistency of the wish to die
  • 2 cases – the request was signed by a witness who wasn’t a recognized professional 
  • 1 case – person did not have a serious and incurable illness.  
  • 1 case – Person’s health insurance had expired.
Cumulative total data - December 10, 2015 - June 27, 2017
Forms/reports Examined = 786 but total of Institutions + College des médecins = 805

  • Cases ruled on = 648 
  • Unexamined and undecided – 138
  • 19 forms/reports appear to be missing.
90% of cases respected the law 
  • 3% insufficient information to make a determination 
  • 7% of cases did not comply with the law. (43)
Reasons why the case did not comply with the law:
  • Second doctor was not independent (29)* 
  • Doctor who administered euthanasia did not speak to the person to verify that: The request was free and informed, that suffering was persistent, the consistency of the wish to die. (7) 
  • The request was signed by a witness who wasn't a medical professional (2) 
  • The person did not have a "serious or incurable illness" (2) 
  • The person was not at the end-of-life (2) 
  • The person did not have health insurance (1)
* As of February 2017 these cases do not violate the law.

Data from institutions and the College des médecins Dec 10, 2015 - June 9, 2017
  • Continuous Palliative Sedation - (1080) 
  • Euthanasia requests - (1245) 
  • Euthanasia administered Institutions - (784)
  • Euthanasia administered - College des médecins - (805)
    [December 10, 2016 - June 27, 2017]
  • Euthanasia not done - (462)
Reasons why euthanasia was not done
  • Person not eligible/no longer eligible - (195) 
  • Person died before euthanasia administered - (128) 
  • Person withdrew request - (103) 
  • Person was still in the process of being evaluated - (18) 
  • Person returned home or transferred to another institution - (10) 
  • Person was in distress and had a rapid decline - (5) 
  • The request was suspended pending the person's choosing date - (3)
Amy Hasbrouck is the founder of the disability rights group: Toujour Vivant - Not Dead Yet and the President of the Euthanasia Prevention Coalition

No comments:

Printfriendly