By Christine Corey
With the recent majority government win by the Quebec Liberal Party with Philippe Couillard as its leader, it is clear that the citizens of Quebec were not in agreement with Pauline Marois’ vision for their future. It is clear that they didn’t want any part in the Charter of Values , recognising that it would only breed fear and intolerance ; that the former government seemed more preoccupied with a separatist agenda and furthering a partisan Quebec identity , rather than addressing the nearly 25 year drought in any form of infrastructure development as a result of massive austerity cuts, leaving us with a hollowed out physical economy  and the very immediate problem of a health care system on the brink of caving in on itself. For all the little that Pauline Marois accomplished during her short 2 years’ time in office, she managed to gain more disapproval for her policies than anything else. And so the hopes of the people have been shifted to their new premier of Quebec… but, can we so assured that the agenda will really be all that different?
A Health-Care System on its last leg
The first day following Philippe Couillard’s majority win, he announced his plan to advance austerity measures which he said were urgently needed to wrestle down a higher-than-expected deficit and reassure credit rating agencies his government will balance the budget by the end of the next fiscal year . This story has been heard too many times before, and the ending is always the same, balancing the budget always equates to cuts, and ambitious claims towards balancing the budget, like those of Couillard’s, means more often than not criminally insane cuts, notably to the game favourites : health-care and education.
However, Quebec is already in a health-care crisis. As per Dr. Louis Godin of the FMOQ (Federation of General Practioners) “At this very moment we have a shortage of more than one thousand family physicians…We have about two million people who do not have access to a family physician.”  That was 25% of the Quebec population in 2011, and yet we continue to slice up the pie into ever smaller slivers. With the growing number of patients entering into their 60s and beyond, another crisis is rapidly gaining speed. In 2012, there were 685 palliative-care beds, which fell 110 beds short of the government’s minimum standard of 1 bed per 10,000 people . With 25% of Quebec’s population anticipated in the 65 and older demographic by year 2031, the need for sufficient palliative care will only increase in importance. In addition both the MUHC and CHUM  super hospitals which are nearly completed, plan to include significantly fewer beds than before, with the budgetary reasoning that these hospitals will ultimately save money because of the higher turnover of patients which will ultimately be “cheaper” per patient. To enforce such an accounting approach to patient care, it is almost certain that penalties will be dealt to the hospital wards who “allow” their patients’ to overstay their calculated recovery time .
This is what Mr. Couillard means by “balancing” the budget, an agenda that was in the works under both Premiers Marois and Charest before him and thus has no party loyalty. Such logic in favour of cutting costs to pay off debt, demands that statisticians and mathematicians, instead of experienced health care professionals, be given the job of deciding what is an “acceptable” length of hospital stay depending on the treatment or surgery that patient came in for. Not only is this something that is impossible to calculate (since you are never assured that there will be no complications to someone’s recovery), but what happens to a hospital ward when it is unable to meet these patient turn-over demands?
If the province is serious about financially penalizing the ward, with every ward responsible for its own budget, what choice does a ward have but to ultimately send these patients packing before their recovery process is done? This will ultimately mean that for more complicated cases, such as co-morbidities and chronic disease(s), patients will have a much harder time finding a place for themselves in one of these shiny new hospitals. Under this logic, survival of the fittest reigns supreme. There is only one leg left and it is teetering under all the weight, obviously we cannot continue to cut away at it much further before things start to really get noticeably ugly…or can we ?
Euthanasia: Beware an Iago
Although Bill 52 itself is a relatively new bill that has come to fruition since it was first proposed by Véronique Hivon in 2012 under former Premier Marois’ government and where it has gained the most notoriety, the fight for the “right to die” cause has been championed by Hivon since as far back as 2009. It was during this time that the roots were firmly planted, and the proposition was first made that Quebec look into adopting a law into medical assistance to die, which was accepted by then Premier Charest and where the first committee to oversee this reform was originated. Véronique Hivon was vice-president of that committee, and while the committee itself was apparently unanimous in their recommendation for such a law, on second reading, most Liberal members voted against it.
The advent and progress of Bill 52 is a somewhat peculiar thing, in that the cause for the “right to die” has gained so much political clout as a “cause for the people”, that it has been trumpeted as a “non-partisan” and issue and an absolute priority on the list. This was made vehemently clear after the sheer outrage expressed by the PQ party towards the Liberals refusal to speed up the process of passing Bill 52 so that it could circumvent the dissolution of parliament ordered by Pauline Marois in preparation for an election, with parliamentary leader Stephane Bédard going so far as to accuse Philippe Couillard of blocking the passage of such a bill . In other words, because it was considered a “non-partisan” issue, the PQ felt betrayed by the Liberals in their apparent refusal to cooperate in passing the bill, with the survival of Bill 52 the utmost priority over even the survival of their very own political party…all for the sake of the people ?
It is thus even stranger, that Philippe Couillard announced during his first day on the job that he planned to reintroduce Bill 52, despite his seeming refusal to cooperate just a few months before, and that he planned on pushing its introduction through before parliament breaks for the summer. Therefore the opinion that this bill has become a non-partisan issue is correct, but why the belief that it is so sacred? Let it be made clear, a bill that gains support from every party that comes to power is so rare a thing that it can be said to be practically non-existent. Therefore, it must be asked “why is Bill 52 trumpeted more than any other policy recommendation, during a time that the economy is collapsing along with a health care system unable to keep up with its growing number of patients?” If “balancing the budget” is the utmost priority of Mr. Couillard’s government, how does Bill 52 fit into this agenda?
The Undermining of Palliative Care
Additionally, Veronique Hivon is again on board as a co-sponsor to the bill calling for the legalization of euthanasia, or the term Ms. Hivon would prefer us using, “medical aid in dying”, which she makes sure to remind everyone of ceaselessly. The reason behind this euphemism is very simple, euthanasia is illegal in Canada under the Criminal Code, and thus the hope is that if it can be dressed up in sheep’s clothing perhaps it won’t attract too much attention to the fact that it is killing village loads of people [see appendix].
Do not mistakenly assume that such a critique of Hivon’s reasoning makes light of the fears and anxieties of the people who have been told that they have so many weeks, months, or years to live. This critique has their very situation in mind. Death is never an easy subject to face, especially alongside fear and anxiety about suffering or losing control of one’s own fate before their time comes. However, what is truly insensitive is utilizing this fear and anxiety as a justification for ending someone’s life and painting it as a dignified death.
It is no small matter that the only medical service in end-of-life care presently, palliative care, finds that its practitioners want nothing to do with this new form of “treatment”. This not only includes the vast majority of palliative care doctors in Quebec but the “father of palliative care in Canada” Dr.Balfour Mount is adamantly opposed to the bill. Under Bill 52, as it was left in February 2014, the entire basis for justifying the term “medical aid in dying” was reliant on it being considered a part of the medical practice of palliative care and could therefore be considered a form of medical treatment for terminal patients to render them, well…terminal.
There are many reasons why palliative care doctors have shown resistance against such a policy to the point that most of them are stating their refusal to partake in the act of euthanasia, with the most important being that patients change their minds frequently on their wanting to die and that this is often centred on their own fears of future suffering or future loss of control. Palliative care offers a holistic approach to addressing these fears and finds that if these fears and concerns are adequately addressed the patient more often than not chooses to live .
Before it is decided that death should become a prescription under the guise of “medical” treatment, we must ask : why hasn’t there been funding towards expanding palliative care services ? As stated by Dr. Saba, leader of the Coalition of Doctors for Social Justice, Bill 52 is not needed were funding to go towards palliative care, vastly improving the conditions of terminally ill patients. Saba makes the point that 80 % of Quebecers do not have access to palliative care largely because of government cutbacks in health care services . Presently the waiting lists go on for months for a bed on a palliative care unit, with only the very terminal (a few weeks left to live) often gaining a spot more quickly. The rest of the patients are left on whatever hospital unit they found themselves being diagnosed on or left at home with no resources. There are few palliative care centres available in the community except for private care which is extremely costly. With this in mind, three questions bear upon the thinking citizen:
1) Why aren’t the people who wish to die with dignity within a palliative care setting not equally supported and championed in comparison to the people who chose to end their life?
2) Why is it ok that the people who will reject euthanasia are to be left with hardly any resources or support or access to care?
3) Could it not be reasoned that the very fact that there is no support and no resources for people facing a terminal prognosis that which in turn causes their fears of an undignified death in the first place ?
One reason that this issue is not being addressed is that increasing palliative care beds to the required number to meet the demand would require a large amount of funding, much larger than the Bill 52 program would require, and we all know that this seems an impossibility with the priority of “balancing the budget” looming over all of our necks.
Dying with Dignity… or as a Sacrificial Scapegoat?
Presently the only thing standing in the way of the adoption of a policy such as Bill 52 is the Criminal Code of Canada, for which the federal government and Supreme Court of Canada are upholding. The Canadian Medical Association has up until recently also made clear their stance against euthanasia. However, the tides are shifting such that without adequate resistance, such a bill will not only soon be adopted for Quebec but for all of Canada. The federal Liberal Party has made it very well known that they are all for euthanasia to the point of handing out badges with the motto “Dying with Dignity”, and voting up a resolution in support of the measure in the Liberal Party convention of 2014 . In turn, the Canadian Medical Association (CMA), though presently advocating a stance against euthanasia , nevertheless, has found its most recent former president, Dr. Louis Hugo Francescutti, stating that the discussion around “end-of-life” care is “evolving naturally” and that the CMA should be prepared to approach this issue as it arises . With the BC Supreme Court already having ruled in 2012 in favour of euthanasia, despite being overruled by the federal government and BC court of appeal, the battering tides are increasing in strength and it is only a matter of time before the flood gates burst forth.
It is therefore crucial that it be understood by any advocate or undecided voyeur to the euthanasia cause that fighting to die is nothing to be celebrated and triumphed as if “overcoming life’s last hurdle”. It is a voluntary admission to the regard that your life has no longer any worth or value and that you are ultimately a burden to others or yourself.
Fighting for the right to die is also in direct accord with the Malthusian doctrine  of depopulation and zero growth and makes the job of thinning the herd much easier if it is considered voluntary. People may be lead to believe that there is every difference between Bill 52 and Hitler’s T4 program , or even the euthanasia laws of the Netherlands and Belgium [see appendix 2]. We could talk until our breath gives out about how Bill 52 would never be allowed by the people, the media or the doctors to grow into such a monster. And yet the irony is that so far, any law that has decreed euthanasia acceptable has ultimately led to a broadening of its criteria and its candidates, as seen in the Netherlands, under the Groningen Protocol, where newborns and infants are accepted for euthanasia, and in Belgium, where most recently, children as young as 12 years of age are now accepted to be euthanized.
With these modern cases in mind, it is chilling to look back to Weimar Germany where the T4 program went so far as to euthanize 70, 273 people by 1941 (in 2 years’ time), and a further 200, 000 by 1945 under the unofficial continuation of the program . Why are we so sure that Quebec will be the first exception ? This becomes increasingly absurd of a defence when it is admitted that the Belgium template is the closest model for Bill 52 in the world , and that the Quebec College of Physicians have already explicitly called for an expansion of who should have access to euthanasia during the recent Bill 52 debates .
It is a tragic time in our culture today, that there are those who would rather fight tooth and nail to have the right to end theirs and other`s lives rather than for the right to have access to a humane system of medical care not only in treatment but in prevention which is almost non-existent in our communities, even if heaven forbid, it costs more.
The Solution: Create Wealth by Development!
It is hoped that by this point the reader is either in accord with their own developed reasoning against euthanasia or that they are at least second guessing some of their notions that are preventing them from doing so. In the midst of a world financial blow out, no one is exempt from the chopping block of austerity cuts, which are now being passed by credulous lawmakers who are more obsessed with saving an illusory speculative debt bubble rather than the general welfare of their fellow citizens.
Quebecers are not the only ones faced with moral dilemmas of what limb to cut off next. Every western nation is being told that they must cut out flesh to save the gangrenous process that is overtaking them. It is clear that there lies no cure down this path, and yet the majority continue down it in hopes that the black cloud looming ahead is somehow not an ominous foreshadowing of still darker things to come.
The reality is that no economy will ever pay off its budget by refusing to grow and develop in favour of policies that promote atrophy and austerity, always postponing a future vision of development in order to satisfy a false sense of momentary “balance”. The truth is that under the current system, the debt is growing larger as the productive sectors and infrastructures are growing ever weaker. The irony is that these are weak in turn due to lack of government spending towards the very public sectors which we are dependent upon and from which real wealth arises, rather than imaginary monetary profits gained by such parlour games as derivatives and speculating on short-term futures , which can turn against you at a moment’s notice. It is not these sort of short-lived ”profits” but real physical profit that we depend upon to sustain us over several generations or more, such as the vast Quebec hydroelectric dams under the Daniel Johnson Sr. initiative of the 1950s-1960s.
In order to continue such an initiative, we must cut out the austerity policy once and for all and re-commit ourselves towards growth and development towards a future where the people will be supported rather than letting them fend for themselves, ultimately to perish. This can only be accomplished by the re-establishment of the Glass-Steagall Act (known formerly as the Four Pillars in Canada)  and the implementation of a credit system , as originated by Alexander Hamilton, encompassing a drive towards not only nation building projects that are desperately needed within Canada, but nation building projects in partnership with the United States (such as NAWAPA XXI), and Russia-China (such as the Bering Strait Tunnel) . It is time we realize that such a future is not only possible but absolutely essential if we are to avoid any more visits to the chopping block.
Philippe Couillard is set to re-introduce Bill 52 in Parliament within the next upcoming weeks. Do not stand for any further criminal austerity measures, contact your MNA now and oppose this bill while there is still time.