Will the end-of-life-care bill turn Quebec into a euthanasia tourist destination?

Quebec's new end-of-life-care legislation is unlikely to turn the province into a so-called euthanasia tourist destination, but it could prompt some terminally ill Canadians to consider moving there to spend their last days.

"It is possible, but how the bill is written, it wouldn't be easy to do it," said Alex Schadenberg, executive director of the Euthanasia Prevention Coalition. 

"Nonetheless, it is possible for other Canadians to go to Quebec and within a reasonable period of time, to die by euthanasia."

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Bill 52, also known as an act respecting end-of-life care, passed Thursday afternoon in a free vote at the National Assembly in Quebec City. It would allow a doctor who has been given the consent of the patient to administer medication to cause death.

The bill lays out a number of qualifications for end-of-life-care, all of which must be met. They include the provision that the person must "be an insured person within the meaning of the Health Insurance Act," meaning they would have to possess a Quebec health card. And in order to receive a health card in the province, one must be a resident or temporary resident of Quebec.

The 2012 legislative committee report on "dying with dignity" recommended the residency criterion "to prevent people from coming to Quebec solely for the purpose of obtaining help to die."

This makes it unlikely that terminally ill people from other countries will flock to Quebec to take advantage of the new law, as they do for Switzerland's Dignitias clinic, which has no residency requirement and accepts foreigners.

The clinic, which has given Switzerland a reputation as a euthanasia tourist spot, states in its brochure that it would be "ethically unacceptable to differentiate between people who are suffering intolerably based on whether they are resident in Switzerland or abroad."

But for a Canadian citizen, establishing residency in Quebec and obtaining a health card might only take a few months.

"Just like now, you can apply for a medical card and it doesn't take very long for you to get one because you're a Canadian citizen," Schadenberg said.

Last year, during hearings about the proposed bill, Yves Bolduc, the former Liberal health minister, said, "We are certainly going to have people from other provinces who will come here, who will stay for a certain time — more than three months — precisely to have medical aid in dying," according to a report in the National Post.

'That's horrendous'

Wanda Morris, chief executive officer of Dying with Dignity Canada, a supporter of the recent legislation, said she doubts terminally ill Canadians with only months to live would move to Quebec.

"For most people when you're dying, your world is getting smaller, your network is tightening up, you want to spend time with your family and your closest friends," Morris said. "So the idea of trying to move at that point, trying to find a doctor and relocate, that's horrendous."

Those suffering from a progressive illness such as Huntington's or ALS and who know how much time they have left might decide to relocate, she said. 

"But imagine a more fast-acting cancer or something like that. The idea of spending your last four to five months of your life away from your home and your network, for most people it's not going to be feasible."

Quebec joined European countries such as Belgium, the Netherlands and Switzerland, and a few U.S. states, which allow for physician-assisted suicide. 

Morris said that Oregon requires a six-month residency requirement and some people have moved there to take advantage of their law. 

"But again it's something that they do thinking 'You know what? For me the spectrum of health care includes my right, my choice, so why don't I retire somewhere where I have full rights?"

And for just that reason, some healthy members of her organization are considering Quebec as a possible place to retire.

"But not in terms of a deathbed move," she said.