This autumn, Quebec will accept MAID advance requests without waiting for federal legislation to change

Quebec is set beginning this fall to allow advance requests for medical assistance in dying (MAID) from certain patients before their condition worsens and prevents them from being able to give consent.

The province adopted Bill 11, an act to amend the province’s end-of-life care law regarding MAID eligibility, in June 2023. It permits people with serious and incurable illnesses to request the procedure in advance so that they can receive MAID once they’ve become incapable of providing consent.
More details will be announced in the fall, the provincial government said.

Quebec had earlier said it would wait until amendment of the Criminal Code so that health-care providers aren’t deemed to have committed a crime if they end the life of someone no longer able to give consent.

The office of Seniors Minister Sonia Bélanger said Quebec made multiple requests to Ottawa to change the Criminal Code but met with no success.

The office of federal Health Minister Mark Holland says Ottawa “continues to collaborate with Quebec on this matter. Minister Holland regularly engages with his counterparts.”

Quebecers Jean Truchon and Nicole Gladu challenged both Quebec’s and Canada’s MAID legislation in 2017, arguing that the laws violate their charter rights, especially the federal requirement for an individual’s natural death to be “reasonably foreseeable” and the Quebec requirement for a person to be at the “end of life.”

In its September 2019 decision, the Superior Court of Quebec agreed, finding these requirements to be unconstitutional. Neither Ottawa nor the Quebec government appealed.

Federal Bill C-7 became law on March 17, 2021, allowing eligible persons whose natural death is reasonably foreseeable and who have a set date to receive MAID to waive final consent if they are at risk of losing capacity in the interim. It also allowed euthanasia for those whose death was not reasonably foreseeable, and expanded eligible conditions to those whose sole condition was a mental illness.

An initial two-year moratorium on MAID from those solely suffering from mental illness was extended in 2023, and again in 2024. It’s now set to expire March 17, 2027.

In February 2023, the Special Joint Committee on MAID’s final report recommended that the federal government amend the Criminal Code to allow for “advance requests following a diagnosis of a serious and incurable medical condition disease, or disorder leading to incapacity.”

Bill S-248, in support of advance requests for MAID, completed second reading in the Senate in June 2023 and is currently at consideration in the Senate Committee on Legal and Constitutional Affairs.

MAID Legalization and Use

MAID became legal in Canada in 2016. The government is also working on legislation to expand MAID to those whose sole medical condition is mental illness, but has postponed a decision on that until 2027.

Canada has the fastest-growing euthanasia regime in the world, says a report by think tank Cardus released Aug. 7.

In 2017, the first full year MAID was legal, 2,838 MAID deaths were reported in Canada, according to Ottawa’s latest annual report, while 2021 saw 10,092 and 2022 saw 13,241 such deaths, accounting for 3.3 percent and 4.1 percent of all deaths in Canada respectively.

In 2022, 4,801 Quebec residents received MAID, a 46 percent increase from the 2021 figure of 3,299, and representing 6.6 percent of all deaths in the province.

Poverty or poor medical supports contributed to influencing some Canadians to choose an early death. Sathya Dhara Kovac, 44, received MAID in Winnipeg in October 2022. She had amyotrophic lateral sclerosis, or ALS, a degenerative disease. In an obituary to loved ones, she wrote, “Ultimately it was not a genetic disease that took me out, it was a system.”

Two Toronto women, both with a condition called multiple chemical sensitivities, chose MAID in 2022. A 31-year-old woman known only as “Denise,“ told media she was driven to MAID ”because of abject poverty.” She decided not to follow through after donations raised enough money for her to find suitable housing.
Another woman, under the pseudonym Sophia, gave up after two years of unsuccessful efforts to secure suitable housing. She posted a video eight days before receiving MAID, saying, “The government sees me as expendable trash, a complainer, useless, and a pain.”

The Canadian Press contributed to this report.