Quebec begins granting early requests for MAID without requested federal changes

MONTREAL — Quebecers who want to arrange a medically assisted death before their condition leaves them unable to grant consent can do so as of next month, the province announced Saturday as it unveiled details of a plan to grant such requests without waiting for Ottawa to update the country’s criminal code.

Quebec’s government said last month it would stop waiting for the federal government to implement the requested amendments and forge ahead with plans to grant early MAID requests. On Saturday, the province announced such requests could be granted as of Oct. 30.

“The issue of advance requests for medical assistance in dying is widely agreed upon in Quebec,” Justice Minister Simon Jolin-Barrette said in a press release.

Seniors Minister Sonia Bélanger called the province a leader in upholding “patients’ right to die with dignity.”

The government said it has asked the Director of Criminal and Penal Prosecutions to respect the conditions laid out in the province’s act respecting end-of-life care when it comes to pressing criminal charges.

In response, the Director’s office issued its own release immediately after the government, saying it would instruct criminal and penal prosecutors that “it would not be in the public interest” to authorize criminal prosecutions for deaths occurring in a context of MAID so long as the care is provided in compliance with the act.

Director Patrick Michel says prosecutors will only intervene when a police investigation has taken place or a complaint has been made that someone’s wishes were not respected in accordance with the law, for example, if someone was alleged to have been coerced.

When asked whether Quebec is acting illegally without Ottawa modifying the Criminal Code, Michel said prosecutors will continue to enforce the law until Ottawa steps in and takes action.

“We’re a law enforcement agency, so we have to take it for granted that the provincial law is valid, and we’ll take that into account in our decisions,” Michel told The Canadian Press in an interview.

“The federal government would have to challenge the legality of the law, then convince a judge to suspend the application of the law while the court ruled on the validity of the provincial law. Otherwise, the law is presumed valid until it is invalidated, or a court suspends its application,” he said.

Quebec previously said it would wait to grant early requests until the federal government modified the Criminal Code in order to better protect health-care workers from facing charges related to ending a patient’s life, but last month it announced it wouldn’t wait any longer.

Quebec adopted a law in June 2023 permitting people with serious and incurable illnesses like Alzheimer’s disease to ask for MAID while they have the capacity to provide consent, with the procedure being carried out after their condition has worsened.

On X, Quebec’s College of Physicians shared its support for the Quebec government’s move and criticized Ottawa.

“We deplore the fact that Ottawa has not yet amended the Criminal Code to authorize this well-established procedure, which has consensus in Quebec.

The Order of Quebec Nurses also expressed its approval and turned its attention to federal lawmakers.

“There are still a number of issues to clarify before it comes into force. We therefore look to the federal government to quickly join the broad Quebec consensus,” said order president Luc Mathieu in an email to the Canadian Press.

The Criminal Code says that “immediately before” a health-care worker administers a medically assisted death, they must “give the person an opportunity to withdraw their request and ensure that the person gives express consent to receive medical assistance in dying.”

There are exceptions, but for the consent requirement to be waived, a person seeking MAID must fulfil several criteria, including that they “entered into an arrangement in writing” specifying the day on which they wanted to die.

Under the Quebec law, a patient’s advance request is made with the help of a health professional and must describe in detail the symptoms that will trigger medical aid in dying after they have lost the ability to consent.

In February 2023, Parliament’s special joint committee on MAID released a report recommending that the federal government amend the Criminal Code to allow for advance requests following a diagnosis of a serious and incurable medical condition, or “disorder leading to incapacity.”

This report by The Canadian Press was first published Sept. 7, 2024.

Joe Bongiorno, The Canadian Press