Quebec says that starting this fall it will authorize early requests for medical assistance in dying from certain patients before their condition renders them incapable of giving consent.
The province has been calling on the federal government to modify the Criminal Code to allow people to make such requests, but Quebec says it won’t wait any longer.
“We will be ready, and we will move forward. What we want is for the federal government to change the Criminal Code, but if they don’t, we are working on our options,” Léa Fortin, spokesperson for Seniors Minister Sonia Bélanger, told The Canadian Press.
Quebec adopted a law in June 2023 permitting people with serious and incurable illnesses, such as 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. The province previously said it would wait until the Criminal Code is amended so that health-care workers are not committing a crime if they end the life of someone no longer able to give consent.
Fortin said that despite multiple requests by Quebec for a change to the Criminal Code, the federal government refuses to do so.
“It’s a consensus in Quebec” that the health system should allow certain patients to make early MAID requests, Fortin said. “It’s a non-partisan initiative: legislators, health-care users, professionals — everyone agrees on moving forward with MAID.”
Fortin said the province will make a more detailed announcement in the fall.
The office of federal Health Minister Mark Holland says the federal government “continues to collaborate with Quebec on this matter. Minister Holland regularly engages with his counterparts.”
Patrick Taillon, a law professor at Université Laval, said Quebec can move forward without Ottawa.
“Who lays the charges? It’s the Quebec state. And if the Quebec state says, through a directive … that when it respects our laws, we won’t ever lay charges, then there will be no problem,” he said.
In April, Québec solidaire asked the provincial government not to wait for Ottawa, arguing that Quebec could move forward as it did with the first version of its MAID law passed in 2015. The federal government didn’t adopt its own law legalizing MAID until June 2016.
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 become incapable of consenting to care.
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.”