The frequency of medical aid in dying (MAID) in Quebec is a cause for concern, according to Dr. Michel Bureau, the head of the independent body that oversees the practice in the province. In a recent interview, Dr. Bureau expressed worry that doctor-assisted deaths are no longer seen as a last resort, but rather as a common procedure.
Dr. Bureau, who leads the Commission sur les soins de fin de vie, the organization responsible for monitoring MAID in Quebec, stated that the practice is becoming increasingly prevalent. He noted that Quebec is on track to end the year with doctor-assisted deaths accounting for seven percent of all deaths in the province, which is significantly higher than any other country or province.
To address this concern, the commission recently sent a memo to doctors clarifying the criteria for MAID. The memo emphasized that only patients with a serious and incurable disease, who are experiencing unbearable suffering and irreversible decline, are eligible for MAID. It also reminded doctors that the procedure must be approved independently by two physicians, and that they should not seek out a second opinion that aligns with their own beliefs.
Dr. Bureau acknowledged that the cases qualifying for MAID are expanding beyond terminal cancer, encompassing a variety of illnesses. While he sees this as a positive development, he stressed the need for doctors to adhere strictly to the legal limits of the procedure.
The commission has noted a slight increase in cases that violate Quebec’s end-of-life legislation. In its last annual report, it disclosed 15 instances out of 3,663 MAID deaths that did not comply with the law. These cases include patients who were ineligible for the procedure, unable to provide consent, or lacked a valid health insurance card.
The cases have been reported to Quebec’s College des médecins du Québec, but it is unclear whether any disciplinary action has been taken against the doctors involved.
Dr. Bureau also expressed concern about elderly patients who desire MAID but do not meet the criteria due to the severity of their health issues. He emphasized that MAID should not be seen as a substitute for natural death.
According to Health Canada’s most recent report on MAID, doctor-assisted deaths accounted for 3.3 percent of all deaths in Canada in 2021. In Quebec, the rate was 4.7 percent, making it the province with the second highest number of MAID deaths after British Columbia.
Despite the strict regulations surrounding MAID in Quebec, the procedure has become an integral part of the province’s healthcare system, allowing patients to receive assistance from their own physicians. This ease of access has contributed to the higher rate of MAID in Quebec compared to other parts of Canada.
In conclusion, while the increasing prevalence of MAID in Quebec may be cause for concern, Dr. Bureau and the Commission sur les soins de fin de vie are actively working to ensure that the procedure remains within the legal boundaries and is reserved for those who truly need it.
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