10 years on, Quebec leads the country in MAID, as debates over its use continue

Ten years after it was legalized, the debate over medical assistance in dying (MAID) continues in Quebec.

A palliative care conference is wrapping up in Montreal, and one of the major topics is medically assisted dying, known as MAID.

It was legalized in the province a decade ago, and Quebec has the highest rates of it anywhere in the world, but there are still debates as to when and how it should be used.

“We realized that the [social acceptability] was very high,” said Universite de Montreal Dr. Marie-Eve Bouthillier. “Also, people now, a lot of people, they have had good experiences with their relatives who receive medical assistance in dying.”

In the rest of Canada, it accounts for 5.1 per cent of all deaths. In Quebec, it’s 7.9 per cent.

“I think it’s a dubious distinction, potentially, that Quebec is the leading provider of medical aid in dying in the world,” said Dr. Julian Sanders.

Sanders argues there should be better health care in life, and that medical aid in dying shouldn’t be the answer to make up for those gaps.

“I really worry that medical aid in dying can become a solution to every problem in a society where things need to happen quickly,” he said.

Earlier this week, the federal government announced that anyone whose primary issue is mental health won’t be able to receive MAID, following the recommendation of a special committee.

“The government will be tabling legislation this fall that will maintain that exclusion on a permanent basis,” said federal Justice Minister Sean Fraser on Wednesday.

Fraser added that advance consent will be part of a new bill from Ottawa.

Quebec has already gone ahead with this policy.

Bouthillier says most people who apply for the procedure are in their late 70s, with advanced or incurable cancer, and many have already received palliative care.

“They are usually at the end of a very long journey with disease and with health care, so they have received a lot of health care, and they don’t want that anymore,” said Bouthillier.

Others argue it’s a permanent end, stemming from a bigger problem.

“I’ve had many patients that I care for who have chosen to have medical aid in dying, and it cannot be a public health solution to an aging society in which we have more and more serious illness,” said Sanders.