Québec Euthanasia deaths increase by 51% in 2021-22 annual report. A discrepancy of 289 deaths.

Amy Hasbrouck

Amy E. Hasbrouck
Toujours Vivant-Not Dead Yet

The seventh annual report from Québec’s Commission on end of life care was filed in Québec’s National Assembly on December 9, 2022. The report covers the 2021-2022 period (April 1, 2021 to March 31, 2022), but appeared about six weeks later than usual due to Québec’s provincial election on October 3.

Article: Quebec euthanasia deaths more than double in two years (Link).

The Commission reported 3,663 euthanasia deaths declared by doctors during the fiscal year (p. 13), while the number of euthanasia deaths reported by facilities (3,629) and the Collège des Médecins du Québec (323) totalled 3,952 (p. 25 at note 25); a discrepancy of 289 deaths. 

Article: Québec Annual 2020 - 21 euthanasia report. Euthanasia deaths increased by 37% unreported euthanasia deaths are a problem (Link).

Counting two streams of euthanasia data is supposed to ensure that all euthanasia deaths are counted, but the totals have never come out even. In every annual report there has been a sizeable discrepancy between the figures for the two data streams. While the Commission on end-of-life care acknowledges the inconsistency, it makes no effort to explain it, except to say that some of the excess is due to duplicate reports.

The annual report uses the figure of 3,663 from the doctors’ reports as the total of euthanasia performed during the fiscal year. This marks an increase of 51% (1,236 more MAiD deaths) over last year and accounted for 5.1% of all deaths in Québec. 

On page 28 of the report, the Commission points out that, added to the 2.6% of Québecois who died from Continuous Palliative Sedation, nearly 8% of deaths in Québec were due to life-ending acts. This year, the number of people who have been euthanized in Québec since the MAiD law went into effect in 2015 surpassed the 10,000 mark, at 10,786 deaths. In its “Findings and Concerns” section, (p. 30) the Commission points out that Québec’s euthanasia rate is “more per million population than Ontario, Canada and Belgium.”

Information about the number of MAiD requests that resulted in euthanasia comes from the institutional data stream (reports from hospitals, hospices, long-term care facilities, and the College of physicians). The Commission said that 5,321 requests for MAiD were received, 3,629 (68%) of which resulted in euthanasia and 1,614 (30%) which did not end in euthanasia (p. 25). Astute readers will note that 5,321 (MAiD requests) minus 3,629 (euthanasia) minus 1,614 (MAiD not administered) leaves 78 people whose MAiD requests are not accounted for. 

Table C6 on page 47 “Reported number of MAiD requests formulated, MAiD granted and MAiD not administered according to the institution and the Collège des médecins du Québec between April 1, 2021 and March 31, 2022” shows five facilities that reported fewer than 10 MAiD, which nevertheless does not account for the discrepancy. As well, on page 28 in notes for table 4.1, we learn that “The total number of MAiD requests not administered (by reason for non-administration) declared by the facilities (n=1,525) does not correspond with the number of requests that did not end in euthanasia (n=1614) reported by institutions,” (a difference of 89 people). The Commission explains that “the reasons for non-administration were not available for certain institutions.” The Commission also reminds us (in note 25 and in the notes for table C6) of the 323 euthanasia reported by the College of physicians, which don’t appear to enter into these calculations.

In light of the discrepancy (289 deaths) between the number of euthanasia reported in doctors’ declaration forms (3,663) and the facilities’/CMQ reports (3,952), and the unaccounted MAiD requests that didn’t end in euthanasia, (78 people) it’s hard to take seriously the Commission’s claim that 99.6% of euthanasia complied with the requirement of the MAiD law. 

Following its review of the doctors’ declarations, the Commission found 15 euthanasia that did not conform to the law. Ten people who were euthanized were ineligible; six because they did not have a “serious and incurable” medical condition, three because they were not capable to consent, and one person who was not insured under Québec’s assurance maladie. The commission found procedural violations in five cases; four people whose request form was signed by a non-medical or social service professional, and one request which was not approved by a second doctor. Half of the people were euthanized within ten days of making the request, and more than half (54%) of euthanasia were performed in hospitals.

Finally, the Commission volunteers its opinions (p. 32) on a bill before Québec’s legislature to allow people to make advance requests for euthanasia in case of incapacity. The Commission supports a proposal in the bill that hospices may only exclude MAID from the care they provide if authorized by the Minister.