Tuesday, June 17, 2025

Québec Medical Group requires physicians and nurse practitioners to refer for euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

memorandum from a Québec medical group reminds healthcare professionals of the obligation to leave their conscience "at the door" and refer patients for death by euthanasia (MAiD). The subject line reads "General reminder regarding requests for medical assistance in dying (MAiD)."
 
Canada legalized MAiD in June 2016 by creating an exception in the Criminal Code for homicide (murder).

An association of healthcare professionals in Montreal Québec sent a memorandum as a "general reminder" regarding requests for medical assistance in dying (MAID) to ensure that all healthcare professionals know that they are obligated to refer all patients who request death by euthanasia (MAiD). If the healthcare professional conscientiously objects the request must be sent to the Interdisciplinary Support Group (ISG). The memorandum states:
No healthcare professional can ignore a request for MAID. It is the responsibility of every professional to ensure that such a request is taken care of. As stipulated in sections 26 & 31 of the s-32.0001 - Act respecting end-of life care, any health or social services professional may complete the (contemporary) MAID request form when a person so requests.

Any physician or specialized nurse practitioner who receives a request for an MAID must notify the Interdisciplinary Support Group (ISG) and, if applicable, forward the request form to the ISG when he or she:
  • refuses a request (based on the eligibility criteria recognized by the Act);
  • refuses to assist a person in formulating an anticipated application (moral or religious conscientious objection) or in withdrawing such an application;
  • refuses to carry out the required examination.
The ISG is to provide clinical, administrative and ethical support for end-of-life care. In particular, for the evaluation of a request or the administration of MAID, continuous palliative sedation and in the drafting of an anticipated MAID application (answering questions, coaching and mentoring by experts).

You can contact the MAID and ISG coordinator by e-mail: amm.comtl@ssss.gouv.qc.ca or at: 514-809-6174.

For more information, the CIUSSS intranet is regularly updated https://intranet.comtl.rtss.qc.ca/en/clinicalpractice/palliative-care-and-end-of-life-care/medical-assistance-in-dying-maid.

We remind you that no intimidation of anyone requesting information or an MAID, nor of the professionals involved, will be tolerated. Anyone witnessing such a situation should report it: employees should inform their superior, users and families should contact the Ombudsman.

Thank you for your cooperation,
For people outside of Canada, healthcare is a provincial jurisdiction, therefore each province will have different rules pertaining to referrals for euthanasia. 
 
When reading this memorandum, it is sadly not surprising that Québec has the highest euthanasia rate in the world.
 
More articles on this topic:
  • Canada's euthanasia deaths continue to rise with approximately 16,500 euthanasia deaths in 2024 (Link).
  • Québec shows the way with euthanasia in Canada (Link).
  • Québec approves euthanasia by advance request (Link).

7 comments:

  1. We must speak out against the lack of protection for health care workers who for conscience or religious reasons cannot take any part of the MAiD process.

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  2. As a healthcare professional in Ontario I am not sure where this memorandum is coming from. It appears to be from a Quebec government agency perhaps the Ontario equivalent of a LHIN (local health integration network) . It appears to be a directive to physicians and nurses but may not be binding legally unless the professional licensing bodies of these professional groups have policies in place that mandate referrals without conscience rights in which case violators could face disciplinary action like suspension or revocation of their licenses to practise.

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  3. This edict is blind to the reality of moral hazard and is best ignored by dissenting HCWs. Your new PM and government may have more compassion than previous.

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  4. I can assure you that this level of effective referral is absolutely required in Quebec. It is right in the law, not in regulations.

    Furthermore, Quebec practice is currently taken as a de facto standard across Canada. In our most recent Story Contest submission our author Barbara, describes a Doctor in Alberta who is clearly under the impression that she must discuss MAID in certain circumstances (even though she is clearly against the practice in this instance).

    Here is the quote:

    “I am embarrassed to ask you this question, but I am required by federal mandate to ask people over the age of 65: Do you want to end this?”

    That is wrong, but it is amazing how many people think it is true. Plus we have the problem of pro-MAID doctors aggressively marketing the product, just because they can.

    Alex is nonetheless correct in stating that individual Provinces may define MAID practice differently. The only trick is getting them to do it.

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  5. Ive been in professional situations that present a moral dilemma. I am not understanding the problem, not really. When moral decisions arise, you prioritize and assess the risk versus benefit. In this case a life is ended. Immediate no brainer, you dont do it. To betray your conscience in this case death occurs. What are you weighing, your salary against that life? No one can "force" another to do this. Easy answer, you quit. If workers banded together this would end immediately.
    Its not comprehensible any person of goodwill, any christian, would go along wirh this when it betrays their morality and conscience. Are we that poorly committed to our faith and values?
    Is our faith for sale?
    Are we so easily bought?

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  6. Dear Evangeline: I agree with your strong position and a large group of medical professionals did stand together for conscience rights. The government imposed referral on them anyway. Some medical professionals will leave Quebec to practise medicine in other jurisdictions.

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