Quebec Euthanasia report - Quebec has the highest euthanasia rate in the world.

FOR IMMEDIATE RELEASE (Link to the Press Release)

2024–2025 Report of the Commission on End-of-Life Care was released providing the Québec MAiD date from April 1, 2024 to March 31, 2025.

In the absence of representative data and a first report without a portrait of palliative care.

Meanwhile, Quebec remains the world leader in medical assistance in dying with 6,268 (7.9% of deaths)

Montreal, November 4, 2025 – The Commission on end-of-life care released its 2024–2025 Annual Report on October 30th (in French). After reviewing the document, the Living with Dignity citizen network (Vivre dans la Dignité) wishes to highlight two aspects of the report that must not go unnoticed in political and media discussions.

Medical assistance in dying: Quebec has the highest rate in Canada.

Quebec remains firmly positioned among the jurisdictions with the highest proportion of assisted deaths (MAiD, euthanasia, or assisted suicide), accounting for 7.9% of all deaths during the period studied—an increase of 9% compared to the previous year.

As Quebec approaches the 10th anniversary of its first cases of medical assistance in dying (December 10, 2025), the report raises several concerns regarding this practice, including:

• Major regional disparities (MAiD represented 13.4% of deaths in Lanaudière vs. 4.7% in Montreal), a nearly 20% increase in Montérégie, and more;
• Very short delays between a MAiD request and its administration (same day or next day in 4% of cases); 
• Non-compliance in a small number of cases (0.3%), with no reported disciplinary consequences in these 19 reported cases—one of which involved administration without the person’s consent at the time. Living with Dignity reiterates that the current self-reporting system for MAiD providers after deaths cannot offer a full picture of non-compliant cases; 
• 50% of those who received MAiD cited suffering from being perceived as a burden to family, friends, or caregivers; 24% cited loneliness and isolation.

In concluding its report, the Commission reminds readers of its duty to ensure that MAiD is not “chosen for lack of access to other curative, palliative, or end-of-life care that is of high quality and adapted to Quebecers’ needs.” Without adequate data, it is clear that this objective cannot be achieved.

We also believe the Commission must remind the Quebec government of its responsibilities regarding how it communicates its constitutional project. The government appears to have forgotten the spirit of the Act Respecting End-of-Life Care by emphasizing medical assistance in dying while neglecting to mention palliative care. This glaring imbalance between palliative care and MAiD in Quebec must end—it is not a “shared social value” across Quebec society.

Palliative care: navigating in the dark

After years of repeated warnings about the weakness of data on palliative care (“limited validity,” according to the most recent five-year report, and “lack of sufficient information,” according to the 2022–2023 report), the Commission has taken a further step by refusing to share data it deems non-representative. From the report:

The Commission reviewed the data submitted by institutions concerning the number of people who received palliative and end-of-life care (PEOLC). Unfortunately, for several years, it has noted that much data is missing, incomplete, or imprecise, or refers to very different contexts from one institution to another. The disparities observed appear to reflect both a lack of shared understanding of the information to be transmitted and difficulties in providing certain requested data. Consequently, the Commission considers that the data submitted are not representative of the real situation of palliative and end-of-life care in Quebec and that including them in this report could lead to misinterpretations. (p. 14 of the report)

We commend the Commission on end-of-life care for its integrity in choosing not to publish data that would not provide an accurate picture of palliative care in Quebec. This courageous decision should serve as a wake-up call for Minister Sonia Bélanger, who resumed her position on October 30th as Minister for Health and is responsible for this file. As the Commission’s five-year report reminded us:

“There are no management indicators or standardized tools for assessing the quality of palliative and end-of-life care services, how well they meet the needs of patients and families, or how efficiently the system operates. The Commission therefore cannot determine whether the needs of people who could benefit from such care are being met.”

We cannot continue to navigate blindly on such a critical issue.

According to those working in the field, there is no doubt that access to quality palliative care remains more difficult than access to medical assistance in dying (MAiD). Palliative care requires more time, as well as greater human and financial resources. In the spirit of the Act respecting end-of-life care, Quebecers should also have similar access to high-quality palliative care. Proper indicators should also clarify where we collectively stand on this matter. We welcome the Commission’s creation of an internal working group tasked with developing recommendations to strengthen access to palliative care. However, urgent and decisive action is needed—particularly to protect and improve access to home-based palliative care, which has been severely undermined by Bill 2 (see numerous testimonies in French here and here).

Media contact :
Jasmin Lemieux-Lefebvre, coordinator, Living with Dignity citizen network
www.vivredignite.org/en / info@vivredignite.org
438 931-1233

Reaction to the Bloc Québécois federal euthanasia bill

The Boundary of incapacity: must not be crossed. (Link to the original release)

Montreal, May 23, 2024 – The Bloc Québécois announced today that it will table a Federal Bill that “would allow advance requests for medical assistance in dying (MAiD) for people suffering from neurodegenerative disorders such as Dementia."

This was presented during a Press Conference in Ottawa, in collaboration of a Coalition made up of the Quebec Association for the Right to Die with Dignity (Association Québécoise pour le droit de mourir dans la dignité, AQDMD), the Quebec Bar (Barreau du Québec), the Chambre des notaires du Quebec (CNQ), the College of Physicians of Quebec (CMQ), the Order of Nurses of Quebec (OIIQ), the Order of Pharmacists of Quebec (OPQ) as well as the Order of Social Workers and Marriage and Family Therapists of Quebec (OTSTCFQ) (see their press release in French) + Dying with Dignity Canada.

Given the tone of the Press Conference, which was very critical of the Liberal government, this maneuver has little chance of finding an attentive ear.

A thorough review is required before expanding access to medical assistance in dying by advance request. Crossing the boundary of incapacity and contemporaneous consent to administer MAiD would have serious and unprecedented consequences.

Here is an excerpt from the Brief from Living with Dignity presented last year during the examination (in Quebec) of Bill 11, An Act to amend the Act respecting end-of-life care and other legislative provisions:

The limits of advanced and substituted consent, the numerous practical issues concerning the administration of MAiD, the possible conflicts of interest (numerous cases of abuse and neglect of elderly individuals) and the major impacts of this new access on a network of already fragile geriatric care, strongly questions the merits of this expansion which we also consider to be marked by ableism.

It is important to remember that the opponents of this expansion were not invited to testify in a parliamentary committee concerning Bill 11 last year at the National Assembly of Quebec.

Webinar by Professor Theo Boer

To reflect on the issue of advance directives, the citizen network Living with Dignity invites interested people to follow a webinar organized by Doctors Say No International. At 4 p.m. (Montreal time), Friday, May 24, Professor Theo Boer, Professor of Health Ethics (PThUniversiteit Groningen, Netherlands) will present (in English) during this webinar on Assisted dying and its impact on culture: 40 years of Dutch experience with euthanasia.

Zoom link (password: 089934).

Holland is the only country in the world that allows the death of a person by advanced request when they are Incapable of decision-making and conscious (Belgium only allows it when a person is Incapable and unconscious). Professor Boer's contributions in French during the International Meeting on the End-of-Life are now also available in print (in French), as are those of all the speakers at this gathering held in Paris on February 28, 2024.

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Jasmin Lemieux-Lefebvre
Coordinator
Living with Dignity citizen network
info@vivredignite.org
438-931-1233

Bill C-62 is now in the Senate, LWD media release

The Euthansia Prevention Coalition is having a rally and press conference on parliament hill on Tuesday February 27 at 11 am (Link).

The following article was published by Living with Dignity.

Federal Bill C-62 seeks to amend the Criminal Code to provide that persons are not eligible, until March 17, 2027, to receive medical assistance in dying “if their sole underlying medical condition is a mental illness” continues its legislative journey.

The adoption of a motion this week allowed this Bill to be expedited. Note that there was a failed attempt by the Bloc Québécois to add the issue of advance requests to C-62.

We thank psychiatrists Pierre Gagnon and Sonu Gaind who spent Valentine's evening participating in the only meeting of the Standing Committee on Health studying the Bill.

Passed Thursday in the House of Commons, Bill C-62 will be debated during the last week of February in the Canadian Senate.

We hope for an adoption without amendment by March 1, 2024 due to the scheduled breaks in the Senate’s session. We will be very vigilant, as many Senators oppose delaying the exclusion of MAID for mental disorders.

Media Release: Memo to Quebec physicians practising medical aid in dying.

For Immediate Release: Link to the original release (Link).

Memo to Quebec physicians practising medical aid in dying

The Commission on End-of-life care had to act

A welcome intervention that unveils some important issues

Montreal, August 7, 2023 – Over the past few days, the Commission on End-of-life care has issued a memo to the hundreds of Quebec physicians who provide medical aid in dying. This information comes from the work of journalists Davide Gentile and Daniel Boily in a text published Saturday in French by Radio-Canada information, then adapted to English by CBC News’ Rowan Kennedy. Living with Dignity citizen network welcomes this intervention by the Commission on End-of-life care and its president, Dr. Michel Bureau. Living with Dignity invites political decision-makers to support the reminders contained in the memo, which highlight important issues that need to be taken very seriously.

The memo addresses three themes, as seen in these excerpts (in quotation marks, our translation) from the e-mail sent by the Commission on end-of-life care:

1) Non-compliance of a growing number of medical aid in dying procedures

"...a growing number of MAiD procedures with very borderline compliance with the conditions contained in the law, and a growing number of non-compliant MAiD procedures administered";

2) The importance of a second physician's opinion and doctor-shopping for a favourable opinion

"...the opinion of a second independent physician confirming the admissibility of MAiD is not just a formality; it must be critical and contemporaneous with the MAiD application";

"Doctor-shopping for a favourable second opinion is not an acceptable practice";

3) Advanced age is not a criterion for MAiD eligibility

"...advanced age and age-related problems do not constitute a serious and incurable disease, and do not justify MAiD".

Comments from Living with Dignity

By Jasmin Lemieux-Lefebvre, coordinator of the Quebec citizen network:

These warnings confirm the information we are receiving on the ground. To avoid refusals, people applying for medical aid in dying may be tempted to turn to MAiD providers who have a broader vision of MAiD access. Doctor-shopping for a favourable second opinion is also a well-known problem in this country. In his essay, No other options, published in The New Atlantis last winter, journalist Alexander Raikin explores the subject in depth in the section Easy to die.

At a conference of the Canadian Association of MAID Assessors and Providers, it was said that “you can ask as many clinicians as you want or need” and that "disagreement doesn't mean you must stop".

It should also be borne in mind that this memo comes at a time when the situation is probably more serious than that described by the Commission on End-of-Life care, which refuses to acknowledge any abuses for the time being. The scientific article The realities of Medical Assistance in Dying in Canada, published by Cambridge Press this summer, addresses the issue of inadequate data collection on MAiD in Canada:

The data are acquired from the MAiD providers via self-reporting. There is no mechanism for objectively, prospectively, or retroactively identifying or uncovering any errors or abuses of the process. Providing assisted suicide and euthanasia outside the parameters of the law remains prohibited. MAiD providers filling out the forms know that any deviation of the key criteria may result in criminal prosecution, making self-declarations of error or deviation unlikely. (see the Inadequate data collection section of the article by Ramona Coelho, John Maher, K. Sonu Gaind and Trudo Lemmens).

On March 7, 2024, medical aid in dying will be available in Quebec to people living with a serious physical impairment (a term adopted by the Act to amend the Act respecting end-of-life care and other legislative provisions and suggested by a group of experts on disability). As of December 7, 2023, it will be required in all palliative care hospices. The revelations of the Commission on end-of-life care must lead to concrete action to avoid the abuses that can be expected.

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Media contact:

Jasmin Lemieux-Lefebvre
Coordinator
Living with Dignity citizen network
directionVDD@gmail.com
438 931-1233

Living with Dignity responds to Québec euthanasia expansion Bill 38

Living with Dignity's reaction to the tabling of Bill 38 in Quebec

Serious ethical issues on the horizon: how to adopt measures of such magnitude in three weeks?

Urgent need to reflect further on human dignity and its impact on our social choices

Montreal, May 28, 2022 – The Minister of Health and Social Services, Mr. Christian Dubé, tabled on May 25 a bill to amend the Act respecting end-of-life care and other legislative provisions.

You can read it here.

In addition to complying with the Federal Bill C-7 (withdrawal of end-of-life criteria) and extending access to medical aid in dying (by advance request) to persons who are incapable, as we had feared, this bill contains a very unpleasant surprise: the obligation for hospices to offer medical aid in dying, unless there is an exception - an item that was unfortunately not part of the press release (available in French only), and only briefly mentioned during the Minister's press conference.

We opposed all of these measures in our August 2021 brief to the Quebec Select Committee. We will actively participate in the upcoming consultations. We are particularly distressed to see that the Quebec government is giving in to the demands of the most militant groups and individuals in favour of an all-out expansion of MAiD by lifting the clause for conscience protection that hospice care teams have benefited from since the adoption of the provincial law in 2015. Of the 37 hospices in Quebec, 16 still refuse to offer medical aid in dying under their roof. Do we really want to impose on 43% of hospices a gesture that is in flagrant contradiction with the principles of their team members?

We urge the members of the Quebec National Assembly to refuse to adopt such a major bill in three short weeks. Whether one agrees or not with the provisions of the legislative project, it concerns very serious ethical issues. There is no justification for such a rush.

Media contact:

Jasmin Lemieux-Lefebvre
Coordinator
Living with Dignity
directionVDD@gmail.com

 

Euthanasia, where and when does it stop?

By Nic Steenhout, Disability rights advocate and the former Director of Vivre dans la Dignité

Nic Steenhout

It is with great sadness and a fair bit of distress that I learned about two recent cases of so-called "Medical Aid In Dying" (euthanasia by any other name). The stories of two disabled women who were pushed to apply for MAID because their circumstances didn't allow them the choice of living would be distressing for most of us.

It is hitting me particularly hard because less than 10 years ago, I was saying that if Québec, and then Canada, legalized euthanasia, it wouldn't take long before people with disabilities no worse than my own, that were not at end of life, would be able to apply for and be granted euthanasia.

I really hate to say "I told you so". I hate even more that I was right.

The government said at the time: "there's not going to be a slippery slope". They lied. They called me alarmist. As it turns out, I was not exaggerating the dangers.

On April 13, 2022, CTV was reporting the story of a 51 year old woman which multiple chemical sensitivity (MCS) who could not find housing. She applied for and was given medical aid in dying.

On April 30, 2022, CTV again reports the story of a disabled woman who could not find housing and applied for euthanasia. This time, the woman is 31, also with MCS, and a wheelchair user. She hasn't yet been killed.

These two women were not given the options to live. Finding wheelchair accessible housing is next to impossible to start with. Finding affordable wheelchair accessible housing is even more difficult. Throw in the need to be protected from chemical exposures, and it becomes really thorny. So thorny that people search for years before being able to find, and opt for death instead.

What are we doing to disabled people? The governmental disability benefits are laughable. Who can find housing, let alone paying all other life necessities, including food, on $1,000 or so a month? The amounts of disability benefits haven't increased in a very long time in Canada. It's almost as if disabled people don't count. It's cheaper to provide euthanasia than support disabled citizens appropriately.

It gets even more interesting when we see that the government was able to unlock funds to help workers through being out of work during the pandemic's early days. The message from our government is very clear. Disabled people don't count.

I haven't been active in the fight against euthanasia (regardless of the name we give it) for the last several years because these public stories, and some very personal ones, just ate at me. It is ironic that as an opponent to euthanasia, I had two family members and a close friend apply for it, and die from it.

My grand mother, in Belgium, died from euthanasia. She was 98 years old. She had some vision issues, and needed a walker to move around. She was most certainly not at imminent risk of dying. But she was incredibly lonely with her family across an ocean.

My aunt, in Québec, was 77 years old. She had Multiple Sclerosis. She'd had a lung removed because of lung cancer, but she'd been in remission for years.

My friend John was in his early 60's. He had cancer. But he was well away from imminent death. He was grocery shopping and preparing meals for the freezer for his spouse the day before his euthanasia.

These three people did not meet the so-called safeguards that the pro-euthanasia crowd said would protect vulnerable people. So even with safeguards in place, there are people dying from euthanasia that shouldn't be. And now... Now we just keep expanding the eligibility criteria.

Where does it stop? When do we decide that supporting disabled people is the right investment in our society, rather than allowing them to die? When do we stop funding suicide prevention programs? Because it's not that far of a stretch to see this happen.

10 years ago I was saying that people with disabilities no worse than my own would soon have access to medical aid in dying. I was right. Please don't let me be right about the elimination of funding for suicide prevention programs. Please.

If you're reading this, it's likely that you already have strong feelings about euthanasia. You're probably outraged by these recent news stories. It's been said before, but we all need to talk to our elected representatives. Personal notes, phone calls, even emails. Let's let them know this is not ok. Let them know that enough is enough. The horse has bolted, we can't close the barn doors. But we can try and fence it in. We can try and limit further erosion.

The Treasure of Palliative Care – a video series

The Treasure of Palliative Care - a video series Link to the PDF English version.

Press Release

The Treasure of Palliative Care – a video series

There is always a better option than euthanasia

A Quebec perspective for a better understanding of palliative care

Montréal, CANADA – September 9, 2021 – The Living with Dignity citizen network (LWD), founded in 2010 in advance of the debate on the issue of "dying with dignity" in Quebec, is officially launching The Treasure of Palliative Care video series today.

Since 2015, the Canadian province has been the first jurisdiction in the world to propose euthanasia as end-of-life care, known as medical assistance in dying. "In this context, a Quebec perspective on the many benefits of palliative care is particularly pertinent and we wanted to share it internationally. It is becoming increasingly clear to us that there is always a better option than euthanasia," said LWD’s president Alex King.

Produced in English and French, the 10-minute video The Treasure of Palliative Care answers six essential questions to help you better understand this form of care whose name "palliative" was coined in Montreal in 1973 by Dr. Balfour Mount. In addition to the brief answers provided by two Quebec experts in the field, Dr. Golda Tradounsky and Dr. Patrick Vinay, six additional videos explore the following questions in greater depth:  

• Is palliative care only for people dying of cancer? 
• Where can we receive palliative care? 
• Does palliative care hasten death? 
• Does morphine cause death? 
• Should pain be part of the end of life?  
• Is medical assistance in dying (term used in Canada for euthanasia) part of palliative care?

Directed by Bruno Olivier and hosted in English by Angela Barrett and in French by Claudette Lambert, The Treasure of Palliative Care is available on the LWD Facebook page as of today (https://www.facebook.com/vivredignite/videos/560224695177761) as well as on YouTube via the https://vivredignite.org/treasure page.

A pre-launch of the video took place during the summer vacations on the occasion of LWD's participation in the Select Committee on the Evolution of the Act Respecting End-of-Life Care on August 9, 2021. This Quebec parliamentary commission is studying the potential extension of medical assistance dying (1) to people who have a mental illness as their only medical problem or (2) to those in a situation of incapacity (caused by a neurodegenerative disease such as Alzheimer’s) who have previously signed advance directives. For full details on LWD's participation in this committee, visit https://vivredignite.org/lwd-select-committee-2021.

The Living with Dignity citizen network is active on the following social networks:
Twitter https://twitter.com/Vivredignite
Facebook https://www.facebook.com/vivredignite
LinkedIn https://www.linkedin.com/company/vivredignite
YouTube https://www.youtube.com/channel/UCh3NsKMNpDum-RyhWSV4WzQ

Living with Dignity is a Quebec non-profit citizen network with no religious or political affiliation. Its mission is to promote the protection of the life and inherent dignity of people made vulnerable by sickness, old age or disability, by ensuring an end to their lives that is natural and respectful of the person and their dignity, through compassionate accompaniment.

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To request an interview with a member of the LWD team.

Jasmin Lemieux-Lefebvre
Coordinator, Living with Dignity
info@vivredignite.org

Our right to quality palliative care in Québec?

Aubert Martin

This article was published by Mercatornet on June 20, 2018

By Aubert Martin

The Act Respecting End-of-Life Care was sold to us as "first and foremost, a law of access to quality palliative care throughout the territory, at the patient's choice.” When it was adopted – not so long ago – its promoters insisted that it only legalized "medical aid in dying" (euthanasia) as an "exceptional measure for exceptional cases."

However it is now obvious that, almost four years since the day of its adoption and close to three years after its coming into effect, the public authorities have essentially concentrated their efforts on this famous "exceptional measure", giving the impression that the act of killing people to end their suffering – still very controversial – was a cool and trendy way of ending one’s life.

• Québec physicians: Shortage of palliative care is pushing people to euthanasia.

Recently, faced with this regrettable reality, several personalities in the health care community have publicly denounced the fact that, ultimately, the Act Respecting End-of-Life Care does not fulfill its main promise: to guarantee to all of the approximately 60,000 Quebecers who die each year the right to receive quality palliative care if it is needed.

Thus, after the heartfelt appeal of Quebec's two major palliative care associations denouncing the lack of efforts and resources to make quality palliative care accessible in all Quebec nursing homes (CHSLDs), or that of physicians who claimed that some patients are turning to physician-assisted suicide for lack of palliative care options, the Collège des médecins du Québec (CMQ) has also expressed its concerns by highlighting the disorderly application of the Act Respecting End-of-Life Care.

In a letter sent to Dr. Gaétan Barrette, the current Minister of Health, the Collège des médecins mentions that, in some cases, “patients, unable to benefit from [clearly identified palliative care], may have had no choice but to ask for [euthanasia] to end their days...".

Even worse, the College reports a disturbing fact that suggests that the exceptional measure may be imposing itself as a supreme: “The College has been told that patients seeking medical aid in dying were becoming the priority for access to available resources (...) to the detriment of other end-of-life patients with similar needs.”

In other words, those who choose euthanasia are entitled to the best support available in the last moments of their lives, while many others – the vast majority – do not receive the care promised to them in the law. Is that really the ideal of justice that we pursue as a society? Or is it for fear of making tomorrow’s headlines that the medical personnel are rushing to satisfy patients who choose euthanasia? Are they trying to avoid being publicly singled out for not immediately providing the act that has been promoted as the new way to die 2.0?

Meanwhile, instead of strengthening palliative care, the current situation threatens its very sustainability, as the College of Physicians also observes, reporting that “doctors are leaving and not being replaced in many palliative care settings, compromising access to such care.”

In conclusion, it is time to step back and reflect on the entirety of the commitments made in the Act Respecting End-of-Life Care. It is also time to listen carefully to what palliative care professionals have to propose as ways to make our end of life comfortable: after all, they are the experts. And it is time to claim the right that has been legally granted to us as citizens to have access to such care. Any delay in that respect abandons citizens to death without the support of the comfort care they were promised.

On the eve of the provincial elections in October, now is the time for the Quebec population to mobilize and demand that the future government finally listen to the vast majority of the electorate who wish to live with dignity until the end of their lives with the help of quality palliative care.

Aubert Martin is the Executive Director of Vivre dans la Dignité (Living with Dignity), a Quebec-based organisation.