Quebec has announced that starting next month, it will grant requests for medically assisted deaths to individuals who want to arrange it before their condition deteriorates to the point where they can no longer consent. The province has decided to move forward with these early requests without waiting for the federal government to update the country’s Criminal Code. Quebec’s government, led by Justice Minister Simon Jolin-Barrette, believes that the issue of advance requests for medical assistance in dying is widely accepted in the province. Seniors Minister Sonia Bélanger also emphasized Quebec’s leadership in upholding patients’ right to die with dignity.

The government of Quebec has instructed the Director of Criminal and Penal Prosecutions to follow the conditions outlined in the province’s act respecting end-of-life care when considering criminal charges related to MAiD. The Director’s office has indicated that criminal prosecutions for deaths occurring in the context of MAiD will not be authorized if the care is provided in compliance with the act. Prosecutors will only intervene in cases where there has been a police investigation or a complaint regarding a failure to respect a person’s wishes in accordance with the law. Despite concerns about the legality of Quebec’s actions without changes to the Criminal Code by Ottawa, the Director of Criminal and Penal Prosecutions stated that they will continue to enforce the law until federal action is taken.

Quebec had previously stated that it would wait for amendments to the Criminal Code before granting early requests for medical assistance in dying to protect health-care workers from potential charges. However, the province has decided to proceed without waiting any longer. Quebec’s College of Physicians has expressed support for the government’s decision and criticized Ottawa for not amending the Criminal Code to authorize this procedure that is widely accepted in Quebec. The Order of Quebec Nurses has also approved of the move and called on federal lawmakers to join Quebec in implementing this well-established procedure.

The Criminal Code currently requires health-care workers to obtain express consent from individuals requesting medically assisted deaths immediately before administering the procedure. Exceptions can be made, but certain criteria must be met, such as having an arrangement in writing specifying the day on which the individual wants to die. Under Quebec’s law, a patient’s advance request for MAiD must be made with a health professional and detail the symptoms that will trigger the procedure after they have lost the ability to consent. In February 2023, Parliament’s special joint committee on MAiD recommended amending the Criminal Code to allow for advance requests following a diagnosis of a serious and incurable medical condition.

Overall, Quebec’s decision to allow early requests for medically assisted deaths reflects the province’s commitment to upholding patients’ rights to die with dignity. While there are concerns about the legality of this decision without changes to the Criminal Code, Quebec is moving forward with its plans. The support from Quebec’s College of Physicians and the Order of Quebec Nurses highlights the consensus in the province regarding this issue. It remains to be seen how Ottawa will respond to Quebec’s actions and whether federal lawmakers will amend the Criminal Code to align with Quebec’s laws on medically assisted dying.

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