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Quebec's advance-request MAID program presents a complex example for other jurisdictions
Summary
Quebec has approved more than 2,100 advance medical assistance in dying (MAID) requests since October 2024, allowing some people with illnesses such as Alzheimer’s to arrange MAID after loss of capacity; federal criminal-law rules still require capacity immediately before MAID and federal and international bodies have raised concerns.
Content
Quebec has implemented an advance-request pathway for medical assistance in dying that allows residents with serious, incurable illnesses leading to incapacity to arrange MAID to occur after they lose decision-making capacity. Since the program began in October 2024, more than 2,100 advance requests have been approved. The province’s approach is unique in Canada and has drawn attention from national groups, clinicians and international bodies. The federal Criminal Code has not been changed to permit advance requests and still generally requires capacity immediately before MAID.
Key points:
- Quebec has approved over 2,100 advance MAID requests since October 2024.
- Advance requests let people with conditions such as Alzheimer’s set terms for future access to MAID after they lose capacity.
- The federal Criminal Code continues to require capacity immediately before MAID, with a limited exception for patients who are near death and have a scheduled date.
- The United Nations Committee on the Rights of Persons with Disabilities recommended that Canada not support advance requests and that MAID be limited to terminal illness in its view.
- Ottawa has delayed a decision on whether people whose sole condition is mental illness can qualify for MAID until 2027.
Summary:
Quebec’s advance-request model has expanded access within the province and prompted debate among advocates, clinicians and international observers about consent and protections. Key legal and policy questions remain, including the federal capacity requirement and pending legal challenges; Ottawa has set a 2027 timeline for its review on MAID for mental illness.
