In Quebec, people at the end of life who are suffering a lot can ask a doctor to give them medication to end their lives.
This is called medical aid in dying. You might have heard it called doctor-assisted death, assisted dying, medical help to die or something similar.
The law is very strict about when it is allowed.
This article explains when it can be given and how patients can ask for it.
When It Can Be Given
To get medical help to die, people must meet these requirements:
- be 18 years old or older
- have a Quebec health-insurance card
- have the mental capacity to make their own decisions about their medical care
- be at the end of life
- have a serious and incurable illness
- have a medical condition that seriously affects their health, with no chance of getting better
- be in constant and unbearable physical or psychological pain that can’t be relieved in a way the patient feels is tolerable (palliative care, sedation, etc.)
Important! A person cannot ask for medical help to die in advance. It can only be done at the end of life. For example, if you have just been diagnosed with a degenerative disease, you can’t ask for medical help to die right after being diagnosed.
Asking for Medical Help to Die
The request must come from the patient, and follow these steps:
- tell the doctor about the decision orally
- ask a health-care professional for the government form and fill it out
- sign and date the form in front of the doctor or another health-care professional
- repeat the wish to receive medical help to die at each new meeting with the doctor or other health-care professional
People who ask for medical help to die can change their minds. They can also ask for a postponement.
There must be at least 10 days between the time the request is made and the time medical help to die is given. In some situations, this period can be shortened.
A doctor asked to give medical help to die must check that all the requirements have been met. For example, the doctor must make sure that this is what the patient really wants and that no one pressured the patient.
The doctor must meet with the patient several times to check whether the patient is still in unbearable pain and still wants medical help to die.
The doctor must discuss the request with the medical team and, if the patient gives permission, with family members.
The doctor must also make sure the patient had a chance to discuss the decision with other people, if that’s what the patient wanted.
The doctor must ensure the patient has all information necessary to make a decision. This includes information on the likely evolution of the patient’s illness and options for treatment.
Finally, the doctor responsible for the patient must get an opinion from another doctor. This second doctor must examine the patient, read the patient’s record and confirm that all the legal requirements to get medical help to die have been respected.
The doctor must personally give the medication causing the patient’s death.
The doctor must stay with the patient throughout the process, until the patient dies. The patient’s loved ones can be there, along with other people the patient wants present.
Important! Doctors can’t be forced to give medical help to die. For example, they can refuse if it is against their personal beliefs. In these situations, the institution must find a new doctor who will agree to look at the patient’s request.
After the patient dies, the doctor must send some forms:
a form to the Commission sur les soins de fin de vie (commission on end-of-life care) within 10 days of the death. One of the duties of this body is to make sure that medical help to die follows all the rules.
a form to the Collège des médecins du Québec (association of doctors), or to the health-care institution where the person who received help to die was being treated.
This article explains in a general way the law that applies in Quebec. This article is not a legal opinion or legal advice. To find out the specific rules for your situation, consult a lawyer or notary.