Report 2021-2022 | Medical assistance in dying administered to 3,663 people

In 2021-2022, 3,663 people received medical assistance in dying (MAD). This is an increase of 51% (ie 1,236 more people) compared to the previous year and the sign of a practice that is becoming more and more commonplace. More, even, than in countries where it has been going on for much longer.

“Initially introduced as exceptional care, medical assistance in dying is on the increase in Quebec”, which “seems to testify to the growing social acceptance of this care”, can we read in the 2021-2021 annual report. 2022 of the Commission on end-of-life care tabled Friday in the National Assembly.

Quebecers use it more than in other provinces of Canada and in other countries where it has been permitted for a long time, such as Belgium and the Netherlands, add the authors of the report.

The significant changes that have occurred in recent years in the way Quebecers approach death and the way they wish to die “raise important reflections”, can we also read. “Collective debates will have to be conducted to determine how far the Quebec population wishes to broaden access to MAID and reflect on the impact of this transformation of dying on our society. »

The law not always respected

Opponents of medical aid in dying point in particular to the risks of abuse or the dangers of drift. According to the report, the law was not respected in 15 cases.

In six files, the person, “although suffering and showing a decline in his abilities, was not suffering from a serious and incurable disease”. In three other cases, the person “was no longer capable of consenting to care at the time of receiving medical aid in dying” (in one of these cases, only oral consent had been obtained by the doctor, whereas writing is required).

In one case, the doctor did not first obtain the opinion of a second doctor and in four other files, the request form was countersigned by a carer who was not a health or service professional. social. Finally, one of the people who received medical assistance in dying had an expired health insurance card.

People with cancer

In total, 93% of people who received medical assistance in dying in 2021-2022 were aged 60 and over; 66% had cancer and 84% had a survival prognosis of one year or less.

Medical assistance in dying was administered an average of 26 days after the signed request, it can be read, and it was in almost two thirds of the requests made.

What happened to the third party who, despite his wishes, did not receive it? According to the report, 34% died before completion of the assessment or before receiving medical assistance in dying, 22% did not meet the criteria and 18% withdrew their request.

Unsurprisingly, the number of doctors called upon to perform this act also jumped: 1,418 doctors did so this year, which represents an increase of 26% compared to the previous year.

In about half of the cases, medical aid in dying was done in the hospital, while a third (33%) was done at home, 8% in a CHSLD and 5% in a palliative care home.

Access to palliative care

Based on the clinical summaries written by the doctors in their declarations, the Commission considers that “medical assistance in dying is not a choice that the person makes by default in Quebec. It is frequently mentioned that the person was receiving palliative care or that it had been offered, particularly for people with cancer.

“The data available to the Commission do not, however, allow us to verify the quality of the care offered, or whether it was sufficient and offered at the right time to meet the needs of the person. »

The Commission therefore wonders “about the supply of and access to palliative care for people suffering from serious and incurable diseases other than cancer”.