10 years of medical assistance in dying: peaceful end of life for thousands

Ten years ago, Quebec became the first province in Canada to make medical assistance in dying accessible, thus becoming a pioneer in this area in North America. Looking back, this has made the end of life more peaceful for thousands of Quebecers. 

“All my colleagues have the same experience. 99.9 per cent of people are (…) at peace, that’s a good term, but above all serene,” commented Dr. Georges L’Espérance, a practitioner of medical assistance in dying and also president of the Quebec Association for the Right to Die with Dignity (AQDMD), in an interview. 

“It always happens in an extremely peaceful way for the patients and for the family,” he continues. “Obviously, for the family, it’s always sad at the time of the injection. There are always tears, but before and after, I call it a certain celebration of life because loved ones understand that their relative, their loved one, their friend, has finished suffering.”

Key moments in the history of MAID in Quebec and Canada

The Act respecting end-of-life care in Quebec was adopted in 2014 and came into force on December 10, 2015. Meanwhile, MAID was not yet being authorized in Canada. Patients turned to the courts. The spotlight shone particularly brightly during the Carter v. Canada case, and then, in February 2015, the Supreme Court recognized the right to medical assistance in dying. 

The federal government amended the Criminal Code, and MAID became legal across Canada in 2016. Over the years, further progress has been made. For approximately five years, patients no longer need to be in a state of imminent death to be eligible for MAID. More recently, in 2024, Quebec authorized advance requests, which allows, among others, people with Alzheimer’s disease to make a request as long as their condition allows them to make it freely and with full knowledge of their facts. 

However, the federal government has not yet incorporated advance requests into the Criminal Code.

In fact, the AQDMD has just published a guide on its website to help patients complete their advance request form for medical assistance in dying. “It’s a kind of easier-to-read summary of the objectives, the main rules, and also the legal aspects. And there’s a section of the guide designed to help families and the patient making the advance request to understand how to navigate the process, how to complete the request, and how to be prepared when they meet with the nurse practitioner or physician to finalize the request. We’re guiding people, so to speak, to help them progress in their decision-making process,” summarizes Dr. L’Espérance. 

Beware of setbacks in terms of access to AMM

Since the law came into effect and to date, 28,105 Quebecers have used MAID, according to data from the most recent report of the Commission on End-of-Life Care (from December 10, 2015 to March 31, 2025). 

According to the AQDMD, there is no misconduct in end-of-life care practices. It emphasizes that 99.7 per cent of the forms assessed between April 2024 and March 2025 were deemed compliant by the Commission. Furthermore, in 2024-2025, the prognosis for individuals requesting MAID was estimated at three months or less in 58 per cent of cases, and at one year or less in 82 per cent of cases. 

“No one decides this on Wednesday evening for Thursday morning; it’s always after careful consideration,” Dr. L’Espérance points out. In his experience, for the vast majority of patients, it takes about a year of reflection before reaching a decision.

Dr. L’Espérance wants to protect access to medical assistance in dying (MAID) and remains vigilant regarding potential threats. He draws a parallel with the right to abortion, which was eroded in the United States in 2022 when the U.S. Supreme Court overturned Roe v. Wade. 

“If we back down on medical assistance in dying, what does that mean? It means that there are people who will still take up arms to commit suicide. There are people who will shoot themselves from their balconies, etc. So no, we must not go back,” the doctor says. 

He is aware that medical assistance in dying continues to face opposition aimed at limiting access or prohibiting it for certain categories of citizens. He argues for continuing to expand access to MAID while regulating it. 

–The Canadian Press’s health coverage is supported by a partnership with the Canadian Medical Association. The Canadian Press is solely responsible for this journalistic content.

–This report by La Presse Canadienne was translated by CityNews