Increasing euthanasia in Quebec : Still no evaluation of palliative care
The Commission for end-of-life care in Quebec has published its 2024-2025 yearly activity report, revealing the continuous rise in euthanasia (referred to as Medical Assistance in Dying or MAiD). This Canadian province is experiencing a world record rate: Their number has increased by 61% in 5 years reaching a total of 6,268 cases, i.e. 7.9% of all deaths for the period 1st April 2024 till 31st March 2025.
Euthanasia on the increase
Among the people euthanised, it was found that:
- Euthanasia concerns slightly more men (53%) than women (47%).
- 15% of them had a life expectancy exceeding 6 months and 7% were not at their end of life.
- 97% of them claimed to be suffering from a combination of physical and psychic conditions.
- The suffering most commonly mentioned concerned a loss of the ability to perform significant activities (97%), loss of dignity (72%), fear of being a burden (50%), loneliness (24%). The fear of existential suffering which represented 35% of cases the previous year, increased to 66%.
- 54% of patients mentioned inadequate pain relief or fear related to that subject.
- 35% of suffering considered as intolerable and unrelievable was the result of treatment rejection.
These data on suffering are all the more worrying in the absence of data on the availability and quality of palliative care. These painful situations demand time and sympathy in order to respond to the underlying needs.
Inability to evaluate the availability and quality of palliative care
Over the same period, the Commission was unable to evaluate the evolution of the situation regarding palliative care due to a lack of reliable data, a context which has persisted for several years. The association Vivre dans la dignité (living with dignity) points out that Quebec cannot “Navigate blind concerning such an important issue.” Moreover 10% of euthanasia take place in palliative care centres, a figure which has increased since last year (6%).
The time-delay prior to a euthanasia is considered short
The Commission is concerned about the very short time-delays between “The expression of a MAiD request” and the administration of the care. “Care” which is in fact an act of euthanasia. Indeed 43% of candidates were euthanised in less than 10 days, of which 4% occurred on the very day or the day following signature of the request form. The commission is also concerned about the disparities between regions and is seeking to “better understand these facts.” Such disparity is also observable for so-called continuous sedations until death which totalled 2,163, i.e. 2.4% of all deaths.
Concerns regarding access to care
In its conclusions, the Commission states that it wishes to ensure that “MAiD does not become an option chosen due to the lack of access to other curative, palliative or end-of-life care.”
However, as in France, the context of access to care in Quebec is in crisis. The Legault government and the Health Minister, Christian Dubé, have opted for a controversial reform: Bill 106, adopted through a special law on 25th October 2025. It aims to guarantee “a family doctor for every Quebecer.” The stated objective: 16.5 million consultations available per year and a reduction in surgery waiting times. In order to achieve these objectives, the law establishes that 15% of doctors’ pay be linked to performance indicators, with quotas on the number of patients to be treated. A system known as “collective responsibility” will be introduced which forces each medical department to accept all admissible patients, in particular those who have no family doctor. The new doctor’s pay scheme will come into effect on 1st April 2026. The doctors’ associations, including FMSQ and FMOQ, are strongly opposed to the reform and also complain about the lack of material means allocated in order to meet such demand. According to some doctors, this reform is likely to change medical practice into a system based on quantity, to the detriment of the time devoted to patients. Dr Nacim Kerouch, a hospital doctor, explains that henceforth each of his consultations will be limited to 10 minutes instead of 30 which was the norm previously. Palliative care, which demands a human and attentive presence, is particularly under threat.
Certain specialist doctors, such as Dr Létourneau, have expressed their concerns about the new law. According to him, this reformed pay scheme will push doctors to give up the practice of palliative care. “Part of my practice is devoted to some forty fragile patients living confined at home. Regular support demands time, which the new law no longer allows (…) Dying with dignity, cannot be achieved with a doctor doing it at high speed.”
As pointed out by the association Vivre dans la dignité who support the promotion of palliative care: “A definite about-turn is now urgent, among others to protect and improve access to palliative care.” What is happening in Quebec should act as a warning for France on the incompatibility between palliative care and euthanasia at a time when the government is announcing a forthcoming examination of the bill on “assistance in dying” by the French Senate next January.
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