The Context of MAiD in Quebec and Ethical Issues Arising

With

Host, Andrea Frolic

And special guests

Marie-Eve Bouthillier and Delphine Roigt

DISCUSSION QUESTIONS

In 2024, Quebec introduced legislation that allow for advance request for MAiD. The legislation is narrow in scope. You can only enact an advance request for MAiD if you are diagnosed with an illness that is known to lead to incapacity. Moreover, the request is only eligible for the condition it was intended for.

It is mentioned in the podcast that a quarter of Quebec’s population are currently without a family physician and that there are ongoing issues with access to care in general. How would you approach the issue of prioritization with regards to people’s access to care for treatment of illness and access to MAiD?

Ethical concerns associated with advance requests for MAiD include issues around decisions to activate a person’s advance request, issues around resource allocation, and issues around conscientious objection. What do you see as the most pressing ethical issues with advance request for MAiD? Why?

In your opinion, how should situations be managed when a patient’s advance request for MAiD is activated and the patient (who no longer has capacity for health care decision-making) manifests refusal?

RESOURCES

Canadian Medical Protection Association (CMPA). Updated Québec MAID legislation. October 30, 2024. https://www.cmpa-acpm.ca/en/news/2024/updated-quebec-maid-legislation [website accessed May 13, 2025]

Government of Quebec. Advance request for medical aid in dying. https://www.quebec.ca/en/health/health-system-and-services/end-of-life-care/medical-aid-in-dying/advance-request-medical-aid-dying [website accessed May 13, 2025]

Variath, C., Peter. E., Cranley, L., Godkin, D. Health care providers’ ethical perspectives on waiver of final consent for Medical Assistance in Dying (MAiD): a qualitative study. BMC Medical Ethics, 23,8 (2022). https://doi.org/10.1186/s12910-022-00745-4

Discussion Guide – PDF