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Requirements for receiving medical assistance in dying

The Act lays down very restrictive conditions that patients must meet to receive medical aid in dying, regardless of where they are receiving care. Several procedures must also be followed by doctors and health and social services institutions both before and while they provide this care.

The administration of medical aid in dying is possible only if all of the following requirements are met, for both the person and the doctor.

For a person wishing to obtain medical aid in dying

Only a person who meets all of the following criteria may obtain medical aid in dying:

  • Be insured according to the Health Insurance Act
  • Be at least 18 years of age
  • Be capable of giving consent to care, which means the person must be able to understand the situation and the information given by health professionals as well as make decisions
  • Be in one of the following situations:
    • suffering from a serious and incurable disease and having a medical situation characterized by an advanced and irreversible decline in capacity;
    • have a serious physical impairment resulting in significant and persistent disability;
  • Experience constant and unbearable physical or psychological suffering that cannot be relieved in a manner the person deems tolerable.

For doctors

According to the Act respecting end-of-life care, doctors must comply with various obligations before administering medical aid in dying.

  1. They must first ensure that the patient requesting medical aid in dying meets all of the conditions prescribed.
    • Make sure that the patient is making the request freely and not as a result of external pressure
    • By making sure that the client fully understands the importance of his or her request (informed request) and that he or she has been informed of:
      • the prognosis for the disease or the foreseeable clinical course of the physical impairment, taking into account the patient's condition,
      • possible therapeutic options and their consequences, or appropriate measures to compensate for incapacity;
    • Verify the persistence of suffering and that the repeatedly expressed wish to obtain medical aid in dying remains unchanged by talking with the patient at different times. These discussions must be held at reasonably spaced intervals given the progress of the patient’s condition
    • Discuss the patient’s request with any members of the care team who are in regular contact with the patient
    • By discussing the person's request with their loved ones or any other person they identify, if they so wish.
  2. They must make sure that the patient has had an opportunity to discuss the request with the persons that they wished to inform.
  3. If the person has a physical disability, he must make sure that the person has assessed the possibility of obtaining support, council or accompaniment services. These services may be obtained from the Office des personnes handicapées du Québec, a community organization or a peer helper, such as assistance in initiating a service plan.
  4. They must obtain the opinion of a second independent competent professional, confirming that the conditions for obtaining medical assistance in dying have been met. The second competent professional consulted must be independent of both the person requesting medical assistance in dying and the professional requesting the opinion

Ability to consent to care

As of June 11, 2021, the Act respecting end-of-life care allows people at the end of life who meet all criteria for receiving medical aid in dying to receive this aid even if they have become incapable of consenting to the care at the time aid is administered. However, these people must have consented to receive this care in writing in the presence of a healthcare professional within 90 days before the date of administration of medical aid in dying.

Conscientious objection

Health professionals must not ignore a request for medical aid in dying. However, a doctor may refuse to administer medical aid in dying because of his or her personal values. The doctor must notify, as soon as possible, the executive director of the institution where the patient resides, who will take the necessary steps to find quickly another doctor who is willing to administer medical aid in dying. The doctor must also ensure continuity of care for the patient, in accordance with the provisions of his or her code of ethics and with the patient’s wishes.

Other health professionals may also refuse to take part in the administering of medical aid in dying for the same reasons. They, too, must notify the responsible authorities, who will make sure that the required care and support are provided to the patient and his or her loved ones.

If you are in a situation that is causing you suffering, don't hesitate to consult a health or social services professional for support, or call 811 if you don't have access to such a professional.

Last update: March 6, 2024


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