How Quebec Became the Only Province Where You Can Pre-Approve Your Death

The federal government’s inaction on advance requests for medical assistance in dying (MAID) is a stark reminder of Canada’s patchwork approach to end-of-life care. While Quebec has taken the lead, allowing its residents to pre-approve their death under certain conditions, the rest of the country remains stuck in limbo.

The case of Clarke Eusanio, who suffered from Lewy body dementia and eventually drowned due to aspiration pneumonia after losing his ability to eat or drink, highlights the need for advance requests. His daughter, Tanya Secord, now advocates for the right to plan her own death, citing the trauma she witnessed as her father’s condition worsened.

Determining suffering, assessing the legitimacy of refusal, and understanding an individual’s pre-illness values all pose significant challenges in implementing advance requests. Dr. Tim Holland, a bioethics expert at Dalhousie University, notes that providers must consider an individual’s experience of suffering before they lost capacity. This requires a deep understanding of the person’s values and preferences.

Quebec’s legislation on advance requests has been successful, with over 2,000 submissions and approximately 30 completed procedures. The federal government’s inaction is “disheartening” for those like Secord who have reached out to politicians across Canada, according to Marie-Ève Bouthillier, professor of clinical ethics at Université de Montréal.

The Special Joint Committee on MAID recommended amending the Criminal Code to allow advance requests in 2023. However, the issue remains stalled due to the government’s inadequate response. A national survey found that a majority of Canadians support advance requests yet offers no clear next steps.

Secord argues for greater flexibility in filling out advance MAID requests, even before a diagnosis, highlighting the need for Canada to re-examine its approach to end-of-life care. As she notes, “We should all have the right to decide how our end is going to be.” This sentiment resonates with Canadians who value autonomy and control over their own lives.

The silence on advance requests perpetuates a system where individuals are forced to endure unnecessary suffering due to bureaucratic red tape. As Canada navigates the complexities of MAID, policymakers must prioritize the needs of those at the end of life. The Quebec model serves as a beacon of hope, but it’s time for the federal government to take action and provide Canadians with the right to plan their own deaths.

The lack of national cohesion on this issue raises questions about Canada’s commitment to patient-centered care. Experts like Dr. Holland advocate for a unified rollout across the country, leaving one to wonder: what is driving the federal government’s inaction? Is it a reluctance to confront the complexities surrounding advance requests or simply a lack of will?

For those like Secord who are waiting for answers, time is running out. As she poignantly notes, “It doesn’t make sense not to allow advance MAID requests when people can agree to a DNR.” Canada must stop talking and start acting on advance requests; the fate of individuals like Clarke Eusanio and their loved ones depends on it.

The consequences of inaction will be far-reaching, with families left to navigate the often-heartbreaking process of end-of-life care without clear guidance or support. By allowing Canadians to pre-approve their deaths under certain conditions, Quebec has taken a crucial step towards providing autonomy and control over one’s own life.

Ultimately, policymakers must prioritize the needs of those at the end of life. The silence on advance requests must be broken, and the federal government must take action to ensure Canadians have the right to plan their own deaths. Anything less would be a betrayal of the values we hold dear: autonomy, compassion, and the right to control one’s own destiny.