In autumn 2023, the Commission for End-of-Life Care (CSFV) presented its annual report, covering the period from April 1, 2022 to March 31, 2023 Law on end-of-life care In December 2015, the CSFV played an important role in assessing the applicability of the law, including monitoring medical assisted dying (MAID).
The analysis of this report shows that MAID accounts for 6.8% (5,211 people) of deaths in Quebec, a significant increase of 42% (+1,548 deaths) compared to the previous year, which itself was already an increase of 51% compared to The previous year represented the period before (+1236 deaths). This upward trend has been constant since 2016. Comparing the figures for Quebec with other countries in the world that allow MAiD, the province of La Belle is at the extreme in the world for MAiD.
Across the rest of Canada, MAID accounted for 4.1% (13,241 people) of all deaths in 2022, compared to just 3.3% (10,064 people) in 2021.
gap
Although the Netherlands, Belgium and Luxembourg were the first to legalize euthanasia (AMM in Quebec) in 2001, 2002 and 2009, it is surprising to note the gap between these predecessors and Quebec.
In Belgium, for example, the euthanasia law covers both adults and emancipated minors. As a result, the selection criteria for euthanasia are broader in Belgium than in Quebec, making these differences even more pronounced. In comparison, euthanasia accounted for 2.5% (2,960) of deceased people in Belgium in 2022, while it was 2.4% (2,700) in 2021 and 1.9% (2,445) in 2020. Reduced to millions per capita, this means that in 2022 almost 2.5 times more people used MAID in Quebec than in Belgium (256 compared to 593 people/million population in Quebec).
These observations raise many questions. Why has the number of MA applications continued to rise since 2016? Are there sociological, cultural, legislative or health-care system-related factors in Quebec that could contribute to the increase in MAID use? How does the perception of physical and psychological suffering influence the decision to use MAID in Quebec? To what extent does the trend observed in Quebec really compare with the experiences of other countries such as Belgium and the Netherlands? What about the evolution of MAID policies and regulations?
Answer
These questions remain unanswered unless significant barriers are overcome, such as the difficulty researchers have accessing relevant data for their research. Let us think in particular of the Commission's data on end-of-life care. Concerted action | A better understanding of the use of medical assistance in dying in the Quebec context, launched jointly by the Fonds de recherche du Québec and the Ministry of Health and Social Services in November 2023, should shed light.
The Quebec Research Network in Palliative and End-of-Life Care (RQSPAL) welcomes the approach of studying MAID in Quebec, but there are many aspects of palliative and end-of-life care that are rarely studied due to lack of funding. dedicated. This network brings together hundreds of people working in research in Quebec and aims to be a key player in answering this societal question.
Pierre Gagnon, Physician and Co-Director of the Quebec Research Network in Palliative and End-of-Life Care and Full Professor and Researcher, Department of Psychiatry and Neurosciences, Université Laval
Diane Tapp, Nurse and co-director of the Quebec Palliative and End-of-Life Care Research Network and full professor and researcher at the Faculty of Nursing at Université Laval
Co-signer:
Emilie Allard, Assistant Professor and Researcher, Faculty of Nursing, University of Montreal
Anne Bourbonnais, Full Professor and Researcher, Faculty of Nursing, University of Montreal
Valérie Bourgeois-Guérin, professor and researcher, University of Quebec in Montreal
Claude Julie Bourque, Associate Professor and Researcher, Department of Family Medicine and Emergency Medicine, University of Montreal
Marie-Eve Bouthillier, Professor and Researcher, University of Montreal
Elaine Champagne, Associate Professor and Researcher, Department of Religion, Spirituality and Health, University of Laval
Josée Chénard, professor and researcher, University of Quebec en Outaouais
Marc Dumas, Full Professor and Researcher, Center for Contemporary Religious Studies, University of Sherbrooke
Jacques Cherblanc, Full Professor and Researcher, Department of Human and Social Sciences, University of Quebec at Chicoutimi
Michel Dorval, Full Professor and Researcher, Faculty of Pharmacy, University of Laval
Gabrielle Fortin, Professor and Researcher, Faculty of Social Work and Criminology, University of Laval
Bruno Gagnon, MD researcher, Laval University
Diane Guay, Associate Professor and Researcher, University of Sherbrooke
Manon Guay, occupational therapist and professor and researcher, Center for Aging Research
Johanne Hébert, professor and researcher, University of Quebec in Rimouski
Melissa Henry, Associate Professor and Researcher, McGill University
Edeltraut Kröger, Associate Professor and Researcher, Faculty of Pharmacy, University of Laval
Sylvie Lapierre, full professor and researcher, University of Quebec in Trois-Rivières
Jérôme Leclerc-Loiselle, Assistant Professor, School of Nursing, University of Sherbrooke
Carmen Lemelin, psychologist, researcher and teacher, CCEG-Cégep de Drummondville
Isabelle Marcoux, Associate Professor and Researcher, Interdisciplinary Faculty of Health Sciences, University of Ottawa
Alexander Moreno, neuropsychologist and researcher, Notre Dame Hospital, CIUSSS du Centre-Sud-de-l'Île-de-Montréal
Marianne O.-d'Avignon, professor and researcher, University of Laval
Félix Pageau, regular researcher, VITAM – Research Center for Sustainable Health
Justin J Sanders, MD-Investigator, Kappy and Eric M. Flanders Chair in Palliative Medicine, McGill University
Alfonso Santarpia, Associate Professor and Researcher, University of Sherbrooke
Josée Savard, Professor and Researcher, Faculty of Psychology, University of Laval
Mélanie Vachon, professor and researcher, University of Quebec in Montreal
Chantale Simard, professor and researcher, University of Quebec in Chicoutimi
Matthew Weiss, MD researcher, Center Mère-Enfant Soleil, CHU de Québec – Université Laval
Deborah Ummel, Associate Professor and Researcher, Department of Psychoeducation, University of Sherbrooke