Quebec Allows People to Break Federal Laws Around Dementia and Medical Euthanasia

By Simon Spichak | January 14th, 2025

Prompted by Quebec, Canada’s government is revisiting its laws about medical assistance in dying for people with dementia.

In 2022, more Canadians died by medical euthanasia than from pneumonia, Alzheimer’s, or liver disease.

The Quebec government announced in October that people with dementia or Alzheimer’s disease would be able to make an advanced request to access medical euthanasia, consenting in advance of their cognitive function declines. Practitioners who provide the procedure known as medical assistance in dying will be defying federal criminal laws. 

Canadian federal law allows people with a terminal illness or a non-terminal condition that causes substantial suffering to access MAiD. However, to date, those with Alzheimer’s and dementia are not able to set a date for MAiD in the future, because they will not be able to provide consent on the day of the procedure. Quebec has asked the Canadian government since February to modify the Criminal Code. 

But instead of threatening prosecution, Canada’s federal government announced it would not penalize practitioners in Quebec for breaking these laws. Rather, Canada’s health minister announced the government would explore expanding its controversial medical euthanasia program, setting forth a public consultation period to amend existing laws.  

“From the perspective of the duty of the federal government to enforce a federal law, it doesn’t make sense,” Trudo Lemmens, a professor of health law and bioethics at the University of Toronto told Being Patient. “We know already that people have asked for MAiD to avoid going into long-term care homes and potential isolation that comes with it.”

The sitting federal government is currently in a minority position and the Prime Minister stepped down just after the New Year. Since the legislation is popular in Quebec, Lemmens thinks that the federal government might not want to interfere as it could affect their chances in a future election. The consultation period was originally slated to end in February. However, at the time of this writing, it is ongoing while parliament is on hold following the Prime Minister stepping down.

The Alzheimer’s Society of Canada has indicated that it supports the right of people with dementia to make an advanced request for MAiD.

Canada’s troubling history of medical euthanasia

The lack of safeguards and protections surrounding MAiD in Canada has been criticized by researchers, disability advocates, the Canadian Human Rights Commission, and United Nations Special Rapporteur on the rights of persons with disabilities

An investigation by The New Atlantis revealed that in Canada’s most populous province, Ontario, between 2018 and 2024, there have been more than 400 cases of euthanasia practitioners failing to comply with safeguards. However, none of these cases were referred for prosecution.  

Lemmens brings up multiple cases of individuals who applied for MAiD because they couldn’t access high-quality healthcare or long-term care. For example, in 2019, Sean Tagert, a 41-year-old man with a neurodegenerative condition called amyotrophic lateral sclerosis named Sean Tagert opted for MAiD because he was unable to find affordable, reliable care. 

Others with chronic illnesses plan to die of MAiD when they run out of money to pay for housing and care. 

Gabrielle Peters, a disabled writer and policy analyst, told Being Patient that we know there’s a high cost associated with illness and disability, like dementia, which puts extra stress on individuals, families, and caregivers. 

“The reality is that with a lot of conditions, ALS, it costs the family around a quarter million dollars from the period of diagnosis, over and above health care costs [throughout the lifetime],” Peters said. “With dementia, there’s a considerable cost as well.” 

Peters co-founded Disability Filibuster, a grassroots organization of disabled advocates and scholars in response to the expansion of MAiD in Canada.

People without resources must secure a spot at a public nursing home, which can take more than 200 days, depending on where they live.

Those who can’t afford care, she said, may face coercion from family members as a result of elder abuse. “Just as the state has offloaded the costs, support, and care onto disabled people and families, they are offloading culpability for the decision of MAiD onto individuals and families,” she said.

Those who have family and a support system still face substantial challenges. “The person themselves feels as if they are a burden, and they worry about the cost that they are causing their families,” Peters said. “Then there’s the actual stress and strain on the family.”

Though the federal government does not report the income of people who opt for MAiD, a report by the Office of the Chief Coroner in Ontario showed that marginalized individuals, which includes those living in poverty, are more likely to seek it out for non-terminal conditions.

What happens now

The federal government will conduct a national conversation that will end in March.

But is two months enough time? “Obviously not,” Peters said.

Research published last year shows that though three in four Canadians support MAiD law, most are unaware of how it works. Lemmens said this study is “flagging major misunderstandings” with the law.

Less than one in four understood that people can access MAiD even if they refuse medical treatment, and less than one in five knew that those without terminal illness could qualify.

The federal government will write a report summarizing its consultation in Spring 2025 before making a final decision.

On January 6th, 2025, Canadian Prime Minister Justin Trudeau stepped down as leader, proroguing parliament until March 24th. A spokesperson for Health Canada told Being Patient over email that this will not affect the timeline of the consultation. The End of Life Care Unit of Health Canada will write a report summarizing its survey, roundtable results, and national consultation overall in Spring 2025, before making a final decision.

UPDATE: 14 January, 9:46 P.M. ET – Updated to clarify that people with Alzheimer’s and dementia are eligible for MAiD but cannot currently request the procedure for a future date. Added comment from Health Canada.

UPDATE: 16 January, 10:40 A.M. ET – Corrected a statement about the study that showed Canadians are unaware of MAiD requirements. The one in four statistic referred to Canadians being unaware that people could refuse medical treatment, not that they could not access the treatment. 

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2 thoughts on “Quebec Allows People to Break Federal Laws Around Dementia and Medical Euthanasia

  1. I wanna die with dignity, and should have a right to choose that. People that have a terminal disease and Suffering should have a choice. Also dementia in its late stages, is awful, I’ve seen many suffer so bad. I agree with MAID for above reasons. I demand to have a choice.

  2. I am 100% on board with this. I am now taking care of my mother whom has dementia it’s not easy there’s only financial aide if you have unemployment then nothing. I have sworn up and down that I will not makey family go through what I am living right now. If I can’t get assisted suicide I will do it on my own.

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