Quebec’s Assisted Dying Model Shapes Canada’s MAID System as Cases Reach Record High

A decade after Canada legalized Medical Assistance in Dying (MAID), Quebec remains at the forefront of the country’s end-of-life care movement, influencing national legislation and recording the highest rate of medically assisted deaths in the world.

According to the latest figures, medically assisted deaths accounted for 7.9 per cent of all deaths in Quebec during the 2024-25 period, representing 6,268 cases. Nationwide, MAID represented 5.1 per cent of all deaths, with 16,499 Canadians choosing the option.

As the numbers continue to rise, debate remains over what is driving the trend. Supporters argue that Quebec’s high participation reflects broad public acceptance and a mature healthcare framework, while critics question whether gaps in care may be pushing some patients toward the decision.

Quebec’s journey toward legalizing assisted dying began long before federal legislation. In 2009, the province launched an extensive public consultation process on end-of-life care. Following years of hearings and discussions, Quebec enacted its Act Respecting End-of-Life Care in 2015, creating a legal framework for assisted dying.

That same year, the landmark Carter v. Canada ruling by the Supreme Court of Canada struck down key Criminal Code provisions that prohibited physician-assisted death. The federal government later introduced Bill C-14, which legalized MAID nationwide in 2016.

Former Quebec legislator Véronique Hivon, who played a leading role in advancing the province’s legislation, believes Quebec’s careful and lengthy consultation process helped build public trust and informed many aspects of the federal framework.

Unlike Ottawa, which acted following a court ruling, Quebec spent years engaging citizens, healthcare professionals and experts in discussions about dignity, suffering and end-of-life choices, Hivon said. The province’s approach helped normalize the conversation and reduce public fears surrounding assisted dying.

Medical professionals also point to Quebec’s pioneering role. Dr. Laurent Boisvert of the Quebec Association for the Right to Die with Dignity said public support for MAID in the province is exceptionally high, reflecting years of dialogue and education.

The roots of the debate stretch back even further. Retired physician and ethicist Dr. Michèle Marchand recalled several widely publicized cases in the early 2000s involving family members helping loved ones end their lives. Those incidents prompted discussions within Quebec’s medical community about whether physicians should be involved in such decisions under strict safeguards.

According to Marchand, some doctors were already facing situations where terminally ill patients experienced unbearable suffering, creating ethical dilemmas before a legal framework existed. Rather than allowing such practices to remain informal and unregulated, policymakers sought to establish clear rules and oversight.

Today, Quebec’s Commission on End-of-Life Care reviews all MAID cases and publishes annual reports to ensure transparency and accountability.

Supporters reject claims that patients are choosing assisted dying because of inadequate healthcare services. Provincial data show that most people who receive MAID have also received palliative care, suggesting the decision is often made despite access to medical support rather than because of its absence.

Boisvert argues that palliative care and MAID should not be viewed as competing options. Instead, they form part of a broader continuum of end-of-life care. While many patients benefit from high-quality palliative treatment, some eventually decide that their physical condition and future suffering no longer align with their personal definition of a dignified life.

As Canada marks ten years since MAID became legal, Quebec’s experience continues to shape national discussions about autonomy, dignity and the choices available to people facing the final stages of life. The province’s model remains both a source of pride for supporters and a subject of ongoing debate as medically assisted deaths reach record levels across the country.