Seek medical assistance in dying: Quebec ranks first in the world

The number of people seeking medical assistance in dying has exploded since the start of the pandemic: it rose from 1,774 in 2019-2020 to 3,663 in 2021-2022.

Commission on End-of-Life Care President, Dr. Michel Bureau explained that this data puts Quebec first in the world in this regard.

” In Quebec, 5.1% of deaths [résultent de] Medical assistance in dying. In the Netherlands, it was 4.8% of deaths and in Belgium, it was 2.3%. »

Dr Bureau said he was surprised by the rapid increase in the number of requestsMA In Quebec. According to him, this increase can be explained by the fact that medical aid in dying is provided as care for patients and not euthanasia.

Does this increase reflect slippages in the application of established standards?

No chance. Quebecers who receive medical assistance in dying are at the end of their lives. They have sufferings that cannot be appeased and do not meet all standards, Dr. Bureau answers. The End-of-Life Care Commission reviews all requests for medical assistance in dying to ensure they comply with the law.

And more and more doctors are performing it. The RAMQ The number of physicians who billed for at least one action related to a request for medical assistance in dying increased by 28% in 2021-2022. Most of them did administrationMA More than once during this period.

Significant regional disparities

The proportion of deaths following a request for medical assistance in dying varies greatly from one region to another in Quebec. In Lanaudière and Bas-Saint-Laurent, nearly 9% of people who died in 2021-2022MA. In Montreal, it’s less than 4%.

The approval rate of requests for medical assistance in dying also varies greatly from one region to another. For example, in Chaudière-Appalaches, 98% of patients appliedMA Access it. In Quebec, the proportion drops to 75% and in Montreal it drops to 54%.

A difference that has nothing to do with the mother tongue of patients or doctors, since the data is essentially the same from east to west in the metropolis.

Is the fact that there are more specialists on the island of Montreal causing us to continue treatment longer? I don’t knowDr. Mitchell Bureau said.

Before the pandemic, the College of Physicians feared that a lack of palliative care would lead patients to choose medical aid to die.

But the End-of-Life Care Commission believes that this fear is unfounded. According to its president, the proportion of deaths resulting from medical assistance in dying will probably continue to rise.

We must be prepared for an increase in medical aid in dying to continueDr. Bureau said. Because the year [2022-2023] A lot has already been committed and the trend continues.

A surprising development for many doctors. In 2016, former health minister Gayton Barrett thought not That we are headed for unbridled growth.