Quebec tables bill to include advanced consent in assisted dying

Quebec lawmakers have presented legislation that, if passed, will expand medical aid in dying (MAID) and allow people to ask for it before they are incapacitated by an incurable disease.

The bill, which was tabled on Thursday by Sonia Bélanger, the minister responsible for seniors, allows people to make an advanced request for MAID which can be applied when they are incapacitated by a serious illness. 

If passed, it will allow those suffering from degenerative diseases, like Alzheimer's, to apply for MAID and give advanced consent.

In the spring of 2022, lawmakers had proposed changes to Quebec's MAID framework to allow for advanced consent, but they decided at the time to postpone changes to law, citing the need for further discussion. 

The bill tabled on Thursday states that "a mental disorder is not considered to be an illness." A consultation process will take place before the bill can be adopted.

The federal government legalized MAID in June 2016 but, at first, only those whose deaths were "reasonably foreseeable" qualified. This essentially limited MAID to those with terminal illnesses who were nearing the end of their lives.

In October 2020, the government expanded the law and did away with the requirement that the death be reasonably forseeable. The change allowed people with "serious and incurable illness, disease or disability [excluding mental illness, for now]" to qualify for MAID.

Patients must also be in an "advanced state of irreversible decline in capability" and be enduring intolerable suffering "that cannot be alleviated under conditions the person considers acceptable."

Provinces and territories have their own regulations and policies for implementing MAID within the framework established by the federal government. 

Currently, Quebec law requires a person to be able to provide informed consent at the time of receiving MAID, which excludes people with degenerative illnesses, including Alzheimer's disease.

In December 2021, a non-partisan committee recommended that adults in Quebec diagnosed with incurable and incapacitating diseases be able to make an advanced request for MAID prior to them becoming incapacitated by their illness.

Canadians whose only ailment is a mental illness like depression or a personality disorder will be eligible for MAID in March 2024. Such requests were initially scheduled to be legalized this year, but Justice Minister David Lametti said a delay was necessary to allow the medical community to prepare for the complexities of those cases.