Medical aid in dying is an exceptional intervention available to end-of-life patients who meet certain specific criteria and who ask for it. It consists of a doctor or a specialized nurse practitioner (competent professional) administering medications in order to relieve the patients’ suffering by bringing about their death. The use of this intervention is governed by strict guidelines set out in the Act.

How can a person access medical aid in dying?

To be eligible for medical aid in dying, you must meet certain criteria, namely:

• Be an adult
• Be capable of consenting to care
• Be insured under the Quebec Health Insurance Plan (RAMQ)
• Have a serious and incurable illness or a serious physical disability causing significant and persistent incapacity
• Be in an advanced and irreversible decline of your abilities
• Experience constant, unbearable physical or psychological suffering that cannot be alleviated in conditions considered tolerable.

Where can I obtain these services?

End-of-life care, namely palliative care, continuous palliative sedation, and medical aid in dying, can be offered:

• in facilities of the health and social services network (hospitals and long-term care centers – CHSLDs)
• at home and substitute living environments (RPA/RI)
• in palliative care centers
• any other location, subject to approval by the DSP or the IT department of the institution.

However, each institution or hospice has a policy regarding end-of-life care specifying the nature and extent of available care offered on its premises.

It is therefore important for the suffering person with significant functional decline, as well as for their relatives, to consult the competent professional, and any other well-informed professional can properly guide the patient and their relatives in this regard.

Procedure

To initiate the process for medical aid in dying, the person must:

• Submit a request for information on medical aid in dying from a healthcare professional
• Complete a written request using the form "Request for Medical Aid in Dying," available from a healthcare professional
• Sign this form in the presence of a healthcare professional and an independent witness.
• Repeat the verbal request in every discussion/ consultation with the doctor or the specialized nurse practitioner

The suffering person with significant functional decline will be accompanied throughout the process of assessing their request by:

• The attending physician, the doctor or the specialized nurse practitioner who will administer the medical aid in dying (referred to as the designated competent professional)
• A multidisciplinary team of health and social services professionals (e.g., nurses, social worker, etc.)

What to expect?

Following the procedure initiated by the user, an eligibility assessment process will be launched, and the person, as well as their relatives, if applicable, will be supported by the designated competent professional throughout the subsequent procedures.

Signing the Request for Medical Aid in Dying form does not automatically mean that the request is accepted. After the form has been signed, an eligibility verification process is launched, and if the end-of-life patient meets the medical aid in dying criteria, his competent professional will then be required to get the opinion of a second competent professional.

It should be noted that any person making a requests medical aid in dying is free to change his mind at any time. The person can thus withdraw his request for medical aid in dying or request its postponement.

Throughout the process, the designated competent professional as well as other health and social services professionals remain available to answer any questions that the suffering person with significant functional decline and their loved ones may have.

Procedure

• When medical ais in dying is administered, the person will be transferred to a private room so that the procedure can take place in a peaceful and appropriate environment.
• Before medical aid in dying is administered, the competent professional, will carry out a final validation of compliance with the Act, as well as the patient’s desire to pursue his request.
• The competent professional, will remain with the patient until death.
• Support will be provided to the patient’s loved ones following his death.

Also see Visit the page on medical aid in dying on the Ministry's Health and Wellness Portal Medical Assistance in Dying: About medical aid in dying | Gouvernement du Québec