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Canada Quebec’s assisted-death requests to top 300 by 2017

Quebec expects more than 300 patients in the province to legally obtain medically assisted deaths this year, three times the number the government had forecast when it brought in its pioneering right-to-die legislation last year.

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Quebec expects more than 300 patients in the province to legally obtain medically assisted deaths this year, three times the number the government had forecast when it brought in its pioneering right-to-die legislation last year.

The first full accounting of Quebec's assisted-death legislation reveals not only that more Quebeckers than anticipated are requesting the measure, but that cultural and religious factors appear to be playing a role in demand, according to the provincial Health Minister.

Gaétan Barrette told reporters that, in the lead-up to the introduction of the law last December, he had anticipated "about a hundred" requests. According to newly released figures, 262 patients were medically assisted to die up to Aug. 31, and Mr. Barrette expects the number to top 300 by year-end.

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"A year ago, two years ago, I mentioned many times that I was expecting about a hundred, and it's almost three times that," he said on Thursday. "That, in itself, is surprising to me."

The report by the provincial commission on end-of-life care also reveals that, on a per capita basis, end-of-life assistance is far less common in Montreal than in Quebec City. Mr. Barrette suggested the differences reflect the secular bent of Quebec's francophone majority compared with its religious minorities, who are concentrated in Montreal.

"The population in Quebec City is a lot more homogenous," he said. "When we're talking about the question of death, Quebec's Catholic francophones, given their social evolution, their thoughts, are different from other religions."

Quebec, the first province to allow terminally ill patients to choose to die with medical aid, included numerous safeguards in its legislation. The report found that of the cases it examined, 21 failed to meet the legal restrictions.

The vast majority of those – 18 – involved questions about the independence of the second doctor who is required to sign off on the assisted death. Mr. Barrette said the problem often arises in smaller communities where doctors know one another.

Of the remaining three cases, two were instances in which assisted death was administered without proving the patient was at the end of life. In one case, it wasn't proven that the patient was facing a serious and incurable illness, as required under the law.

All 21 cases have been referred to Quebec's College of Physicians, which will review them, a spokeswoman said.

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Mr. Barrette said he considers that while physician-assisted dying remains a "delicate subject," the figures show there have been no "excesses" since the provincial law came into effect.

In all, 87 patients didn't get help to die after requesting it, either because they didn't meet the criteria, changed their minds, or died before the process could be carried out.

"I think the public can continue to have confidence in the process, which is being done properly," Mr. Barrette said.

The figures made public on Thursday stem from mandatory reports filed by doctors who administer assisted death. They help address the question of how many patients in Quebec and elsewhere would resort to medically assisted death if it was offered to them. Quebec made the option available six months before Ottawa enacted Bill C-14, which applies from coast to coast.

Proponents of Quebec's law say the figures show the legislation filled a fundamental need among terminally-ill patients.

"Doctors are responding to the demands of their patients with empathy, and they're answering a social and medical need," said Georges L'Espérance, a physician and head of the Association québécoise pour le droit de mourir dans la dignité, a dying-with-dignity group.

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He said that while the figures to date did exceed projections, they still represent less than half a per cent of all deaths in the province; in European countries such as Holland and Belgium that have right-to-die laws, the rates are closer to 2 per cent or 3 per cent of all deaths, he said.

"Everything indicates that doctors [in Quebec] are respecting the guidelines," Dr. L'Espérance said.

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