Doctors and legislators affirm that Quebec established the foundational blueprint for medical assistance in dying (MAID) across Canada. The province currently holds the highest MAID rate in the world, with medically assisted deaths comprising a record 7.9 per cent of all mortalities in 2024-2025.
The legal framework traces back to a 2009 special commission that spent years gathering public testimony before passing the Act Respecting End-of-Life Care in 2015. That same year, the Supreme Court of Canada’s Carter decision struck down parts of the Criminal Code, directly echoing Quebec’s regulatory approaches.
“It’s clear that Quebec has truly been the pioneer,” said Véronique Hivon, the former provincial legislator who championed the file. Hivon noted that the distinct, slow-paced social dialogue in Quebec normalized the concept in a way the federal clock, driven by the courts, could not.
Dr. Michèle Marchand, a physician and ethicist, highlighted that the formal debate emerged in the early 2000s after high-profile cases pressured the Quebec College of Physicians. The college concluded that if assistance in dying was occurring informally, only medical professionals should provide the oversight.
A prevailing view among experts is that MAID exists on a continuum with palliative care, not in opposition to it. Dr. Laurent Boisvert, a right-to-die spokesman, asserts that patients with excellent palliative support still reach a threshold where their lived experience no longer aligns with their definition of a dignified life.