Trudeau government encourages doctors to issue 'advance directives' for patients seeking MAID

Quebec is telling its provincial doctors that they can issue “advance directives” to authorize Medical Assistance in Dying (MAID) on unresponsive or mentally ill patients. The Quebec legislature’s Bill 11 allows doctors to administer euthanasia providing the patient had previously offered “advance” permission to do so.

Critics say it is another example of Canada’s euthanasia program expanding out of control and into the realm of murder. Because the assisted suicide of a mentally ill patient would qualify as murder under the Criminal Code of Canada, Quebec has told its prosecutors to just ignore the law, the National Post reported.

The Trudeau government has approved that decision, with the Ministry of Health saying there would be no court challenge even as it discouraged the expansion of the practice outside of Quebec. Yet it also indicated the fundamental fault of the bill.

“As the Criminal Code applies uniformly across Canada and does not permit the provision of MAID based on an advance request, providing MAID pursuant to an advance request remains an offense under the Criminal Code,” it read.

The parameters of the MAID program allows doctors to administer the procedure for any adult with a “grievous and irremediable medical condition” — but the patient must give “informed consent” before the doctor can continue. The Quebec law simply ignores this and will allow doctors to proceed even if the patient is in a coma, has dementia or “incapable of giving consent to care.”

The Quebec law proposes to ignore this, and to allow MAID for anyone with an “advance directive.” Patients can be in a coma, suffering from dementia, or otherwise be “incapable of giving consent to care,” as long as they have previously signed an approval form. But the Trudeau government’s sanction of Quebec’s decision has no basis in law because a province cannot overwrite the federal Criminal Code, meaning that a doctor or nurse administering MAID under these new circumstances could conceivably be charged with murder.

The Quebec ministry of health and the provincial justice ministry have told healthcare workers to just ignore the law and not to worry about the consequences, the Post noted. Prosecutors were simply informed that MAID enjoys a “broad consensus of Quebec society,” and that doctors should “respect the autonomous right of people who wish to obtain medical assistance in dying.”

While the Trudeau government initially balked at Bill 11, it has since decided to do nothing to impede the legislation. “We are launching a national conversation and will not be initiating a challenge of Quebec’s Bill 11,” read a Monday joint statement by Attorney General Arif Virani and Health Minister Mark Holland.

Holland has already announced that the Liberal government plans to expand MAID for the mentally ill and it will proceed in 2027. "On February 29, 2024, legislation to extend the temporary exclusion of eligibility to receive MAID in circumstances where a person's sole underlying medical condition is a mental illness received royal assent and immediately came into effect. The eligibility date for persons suffering solely from a mental illness is now March 17, 2027," the Canadian government states.

An investigation into private online posts revealed that Canadian doctors are increasingly feeling uneasy or even guilty about their participation in the MAID program. Patients are sometimes offered euthanasia in lieu of medical treatment. Canadian cancer patient Allison Ducluzeau revealed in November 2023 how doctors had also told her that she was eligible for MAID before she was offered any significant medical assistance to treat her abdominal cancer. Facing a long waiting list for the operation in BC, she opted to go to Ohio for a live-saving operation. Another woman expressed concern that she was told twice by doctors about her euthanasia options while she waited for cancer surgery.