Who can request medical aid in dying?

2) Be capable of giving consent to care

You must be capable of giving consent to care.

Only a health professional can determine whether you’re capable of giving consent to care. When it comes to medical aid in dying, an assessment must be made by a physician or a specialized nurse practitioner (SNP).

During your assessment, the physician or SNP must answer the following questions:

• Does the patient understand the nature of the illness for which they’re requesting medical aid in dying?
• Does the patient understand the nature and purpose of medical aid in dying?
• Does the patient understand the advantages and risks of medical aid in dying?
• Does the patient understand the advantages and risks associated with care other than medical aid in dying?
• Does the patient understand the risks and consequences of not proceeding with medical aid in dying?
• Is the patient’s ability to understand compromised by the illness?

Based on the answers, the professional will be able to determine whether you’re capable of giving consent to care, including medical aid in dying.

Did you know?

The fact that you’re represented by a mandatary or a tutor does not mean that you’re automatically considered incapable of making decisions about your health care.

It’s up to your attending physician to determine whether you’re capable of making a decision about the care proposed to you.

Consent to Medical Care and the Right to Refuse Care (Éducaloi)

3) Be insured by the public health insurance plan

Before requesting medical aid in dying, you must check that you’re covered by the health insurance offered by the Régie de l'assurance maladie du Québec (RAMQ).

To be covered by the RAMQ’s health insurance, you must meet the criteria prescribed by law.

The main criterion to meet to be insured by the RAMQ is to reside in Quebec for at least 6 months per year.

If you’re not insured or if you’re not certain, contact the RAMQ.

Know the eligibility conditions for health insurance (Régie de l’assurance maladie du Québec (RAMQ)

Register or re-register for health insurance (Régie de l’assurance maladie du Québec (RAMQ)

4) Suffer from a serious and incurable illness

To request medical aid in dying, you have to be suffering from a serious and incurable illness. By definition, an incurable illness is an illness that cannot be cured.

Your illness must lead to an advanced, irreversible decline in your capability.

Generally, requests for medical aid in dying are made by patients suffering from cancer and neurodegenerative or neurological illnesses.

The law does not identify any specific illness. Assessment is done on a case-by-case basis.

The only exception in the law concerns persons suffering from mental disorders. If someone requests medical aid in dying solely because they’re suffering from a mental disorder such as an anxiety disorder, a mood disorder, or a personality disorder, they will not be eligible.

About mental disorders (Government of Quebec)

5) Experience enduring and unbearable suffering

You must be experiencing enduring and unbearable suffering as a result of your illness.

This suffering must not be able to be relieved in a way you consider tolerable.

The term “suffering that cannot be relieved” generally refers to the fact that the treatment proposed is ineffective for the patient or no treatment is available to relieve the pain.

Your suffering can be physical or psychological. Your medical condition may cause a combination of physical and psychological suffering.

Generally, the suffering described by patients requesting medical aid in dying include:

• loss of the ability to perform activities that give meaning to their lives or perform their activities of daily living,
• loss of dignity,
• inadequate control of pain.

6) Make the request in a free and informed manner

If you wish to receive aid in dying, you must make a request in a free and informed manner.

A decision is considered “free and informed” if it’s made without external pressure (for example, from the patient’s family) and after the patient has received the necessary information to make the decision.