Select Committee ON THE EVOLUTION OF THE ACT RESPECTING END-OF-LIFE CARE Consultation Paper Select Committee ON THE EVOLUTION OF THE ACT RESPECTING END-OF-LIFE CARE

THE COLLABORATORS OF THE SELECT COMMITTEE ON THE EVOLUTION OF THE ACT RESPECTING END-OF-LIFE CARE

SECRETARIAT AND COORDINATION OF WORK Ann-Philippe Cormier Constance Goodrich-Maclean Astrid Martin

RESEARCH SERVICE Félix Bélanger Mathieu Houle-Courcelles Julie Paradis Pierre Skilling

REFERENCE SERVICE Simon Mayer Stéphane Wimart

COPYEDITING Danielle Simard Martine Dignard

GRAPHIC DESIGN AND LAYOUT Isabelle Bédard Louise Williams

COMMUNICATIONS Julie Champagne

For more information on the proceedings of the Select Committee on the Evolution of the Act respecting end-of-life care, please contact the Committee Clerk, Ann-Philippe Cormier.

Édifice Pamphile-Le May, 1035, rue des Parlementaires, 3e étage Québec (Québec) G1A 1A3 Telephone 418 643-2722 Toll-free: 1 866 337-8837 Email: [email protected]

This document is available online in the Parliamentary Proceedings section of the National Assembly website: assnat.qc.ca.

Legal deposit – June 2021 Bibliothèque et Archives nationales du Québec ISBN (Print): 978-2-550-89647-0 ISBN (PDF): 978-2-550-89648-7

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MEMBERS OF THE SELECT COMMITTEE ON THE EVOLUTION OF THE ACT RESPECTING END-OF-LIFE CARE

Ms. (Roberval), Chair Ms. (Maurice-Richard), Vice-Chair

Mr. (D’Arcy-McGee) Ms. (Abitibi-Ouest) Mr. Éric Girard (Lac-Saint-Jean) Ms. Geneviève Hébert (Saint-François) Ms. Véronique Hivon (Joliette) Mr. François Jacques (Mégantic) Ms. (Westmount–Saint-Louis) Mr. Gabriel Nadeau-Dubois (Gouin) Ms. (Soulanges)

OTHER MEMBER OF NATIONAL ASSEMBLY INVOLVED IN THE WORK

Mr. (Chomedey)

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TABLE OF CONTENTS

A word from the steering committee 5

Introduction 6 What the words mean 6 Medical aid in dying 6 Capable and incapable 7 Advance medical directives 7 Palliative care 7 Mental disorder 8

Portrait of the evolution of end-of-life care in Québec 8 The legislative, legal and regulatory framework (2009-2021) 8 The Act respecting end-of-life care 8 The Commission on end-of-life care 10

The Truchon and Gladu case and its repercussions (2019) 10

The consultations carried out in Québec on the potential expansion of the Act 1 1

A statistical portrait (2015-2021) 13 The situation in Belgium 14 The situation in the Netherlands 15

Presentation of the issues at the heart of the Committee’s mandate 16 The potential expansion of medical aid in dying for persons who are incapacitated 16 The potential expansion of medical aid in dying for persons whose only medical problem is a mental disorder 18

Avenues for reflection 20 Inaptitude 20 Mental disorder 2 1

Conclusion 22 How to participate in the Committee’s mandate 22

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A word from the steering committee

On March 31, 2021, the National Assembly unanimously adopted a motion creating the Select Committee on the Evolution of the Act respecting end-of-life care. At the heart of its mandate is the issue of the potential expansion of medical aid in dying for persons who are incapacitated and for persons whose only medical problem is a mental disorder. By establishing this Committee, parliamentarians were sending a strong message about their willingness