In the absence of representative data, a first report without a portrait of palliative care
Meanwhile, Quebec remains the world leader in medical assistance in dying (7.9% of deaths)
Montreal,
November 4, 2025 – The Commission on end-of-life care released its 2024–2025 Annual
Report on October 30th (in French). After
reviewing the document, the Living with Dignity citizen network (Vivre dans la
Dignité) wishes to highlight two aspects of the report that must not go
unnoticed in political and media discussions.
Palliative care: navigating in the dark
After years of
repeated warnings about the weakness of data on palliative care (“limited
validity,” according to the most recent five-year report, and “lack of
sufficient information,” according to the 2022–2023 report), the Commission has
taken a further step by refusing to share data it deems non-representative.
From the report:
The Commission
reviewed the data submitted by institutions concerning the number of people who
received palliative and end-of-life care (PEOLC). Unfortunately, for several
years, it has noted that much data is missing, incomplete, or imprecise, or
refers to very different contexts from one institution to another. The
disparities observed appear to reflect both a lack of shared understanding of
the information to be transmitted and difficulties in providing certain
requested data. Consequently, the Commission considers that the data submitted
are not representative of the real situation of palliative and end-of-life care
in Quebec and that including them in this report could lead to
misinterpretations. (p. 14 of the report)
We commend the
Commission on end-of-life care for its integrity in choosing not to publish
data that would not provide an accurate picture of palliative care in Quebec.
This courageous decision should serve as a wake-up call for Minister Sonia
Bélanger, who resumed her position on October 30th as Minister for Health and
is responsible for this file. As the Commission’s five-year report reminded us:
“There are no
management indicators or standardized tools for assessing the quality of
palliative and end-of-life care services, how well they meet the needs of
patients and families, or how efficiently the system operates. The Commission
therefore cannot determine whether the needs of people who could benefit from
such care are being met.”
We cannot
continue to navigate blindly on such a critical issue.
According to
those working in the field, there is no doubt that access to quality palliative
care remains more difficult than access to medical assistance in dying (MAiD).
Palliative care requires more time, as well as greater human and financial
resources. In the spirit of the Act respecting end-of-life care,
Quebecers should also have similar access to high-quality palliative care.
Proper indicators should also clarify where we collectively stand on this
matter.
We welcome the
Commission’s creation of an internal working group tasked with developing
recommendations to strengthen access to palliative care. However, urgent and
decisive action is needed—particularly to protect and improve access to
home-based palliative care, which has been severely undermined by Bill 2 (see
numerous testimonies in French here and here).
Medical assistance in dying: Quebec still at the top
Quebec remains
firmly positioned among the jurisdictions with the highest proportion of
assisted deaths (MAiD, euthanasia, or assisted suicide), accounting for 7.9% of
all deaths during the period studied—an increase of 9% compared to the previous
year.
As Quebec
approaches the 10th anniversary of its first cases of medical assistance in
dying (December 10, 2025), the report raises several concerns regarding this
practice, including:
– Major regional
disparities (MAiD represented 13.4% of deaths in Lanaudière vs. 4.7% in
Montreal), a nearly 20% increase in Montérégie, and more;
– Very short
delays between a MAiD request and its administration (same day or next day in
4% of cases);
– Non-compliance
in a small number of cases (0.3%), with no reported disciplinary consequences
in these 19 reported cases—one of which involved administration without the
person’s consent at the time. Living with Dignity reiterates that the current
self-reporting system for MAiD providers after deaths cannot offer a full
picture of non-compliant cases;
– 50% of those
who received MAiD cited suffering from being perceived as a burden to family,
friends, or caregivers; 24% cited loneliness and isolation.
In concluding
its report, the Commission reminds readers of its duty to ensure that MAiD is
not “chosen for lack of access to other curative, palliative, or end-of-life
care that is of high quality and adapted to Quebecers’ needs.” Without adequate
data, it is clear that this objective cannot be achieved.
We also believe
the Commission must remind the Quebec government of its responsibilities
regarding how it communicates its constitutional project. The government
appears to have forgotten the spirit of the Act Respecting End-of-Life Care
by emphasizing medical assistance in dying while neglecting to mention
palliative care. This glaring imbalance between palliative care and MAiD in
Quebec must end—it is not a “shared
social value” across Quebec society.
– 30 –
Media contact :
Jasmin Lemieux-Lefebvre
Coordinator, Living with Dignity citizen network
info@vivredignite.org
NOV
2025