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In Quebec, euthanasia deaths in 2022 increased by 45.5% compared to 2021. Euthanasia accounted for 6.6% of all deaths, compared to the national average of 4.1%. Michel Bureau, head of the Quebec Commission on end-of-life care, worries that euthanasia is no longer seen as a last resort within that province, stating, “We’re now no longer dealing with an exceptional treatment, but a treatment that is very frequent.”

Despite these disturbing statistics, the government of Quebec continues to push euthanasia as the solution to suffering, particularly in palliative care settings. This push is the focus of a recent legal challenge filed in the Quebec Superior Court.

Background

The National Assembly of Quebec passed The Act respecting end-of-life care in 2014 for the purpose of establishing an “integrated vision of palliative and end-of-life care.” The framework includes palliative care as well as euthanasia. Through that framework – and this is true throughout the country – euthanasia is one among many end-of-life care options.

The legalization of euthanasia throughout Canada in 2016 created a host of problems for federal and provincial governments as they craft legislation, regulations, and professional guidelines. One issue for governments is how to handle medical professionals who believe euthanasia is never the appropriate solution for suffering. Some provincial governments have tried to force doctors to facilitate euthanasia deaths, even if doctors do not have to provide the procedure directly.

Beyond individual conscience rights, another issue is whether institutions can refuse to offer euthanasia within their facilities. In June 2023, the government of Quebec amended their euthanasia law through Bill 11, An Act to amend the Act respecting end-of-life care. Among other changes, these amendments addressed questions of religious or conscientious objection when it comes to institutions providing euthanasia.

Religious Objection

Other provinces allow religious palliative care facilities to opt out of providing euthanasia. For example, British Columbia, when pressured to force a Catholic hospital to provide euthanasia, came up with a compromise that gives patients easier access to euthanasia without forcing religious institutions to provide it. You can read more about that here.

Quebec’s law was clear, until recently, that palliative care providers could decide whether euthanasia would be done on their premises. Bill 11 changed that in 2023, mandating that “no palliative care hospice may exclude medical aid in dying from the care it offers.” According to the government of Quebec, palliative care must include the option of euthanasia. This creates a dilemma for religious facilities opposed to euthanasia.

According to the Quebec palliative care association, as of March 2023 there were only four palliative care facilities in Quebec that did not offer euthanasia. One of these facilities is St. Raphael’s, a Catholic palliative care centre in Montreal. Its founders and supporters have clearly stated their opposition to euthanasia and their emphasis on relieving pain to enhance quality of life. Prior to the change in law, if a patient at their centre wanted to be euthanized, staff at the facility would send them to a provincially run facility. But now St. Raphael’s must either provide euthanasia or close its doors. The Catholic Archbishop of Montreal has filed a legal challenge, arguing that the law violates religious freedom.

Legal Precedent

Although we have seen disputes between Christian healthcare institutions and governments, such as those in British Columbia, the Archbishop’s legal challenge is the first of its kind in Canada. Whether the challenge succeeds or fails will set an important precedent for how religious freedom and religiously supported health care institutions are viewed in Quebec.

A win for the Archbishop would be binding precedent only in Quebec, but it would signal to other governments that Christian institutions must be allowed to provide care in a way that aligns with their beliefs and convictions.   This legal challenge is important, not simply because of what it means for St. Raphael’s and other religiously supported institutions in Quebec, but also for institutions across the country. Rather than pushing religious institutions out of providing health care, governments should give them the freedom to continue helping the sick and dying in their communities.