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Dementia Doctors, Provinces Differ on Question of Advance Consent in MAID
Federal legislation would let people with dementia make advance MAID requests while provinces decide how to apply them, as Quebec and Alberta remain divided.
Justice Minister Sean Fraser announced on Oct. 7 federal legislation to decriminalize advance requests for MAID among people with dementia, but Quebec and Alberta have taken sharply opposing stances on implementation.
Quebec legalized advance requests on Oct. 30, 2024, and had registered 3,463 requests as of Oct. 4 this year, allowing individuals to designate one or two 'trusted third person' to advocate for their wishes.
Alberta passed legislation last March barring advance requests entirely, and press secretary Maddison McKee confirmed the province's safeguards enacted last spring will remain in place regardless of federal moves.
Dr. Samir Sinha of Sinai Health describes the ethical challenge as 'complicated,' noting that cases where patients' current quality of life appears happy but conflicts with advance requests create 'grey area' scenarios where 'that's where I get nervous.'
The Physicians' Alliance Against Euthanasia argues such laws contradict medical goals, while Dying with Dignity contends bans harm patients; Justice Minister Fraser acknowledged the issue will spark debate over 'the next number of months and years.