By Paul Schratz / Canadian Catholic News, OSV News
(OSV News) -- Former Quebec Premier Philippe Couillard’s reservations about the expansion of Medical Assistance in Dying, or MAiD, are drawing international attention, with a longtime opponent calling on him to do something about the legislation he helped enact.
“What are you going to do about this now that you supported this?” Alex Schadenberg, executive director of the Ontario-based Euthanasia Prevention Coalition, asked in an interview with Canadian CatholicNews.
“These laws need to be reviewed,” he said, calling for complete reviews of both Quebec’s and Canada’s assisted-dying laws -- not only possible expansions, but how the legislation has operated since coming into effect.
He said a review would allow people to appear before a government committee and describe how the legislation has affected their families.
CCN asked Couillard whether he planned to act on his concerns and whether governments should restore earlier restrictions on eligibility.
“I appreciate your interest, however I will make no further comments on the matter,” he replied by email.
In an Oct. 10 interview with Canadian Broadcasting Corporation’s radio program “The House,” Couillard questioned how far MAiD eligibility has expanded beyond Quebec’s original law, which he said was intended for people approaching death. He said he was unsure whether he would again support the legislation his government helped pass in 2014.
“It was clearly reserved for terminal or pre-terminal conditions with a defined, unfortunate road to the end of life. And this is not the case anymore,” he told host Catherine Cullen.
“I’m not sure that I would have again voted for that law with the extension that we have seen in the recent years.”
Couillard, a former neurosurgeon, led the Quebec Liberal Party to a majority government in 2014 and served as premier until 2018. He was among those former Prime Minister Justin Trudeau consulted before the federal government passed its own MAiD legislation in 2016, two years after Quebec adopted its law.
In 2019, the Quebec Superior Court struck down two eligibility restrictions: the federal requirement that a person’s natural death be reasonably foreseeable and the provision in Quebec’s law requiring patients to “be at the end of life.”
Parliament responded in 2021 with Bill C-7, removing the reasonably foreseeable death requirement for eligibility and establishing separate safeguards for people whose deaths were not reasonably foreseeable. The legislation also provided for future eligibility where mental illness was the sole underlying medical condition, although that expansion has since been delayed until March 17.
In 2024, Quebec began allowing people diagnosed with conditions such as Alzheimer’s disease to make advance requests for MAID before losing the capacity to consent.
Couillard acknowledged that opponents had warned him eligibility would expand.
“I was warned about this by people opposing the law that told me, ‘We see your motivation is good, but you will see, once you open the door you will not close it and it will open wider.’ And this is what happened,” he said.
Schadenberg told CCN he had lunch with Couillard in 2014 and warned him about expansion. He said he told Couillard that euthanasia had continually expanded in other jurisdictions and that the bill’s language would allow it to expand in Quebec too.
Schadenberg recalled Couillard responding, “Well, I know your position.”
In the CBC interview, Couillard nevertheless defended the original decision, recalling patients he had treated.
“In general, when this hits me, I think about specific patients that I’ve known in my medical career that were in such deep distress and pain that I think we did the right thing,” he said.
In 2014, Couillard said he would have opposed an earlier version of the bill but supported the amended legislation, citing clearer safeguards and protection for health professionals who objected on grounds of conscience. The bill passed 94–22, with all opposing votes coming from Liberals, including 10 Cabinet ministers.
Couillard’s latest remarks came days after Justice Minister Sean Fraser announced Oct. 7 that the federal government plans to introduce legislation to indefinitely exclude people whose sole underlying medical condition is a mental illness from MAiD eligibility.
Fraser also said the government plans to allow advance requests in provinces that choose to provide them. Both measures are to be included in legislation the government says it will introduce this fall.
The mental-illness exclusion faces a constitutional challenge involving Dying With Dignity Canada, Claire Elyse Brosseau and Dr. Patricia Smith, who filed a joint court challenge in August 2024. They argue that excluding people whose sole underlying condition is mental illness violates the Canadian Charter of Rights and Freedoms.
Without legislative change, Canada is set to expand eligibility for euthanasia on March 17 to those whose sole underlying medical condition is a mental illness. The country recorded a world-leading 16,499 MAiD deaths in 2024, with some patients qualifying although they were not dying.
The Catholic Church upholds the sanctity of human life from the moment of conception until natural death. The catechism teaches that any act or omission that intentionally causes death to eliminate suffering is considered murder.
In September, cautionary tales from the front lines of Canada’s permissive euthanasia system helped fuel British politicians’ successful campaign to defeat a bill that would have legalized doctor-assisted suicide in England and Wales, according to a leading British anti-euthanasia advocate.
The Sept. 11 vote saw members of the U.K. Parliament reject the measure 286-270.
Gordon Macdonald, CEO of Care Not Killing, told CCN that Canada’s 10-year experience with MAiD created “an awareness of how badly wrong (legal assisted-death) could go.”
Although Canada was not mentioned in the debate immediately preceding the vote, the country’s experience was cited in previous parliamentary exchanges.
Speaking in 2024 against an earlier assisted-suicide bill, Conservative MP Saqib Bhatti used Canada as an example of how even a narrowly defined law can expand over time.
“On (the subject of) slippery slopes,” he said, “someone (in Canada) does not even have to have a terminal or fatal illness now; mental illness will be an acceptable reason for assisted suicide in 2027.”
“Pandora’s box has clearly been opened,” he said, “and we risk embarking on that route today.”
