Quebec Leads in Medical Assistance in Dying, Lags in Home Palliative Care
Quebec has emerged as a global leader in medical assistance in dying (MAID), with the practice accounting for 7.9% of deaths in 2024–2025. However, the province’s provision of dignified end-of-life care at home falls short compared to other regions worldwide.
Dr. Geneviève Dechêne, a seasoned family physician specializing in home-based palliative care, highlights Quebec’s low rate of natural deaths at home—around 10 to 11%, significantly below the Western average of 30%. This disparity underscores the need for improved home palliative care services in the province.
Despite the cost-effectiveness and benefits of home palliative care, Quebec’s healthcare system struggles to expand these services. Dr. Dechêne, who spearheaded the SIAD (intensive home care) team at Verdun CLSC, points out the correlation between inadequate palliative care and the increasing reliance on MAID by Quebecers.
Accessing palliative care outside of hospital settings remains challenging in Quebec, with limited hospice care facilities and beds available. The Maison St-Raphaël Palliative Care Home and Day Centre, along with SIAD teams, strive to provide comprehensive care to patients in their homes, aiming to enhance comfort and quality of life during their final days.
While initiatives like SIADs have shown significant reductions in hospitalizations and costs, the government’s investment in home-based palliative care remains insufficient. Dr. Dechêne criticizes Quebec’s healthcare system for prioritizing hospital-centric care, leading to a shortage of family physicians dedicated to home palliative care.
The development of robust home-based palliative care services requires bold investments and a shift towards prioritizing end-of-life care outside hospital settings. By enhancing access to quality palliative care, Quebec can offer its aging population a dignified and compassionate alternative to hospitalization, ultimately reducing healthcare costs in the long run.
