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Protection of Conscience Project

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Service, not Servitude
Background

Euthanasia statistics: Quebec

10 December, 2015 to 10 June, 2017

Introduction

Since 10 December, 2015, euthanasia has provided by physicians in Quebec under the terms of An Act Respecting End of Life Care (ARELC).  Health and social services agencies established by the government throughout the province are state agencies responsible for the delivery and coordination of health care in the province administrative regions. These are called Centres intégrés de santé et de services sociaux (CISSS) and Centres intégrés universitaires de santé et de services sociaux [CIUSSS).  Some administrative regions (like Montreal and the Quebec City region) have more than one CISSS or CIUSSS.

These agencies are responsible for the delivery of euthanasia and are required to make reports to a commission established by the law to monitor the administration of euthanasia (the Commission sur les soins de fin de vie).  The Commission draws from these and other reports to make its required summary of activity to the legislature (National Assembly).

The most recent reports from the CISSS and CIUSSS cover the period from 10 December, 2016 to 10 June, 2017.  The Project has compiled the statistics provided in these reports.  The compilation includes tables and charts, some of which are reproduced below.  Note that, in some cases, the number of patients lethally infused is higher than the number of requests because euthanasia was provided in response to a request made in the previous reporting period.

However, this compilation is incomplete: 

  • This compilation accounts for the provision of euthanasia in only 454 cases in 2015/2016.  However:
    • According to a CBC News report dated 14 March, 2017, euthanasia was administered to 461 people in 2015/2016.  The source of this information was not identified, and the main chart published in the news article (as of 2017-09-01) was incomplete and outdated.
    • According to a CBC News report dated 20 April, 2017, euthanasia was administered to 469 people in Quebec.  The source of the statistics provided in the report was said to be health ministries and coroners' offices.
    • It is possible that, in the 7 to 15 Quebec cases not accounted for here, euthanasia was administered in private institutions. The Commission received four reports from private institutions, but did not include the data in its annual report (see Commission report, p. 15).
  • As of 1 September, 2017, three agencies in major population centres (Outaouais, Nord-de-l'Île-de-Montréal and Ouest-de-l'Île-de-Montréal) and one agency in a sparesly populated region with sparse population (Nunavik) had not made public their most recent reports.
  • One agency (Montérégie-Centre), while noting that euthanasia was not provided in 7 cases because patients died before, became incompetent, were ineligible, or withdrew their request, did not report the number of patients in each category.

The compilation will be updated as the reports from these agencies become available.  Subject to these updates, the following points appear to be of interest:

  • About 18-19 requests for euthanasia were made weekly in the province in the first half of 2017, about the same as the last half of 2016.
  • The percentage of requests that did not result in euthanasia increased slightly from about 37% to 39%
    • Increases in this category, when reported, were attributed mainly to patients becoming incompetent, dying or withdrawing their requests.
  • Of the 22 agencies reporting euthanasia in the first half of 2017,
    •  in 18 the average weekly number of requests for euthanasia increased;
    • in 15 there was an increase in euthanasia provided weekly;
    • in 17 there was an increase in the rate of euthanasia per 100,000 palliative patients.
  • Of the 22 agencies reporting the use of "continuous palliative sedation" (CPS) in the first half of 2017
    • in 15 there was an increase in the rate of CPS per 100,000 palliative patients.

If rates in the first half of 2017 persist without escalation, Quebec euthanasia rates will reach levels after two years that correspond to Belgian rates after six to eight years (i.e., per 100,000 population and as a percentage of deaths from all causes).

Download the full Excel file (10 December, 2015 to 10 December, 2017) (Includes links to original reports).

Creative Commons LicenceThis work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Suggested citation:  Murphy S. Euthanasia reported in Quebec: statistics compiled from the Rapports aux directeur général au Conseil d'administration de l'établissement et à la Commission sur les soins de fin de vie (10 December, 2015 to 10 June, 2017), Protection of Conscience Project (1 September, 2017).

CONTENTS
Euthanasia Requests
Euthanasia Provided
Euthanasia Not Provided
Frequency of Euthanasia Requests
Frequency of Euthanasia
Mortality Rates
Quebec, Belgium and Netherlands
Projected Quebec Euthanasia Deaths in 2017
Continuous Palliative Sedation

To be distinguished from palliative sedation per se.  See the following important commentary concerning this subject:

Reports of CPS


Euthanasia Requests
Province wide
Euthanasia requests province wide
In reporting agencies
Euthanasia requests in reporting agencies
In administrative regions
Euthanasia requests in administrative regions
Per 100,000 palliative patients in reporting agencies
Euthanasia requests per 100,000 palliative patients in reporting agencies
Per 100,000 palliative patients in administrative regions
Euthanasia requests per 100,000 palliative patients in administrative regions
Per 100,000 population in administrative regions
Euthanasia requests per 100,000 population in administrative regions
Euthanasia Provided
Province wide
Euthanasia provided province wide
In reporting agencies
Euthanasia provided in reporting agencies 
In administrative regions
Euthanasia provided in administrative regions 
Per 100,000 palliative patients in reporting agencies
Euthanasia provided per 100,000 patients in reporting agencies
Per 100,000 palliative patients in reporting agencies
Euthanasia provided per 100,000 palliative patients in reporting agencies
Per 100,000 population in administrative regions
Euthanasia per 100,000 population in administrative regions 

Euthanasia Not Provided
Of all requests province wide (number)
Euthanasia not provided of all requests province wide (number) 
Of all requests province wide (percentage)
Euthanasia not provided of all requests province wide (percentage) 
Reasons not provided of all requests province wide (number)
Reasons euthanasia not provided of all requests province wide (number)
Reasons not provided of all requests province wide (percentage)
Reasons euthanasia not provided of all requests province wide (percentage)

Frequency of Euthanasia Requests
Weekly province wide
Euthanasia requests weekly province wide 
Weekly in reporting agencies
Euthanasia requests weekly in reporting agencies
Weekly in administrative regions
Euthanasia weekly in administrative regions 

Frequency of Euthanasia
Weekly province wide
Euthanasia weekly province wide
Weekly in reporting agencies
Euthanasia weekly in reporting agencies
Weekly in administrative regions
Euthanasia weekly in administrative regions

Quebec mortality rates

Note:  Euthanasia is normally classified as homicide, but physicians in Quebec have been instructed to record euthanasia as death from an underlying cause.  Homicide by euthanasia is distiguished here from non-medical homicide.

 

Quebec euthanasia and selected mortality rates
Euthanasia and selected mortality rates
Quebec euthanasia and non-medical homicide and suicide rates per 100,000 population
Euthanasia and non-medical homicide and suicide rates

Quebec, Belgium and Netherlands

Note: The 2002-2003 period in Belgium covered 15 months.  The 2015-2016 period in Quebec reported here covered about 12.75 months.

Reported euthanasia deaths per 100,000 population
Quebec, Belgium, Netherlands; Reported euthanasia deaths
Reported euthanasia deaths as percentage of all deaths
Quebec, Belgium, Netherlands: Euthanasia deaths per 100,000 population
Reported euthanasia deaths and suicide per 100,000 population
Quebec, Belgium, Netherlands: Euthanasia deaths as percent of all deaths 
Reported euthanasia deaths and suicide as percentage of all deaths
 Quebec, Belgium, Netherlands: Frequency of euthanasia

Projected Quebec Euthanasia Deaths in 2017

Based on the continuance of all rates in the first half of 2017, without escalation.

Projected euthanasia deaths per 100,000 population
 Projected euthanasia deaths per 100,000 population in 2017
Projected euthanasia deaths as a percentage of all deaths

Projected euthanasia deaths as percentage of all deaths


Continuous Palliative Sedation
Province wide

CPS province wide

In reporting agencies

CPS in reporting agencies

In administrative regions

CPS in administrative regions

Per 100,000 palliative patients in reporting agencies

CPS in administrative regions

Per 100,000 palliative patients in administrative regions

CPS in administrative regions

Per 100,000 population in administrative regions

CPS in administrative regions

 

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