‘What are you going to do now?’ MAiD opponent asks former Quebec premier

Former Quebec premier Philippe Couillard’s reservations about the expansion of medical assistance in dying 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 Euthanasia Prevention Coalition, asked in an interview with Canadian Catholic News.

“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.

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He said a review would allow people to appear before a government committee and describe how the legislation has affected their families.

Canadian Catholic News 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 CBC’s 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.

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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.

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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. Without legislative change, MAiD solely for mental illness is scheduled to begin March 17.

The mental-illness exclusion faces a constitutional challenge involving Dying With Dignity Canada, Claire Elyse Brosseau, and Dr. Patricia Smith. They argue that excluding people whose sole underlying condition is mental illness violates Charter rights.