Opinion: How Josée became one of the 7.9% of Québécois who die by assisted suicide

On December 1, 2023, Josée Lamère, a former teacher and advocate for medical aid in dying (MAID), was diagnosed with stage 4 gallbladder cancer. Within days, she requested assistance in ending her life, and she passed away 18 days later, on December 19, 2023. Her case highlights the growing role of MAID in Quebec, where 7.9% of all deaths occur through assisted suicide, by far the highest rate globally. This statistic reflects both the legal framework and the cultural tensions surrounding end-of-life care in the province. Josée's journey began in 1984, during the height of the Quiet Revolution in Quebec. That year, Céline Dion performed at Montreal’s Olympic Stadium, drawing global attention. While the performance was a defining moment for pop music, it also marked a turning point for Josée Lamère, who was working behind the scenes as a youth adviser to the archbishop of Montreal. Unlike many others, she saw the event as a symbol of secular progress rather than religious triumph. Her early career in education reflected this shift, as she taught religion in Quebec’s public schools, a subject that, under the principle of laïcité, often took on ethical dimensions. Over the course of her career, Josée witnessed the evolution of medical ethics in Quebec. By the mid-20th century, the Catholic Church had begun to soften its stance on end-of-life decisions, allowing patients to refuse overly aggressive treatments. This concept, known as l'acharnement thérapeutique, would later influence Canadian policy. In the 1990s, public discourse around MAID intensified, with cases such as that of Nancy B., a paralyzed woman who successfully petitioned for the discontinuation of life-sustaining treatment, becoming emblematic of the broader debate. By 2009, Quebec had formed a National Commission on Dying with Dignity to determine the boundaries of end-of-life choices. The commission’s work culminated in the legalization of MAID in 2016, making Canada the first country to pass such legislation nationwide. The law requires individuals to be mentally competent and to suffer from a grievous and irremediable condition. However, the definition of suffering remains subjective, influenced by personal experiences, cultural norms, and historical context. Josée became increasingly engaged in discussions around MAID after caring for her mother, who suffered from Alzheimer’s disease. The slow deterioration of her mother’s condition left Josée deeply affected, prompting her to advocate for expanded access to MAID. In 2024, Quebec’s courts ruled that individuals with irreversible conditions could receive MAID even if they lacked the ability to give consent at the time of death. This decision aligned with Josée’s belief that autonomy should extend beyond physical capability. In late 2023, Josée faced her own health crisis. Diagnosed with advanced gallbladder cancer, she chose to seek MAID, believing it offered dignity in the face of inevitable decline. Her choice was not taken lightly, nor was it isolated. It followed a pattern of advocacy and reflection that spanned nearly four decades. Her daughter, Constance, described her mother’s final wishes: “Just let me die in peace. I don’t want to be alive for the sake of being alive.” These words encapsulated the emotional and philosophical stakes of the issue. As of March 31, 2025, 7.9% of all deaths in Quebec occurred through MAID, a figure that underscores the ongoing impact of the law. The debate continues, with discussions focusing not only on eligibility but also on the lived experiences of those who choose to end their lives. Josée’s story, like so many others, illustrates the complex interplay of law, ethics, and personal conviction in shaping end-of-life decisions.