In Common Sense, Rupa Subramanya discusses how quickly MAID (Medical Assistance in Death) became a commonality in Canada:
Toronto General Hospital in 2005.
Photo via Wikimedia Commons.
When we think of assisted suicide or euthanasia, we imagine a limited number of elderly people with late-stage cancer or advanced ALS in severe pain. The argument for helping them die is clear: Death is imminent. Why should they be forced to suffer?
In 2015, Canada’s Supreme Court ruled that assisted suicide was constitutional. In June 2016, Parliament passed Bill C-14, otherwise known as the Medical Assistance in Dying Act. MAiD was now the law of the land. Anyone who could show that their death was “reasonably foreseeable” was eligible. In this respect, Canada was hardly alone: The Netherlands, Switzerland, Belgium, Spain, Australia, and New Zealand, among others, allow assisted suicide. So do ten states in the U.S.
In 2017, the first full year in which MAiD, which is administered by provincial governments, was in operation, 2,838 people opted for assisted suicide, according to a government report. By 2021, that figure had jumped to 10,064 — accounting for more than 3 percent of all deaths in Canada that year.
There have been a total of 31,664 MAiD deaths and the large majority of those people were 65 to 80 when they died. In 2017, only 34 MAiD deaths were in the 18- to 45-year-old category. In 2018, that figure rose to at least 49. In 2019, it was 103; in 2020, 118; and in 2021, 139.
Today, thousands of people who could live for many years are applying — successfully — to kill themselves.
Indeed, in some Canadian provinces nearly 5 percent of deaths are MAiD deaths. In 2021, the province of Quebec reported that 4.7 percent of deaths in the province were due to MAiD; in British Columbia, the number was 4.8 percent. Progressive Vancouver Island is unofficially known as the “assisted-death capital of the world”, doctors told me.
Why the dramatic increase? Over the past few years, doctors have taken an increasingly liberal view when it comes to defining “reasonably foreseeable” death. Then, last year, the government amended the original legislation, stating that one could apply for MAiD even if one’s death were not reasonably foreseeable. This second track of applicants simply had to show that they had a condition that was “intolerable to them” and could not “be relieved under conditions that they consider acceptable”. This included applicants like Margaret Marsilla’s son, Kiano.
In 2023, those numbers are almost certain to rise.
Next March, the government is scheduled to expand the pool of eligible suicide-seekers to include the mentally ill and “mature minors”. According to Canada’s Department of Justice, parents are generally “entitled to make treatment decisions on their children’s behalf. The mature minor doctrine, however, allows children deemed sufficiently mature to make their own treatment decisions.” (The federal government does not define “mature”, nor does it specify who determines whether one is mature. On top of that, the doctrine varies from one province to another.)
Dr. Dawn Davies, a palliative care physician who supported MAiD when it was first conceived, said she had “tons of worries” about where this might lead. She could imagine kids with personality disorders or other mental health issues saying they wanted to die. “Some of them will mean it, some of them won’t,” she said. “And we won’t necessarily be able to discern who is who.”
Hugh Scher, an attorney advising Margaret Marsilla, told me: “While other countries have explored extending assisted suicide to minors, those governments have insisted on substantial safeguards, including parental notification and consent. Canada is poised to become the most permissive euthanasia regime in the world, including for minors and people with only psychiatric illness, having already removed the foreseeability of death or terminal illness as an essential condition to access euthanasia or assisted suicide.”
