Medically assisted suicide is a touchy and sensitive topic. Questions about humanity, pressures, proper decision making, and even religious views can all come into play. One country where this has become a very slippery slope is in Canada.
People in Canada are having their lives ended by assisted dying on the same day that requests are made, adding to fears that wrongful deaths may be occurring.
What is This Program Called?
In Canada, the assisted dying program is called Medical Assistance in Dying, or MAiD. It was legalized in 2016 with Bill C-14 and later expanded in 2021 by Bill C-7, which removed the requirement that death be imminent. To be eligible, a person must be at least 18 years old, capable of making decisions, and have a “grievous, irremediable condition”. The process includes assessments by two practitioners and strict safeguards.
A “grievous and irremediable medical condition” is defined as a serious, incurable illness, disease, or disability that leads to an irreversible decline in the person’s abilities, and causes enduring physical or psychological suffering that can’t be relieved in ways the person finds acceptable. And, importantly, it doesn’t have to even be a terminal condition, but the person must meet all three criteria to be eligible.
Does Healthcare in Canada Cover Medically Assisted Suicide?
Canada’s healthcare system is publicly funded and provides universal coverage, but it’s not fully socialized. Each province runs its own insurance plan, covering medically necessary hospital and physician services, all paid for mostly by taxes. The providers (doctors and hospitals) are typically private, and only services beyond core care, like prescriptions or dental care, often require private insurance. Overall, it ensures broad access but can have long wait times for some procedures.
In Canada, Medical Assistance in Dying, or MAiD, is considered a covered health service under the public healthcare system. If you meet the eligibility criteria and are covered by your province’s plan, the main procedure and medications are typically funded. The exact details, though, can vary by province.
The Sad Case of “Mrs.B”
Here is a shocking story. An official report by the Chief Coroner of Ontario’s Medical Assistance in Dying Death Review Committee highlighted that, in 2023, 65 people in Ontario had their lives ended by Canada’s assisted suicide and euthanasia program on the same day that they made their requests to do so. A further 154 people had their lives ended the day after their request was made. SO over 200+ people just in Ontario alone were able to die within two days of a consultation!
These same-day suicides, which comprise both assisted suicide and euthanasia, include the case of Mrs. B, a woman in her 80s who suffered from complications following coronary artery bypass graft surgery and who chose to receive palliative care support at home.
After sharing her desire with her family to end her life through the program, her spouse requested an assessment. However, Mrs. B informed the suicide assessor that she “wanted to withdraw her request, citing personal and religious values and beliefs”, preferred instead to pursue “in-patient palliative care/hospice care”.
After being denied hospice palliative care, Mrs. B’s spouse subsequently requested another assisted suicide assessment. This approval was granted despite reservations from the first practitioner, who held “concerns regarding the necessity for ‘urgency’ and… the seemingly drastic change in perspective of end-of-life goals, and the possibility of coercion or undue influence (i.e. due to caregiver burnout)”. Basically, she was flip-flopping. So how can her request be taken so seriously? And why would it require such a “speedy” response.
Despite all of this madness, Mrs B’s request was approved by two separate assessors, and she died the same day.
Same-day Suicides are Commonly Due to Poor Quality End-of-Life Care
Canada’s Medical Assistance in Dying (MAiD) law, passed in 2016, and it required a 10-day waiting period between requesting assisted dying and being given the assistance to end one’s life. But then the Canadian Parliament removed this requirement for individuals whose deaths were “reasonably foreseeable” in 2021. There are no specific criteria used to discern whether a same-day suicide should be applicable or not. (That is scary)
Members of the Medical Assistance in Dying Death Review Committee expressed concerns that same-day suicides could be an influencing factor for people to choose to end their lives, as this accessibility is much more timely than accessing high-quality end-of-life care. Let alone how much cheaper it is to just kill someone, rather than administer actual care.
The report outlined, “Many members opined that poor quality end-of-life care potentially impacted the request for a brief MAiD provision timeline”. “Some members expressed their concern that access to MAiD was more easily organized and accessible in this circumstance than the previously requested and preferred option for end-of-life care”, the report added.
A member of the MDRC criticized the actions of those involved in Mrs B’s death, saying, “The focus should have been on ensuring adequate palliative care and support for Mrs. B and her spouse. Hospice and palliative care teams should have been urgently re-engaged, given the severity of the situation”.
So How is the Suicide Actually Administered?
In Canada, the process for Medical Assistance in Dying, or MAiD, involves several steps. First, a person makes a written request to a physician or nurse practitioner, and this request is witnessed. Then, two independent practitioners assess whether the person is eligible, based on age, decision-making capacity, and having a grievous, irremediable condition. Once confirmed, a final consent is given, and the procedure is either clinician-administered or self-administered, usually within a short time. Afterward, family support and aftercare are provided.
In Canada, Medical Assistance in Dying is usually administered in one of two ways. Most often, it’s done via an intravenous route, starting with a sedative like midazolam to induce unconsciousness, then propofol to induce a deep coma, and finally a paralytic like rocuronium to stop breathing. In some cases, it can also be self-administered orally with a prescribed medication under supervision.
At the end of the days, no pun intended, this is a very debatable topic. One thing that is not being discussed enough is the financial benefits to the country, state, or province to just “kill” the patient instead of costly medical treatment and care. And if you think that money is not a huge factor in these decisions, then you are being quite naive, aren’t you?
