Canada – A year of ‘Medical Aid in Dying’.

Canada’s death toll from euthanasia seems to be following the Dutch pattern

Official data have been released on the first full year’s outturn of Canada’s Medical Aid in Dying (ie euthanasia) law, which came into force in June 2016.  These show that between June 2016 and June 2017 there were 1,982 deaths in Canada under the terms of the MAID law.  All but five of these consisted of physician-administered euthanasia – ie the administration of lethal drugs by a doctor to a patient rather than the supply of such drugs to a patient for self-administration (physician-assisted suicide). 

The report states that deaths under the MAID law accounted for 0.9 per cent of deaths in Canada in the twelve month period.  It states that this “remains consistent with international experience, between 0.3 and 4.6 per cent of all deaths are reported as euthanasia or physician-assisted suicide in jurisdictions where they are legal”.  Yes, but this is the first year of Canada’s MAID law.  In the first year following enactment of Holland’s very similar and more accurately-named ‘Termination of Life on Request and Assisted Suicide’ law in 2001, the death rate from euthanasia and assisted suicide was just 1.3 per cent.  15 years later it is 4.1 per cent – and rising.  In The Netherlands in 2016 one in twenty five of all deaths was the result of legalised euthanasia or assisted suicide.

As in the US State of Oregon and The Netherlands, the greatest uptake of MAID was among the elderly.  The report states that the average age of those who died from MAID was 73 years. 

The report speculates as to the reasons why all but a tiny handful of the 1,982 MAID deaths involved physician-administered euthanasia (PAE) rather than physician-assisted suicide (PAS).  It comments that “providers are less comfortable with self-administration due to concerns around the ability of the patient to effectively self-administer the series of medications and the complications that may ensure” and that “some health institutions within [provincial] jurisdictions have developed their own assisted dying policies that do not encourage self-administration”.  Complications certainly can arise with PAS.  But PAE, with its direct involvement of a doctor in administering intravenous injections of lethal drugs and its placing of the patient in the position of passive recipient rather active ingestor, arguably poses greater risks of being misperceived as having attributes of medical care.  Whatever the reasons, it is indisputable that, where PAE is legalised alongside PAS, it has the effect of driving out the latter.  In 2016 96 per cent of deaths in The Netherlands under the terms of that country’s 2001 Act were the result of doctors injecting patients with lethal drugs rather than prescribing them for self-administration.  It is also undeniable that PAE produces significantly higher death rates than does PAS.

All things considered, Canada seems to be well on the way to following The Netherlands along an increasingly-worrying road.