This summer, Health Canada released the second annual report on Medical Assistance in Dying (MAiD). The report contains several warning-signs that show Canada seems to be heading down a dangerous, but familiar, path.
Participation in MAiD continues to grow exponentially. Based on reports from practitioners and pharmacists, during the 2020 calendar year there were 7,595 cases of ‘assisted deaths’ – almost all were euthanasias. This brings the total number of such deaths since the enactment of federal legislation in 2016 to 21,589. In 2020, medically assisted suicide and euthanasia accounted for 2.5% of all deaths in Canada, representing a growth rate of 34.2% since 2019.
In 2020, there was a 17.7% increase in the number of practitioners who administered MAiD compared to 2019, but the number of practitioners willing to provide MAiD seems unable to keep pace with the rising demand for euthanasia. This results in several doctors are undertaking an alarming number of ‘assisted deaths’ each year. Of those doctors administering lethal drugs, 44.7% euthanased 2-9 patients and 14.7% euthanased 10 or more. As in previous years, the vast majority of MAiD deaths consisted of euthanasia and there were ‘fewer than seven’ reported cases of self-administered lethal drugs, as in previous years.
Many patients sought lethal drugs in 2020 for psychosocial reasons. 36% perceived themselves to be a burden on their family, friends, or caregivers, 18.6% experienced significant isolation or loneliness, and 5.6% described emotional distress, anxiety or fear. Despite these emotional vulnerabilities, only 10.9% of practitioners providing MAiD in 2020 had consulted a social worker and only 2.2% consulted a psychiatrist.
The original criteria in MAiD aimed to act as safeguards, but they are already beginning to crumble. In Québec, the ‘end of life’ requirement was dropped, meaning that death is no longer has to be ‘reasonably foreseeable’. And last year 34.3% of Canadian patients who died by lethal had not completed the statutory10-day cooling-off period.
Canada’s report shows the impossibility of creating robust boundaries around such legislation and reflects the incremental extension that has also been seen elsewhere.