Commentary
We’ve finally applied the brakes to the slippery slope of assisted suicide in Canada. For a while, it seemed like nothing could stop our euthanasia laws from becoming increasingly permissive.
There was a time not too long ago when a place like Amsterdam was looked at by Canadians as a strange realm for having long allowed assisted suicide. Then, all of a sudden, our rules became arguably more expansive than theirs.
Thankfully, assisted suicide for mental illness has now been ruled as a step too far by the federal Liberal government. A line has been drawn.
“Canada has made a decision not to move forward with the expansion that is scheduled in the Criminal Code of medical assistance in dying in circumstances where mental illness is the sole basis,” Justice Minister Sean Fraser said recently in the foyer of the House of Commons.
This fall, the government will introduce legislation to indefinitely continue the ban on MAID (medical assistance in dying) for individuals solely suffering from mental illness.
Minister Fraser did add that the changes will also pave the way for advance consent for people whose illness erodes their mental capacity to consent to MAID right at a time when they otherwise would most request it. The advance consent requirements will include that the person’s illness be incurable and that it involves intolerable suffering.
While public opinion polling may show that the majority in Canada support the most basic forms of assisted-suicide, that support wanes as the rules expand. An Angus Reid poll from earlier this year found a split over expanding it for mental illness, with 46 percent of respondents in support and 44 percent opposed.
I’m one of those voices who first wrote supportively of allowing a limited form of assisted suicide in Canada a decade ago. I wasn’t dismissive of those who said we were heading down a slippery slope, but I believed we should address broadening rules if and when they happened. Well, they certainly came about.
Back then, mental illness as a sole condition wasn’t being discussed. And we certainly weren’t tossing around the euphemism of “mature minors” to expand it to kids and teenagers. (Canada still restricts MAID to those 18 and over, but advocacy groups such as Dying With Dignity Canada call for lowering the age.) The MAID regime has gone much further than Canadians were led to believe it would go.
It’s also been shocking to learn just how cavalier some aspects of the system have been with recommending MAID.
There was the scandal from a few years ago when a number of military veterans were told MAID was an option for their serious but manageable problems. After an investigation, it was determined that all of these incidents led back to a single Veterans Affairs Canada caseworker. Lawrence MacAulay, who was the veterans minister at the time, labelled the situation “simply disgusting.”
Then there’s the absolutely wild case of a London, Ont., doctor meeting a patient suffering from Crohn’s disease at a Tim Hortons parking lot, assessing him for MAID, and then personally driving him to a clinic to meet his death. The doctor was in turn placed under six months of practice supervision by the College of Physicians and Surgeons of Ontario, which is a shockingly minor consequence for a story that rocked the nation.
These are what’s called edge cases—they’re the anomalies. The majority of MAID deaths are still within the confines of how Canadians were first sold on the rules.
Track 1 MAID are cases where the patient is already on a clear trajectory to an imminent death. In 2024—the last year complete numbers are available—there were 16,499 incidents of MAID in Canada. Track 1 accounted for 95.6 percent of these cases. The median age was 78 years, with 61 percent over 75 years of age. The most frequently cited underlying condition was cancer, in two-thirds of cases. So most MAID cases involve older people already dying of a terminal illness.
These numbers show that the system is working—except when it isn’t. And that’s the problem. The more cases of MAID there are—and they are increasing by the year—the more edge cases and abuse we will see. And the more expansive the permissions, the more general cases there will be.
The people deserve to have a say in their government’s policies, and that includes MAID policies. Remember, what’s at issue here is not a general opinion on whether someone should be able to choose when to end their life. It’s about whether or not the public sector assists with suicide in multiple ways—administratively, financially, legally and, lastly, through doing the procedure.
The expansion of MAID has paused for now, but the conversation continues.
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