Report: Canada ‘Poised to Lead World’ in Assisted Suicide Deaths

Canada is expected to lead the world in assisted suicide deaths under its medical assistance in dying (MAID) program as soon as 2025, the Toronto Star reported. 

The Investigative Journalism Bureau and the Toronto Star analyzed data from all 11 countries where assisted suicide exists and found the number of Canadians dying from the MAID program has “grown at a speed that outpaces every other nation in the world.” 

“Some experts see the rapid growth as a human rights triumph that allows Canadians to make their own choice about when they wish to die with the full support of the state and their doctors. Others fear that failures in the health-care system and social safety net may be contributing to the surge,” according to the report. 

Assisted deaths accounted for 4 percent of all death in Canada in 2022 — an increase from 1 percent in 2017, when the legislation allowing MAID was first enacted. Since then, MAID deaths have “quadrupled” hitting 13,000 nationwide in 2022, “a 31 percent jump from the previous year,” according to the report. 

MAID can be administered one of two ways: either by a physician or nurse practitioner or self-administration after being prescribed a substance by a physician or nurse practitioner, according to Dying with Dignity Canada, a pro-assisted suicide organization. 

According to the Government of Canada website, people who wish to receive MAID must:

• be 18 years of age or older and have decision-making capacity
• be eligible for publicly funded health care services
• make a voluntary request that is not the result of external pressure
• give informed consent to receive MAID, meaning that the person has consented to receiving MAID after they have received all information needed to make this decision
• have a serious and incurable illness, disease or disability (excluding a mental illness)
• be in an advanced state of irreversible decline in capability
• have enduring and intolerable physical or psychological suffering that cannot be alleviated under conditions the person considers acceptable

The analysis shows that more people have died by assisted suicide under Canada’s MAID program in the past two year than any other nation in the world.

“We’ve gone in a trajectory that no other country on the planet has gone,” Dr. Sonu Gaind, chief of psychiatry at Sunnybrook Hospital, told the publication. “We don’t know what the full impact is going to be.”

Canada is ultimately “poised to lead the world as soon as next year” in MAID deaths, despite other countries having such laws for decades longer, the report states.

The Netherlands has the highest global physician-assisted death rate at 5.1 percent, and the process has been legal there for more than two decades, according to the report. By comparison, “some Canadian provinces already exceed that,” the report noted, with Quebec’s MAID mortality rate hitting 6.6 percent and British Columbia’s rate hitting 5.5 percent in 2022.

Assisted deaths in the Netherlands reached 4 percent of deaths over 14 years, whereas in Canada, “it happened in six years,” according to the report.

“[T]here hasn’t been a slippery slope. We’ve had a cliff. We’re falling off it … I’m concerned about what it says about our society,” Gaind said. 

Gaind said he views the upward trend as a warning sign that patients are actually choosing to die because they cannot access the care they need to make their lives more livable, the report stated. 

“I’m concerned about the marginalized lives that are going to be lost,” he said. “We didn’t give them the chance to live with dignity, but are all too eager to say ‘Oh, here’s the path to dying with dignity.’”

Dr. Scott Kim, a psychiatrist and researcher at the National Institutes of Health in Washington, DC, who has studied international assisted-death rates and reviewed the IJB/Star data, told the publication that Canada’s MAID program is unique because assisted death is not viewed as a last resort option, unlike in other countries. 

“It gives doctors almost free reign on what to do if someone has a diagnosis and they’re miserable with it,” he said. “Then you marry it to a very-well organized delivery system — your healthcare system. It gives the medical system and your sociopolitical system an out when you abandon people.”

Kim has notably consulted on Canadian MAID legislation and even gave expert witness testimony in 2020 before the Canadian Senate Committee on Legal and Constitutional Affairs. He noted that discussion of MAID roll-out has mostly taken place “behind closed doors where physicians and lawyers appointed by the government pushed hard for broad accessibility to assisted death for Canadians,” the report stated. 

“The aggressive philosophy of implementation, in coordination with advocacy groups rather than wide input from varying perspectives, has been truly astonishing,” he said. 

The Toronto Star estimated that the share of Canadians pursuing assisted death could be even greater if lawmakers expand the program to include people whose sole underlying condition is a mental health disorder.

Canada was supposed to make such an expansion in March; however, Liberal Health Minister Mark Holland announced Monday that Canada is not ready to expand its MAID program to the mentally ill. This is the second time the Trudeau government has stalled the controversial expansion.

Holland said despite concerns from provinces, the government has not changed its belief that the mentally ill should have the right to choose when to die. The question is instead “one of readiness,” he said. The Toronto Star noted that one-in-five Canadians are “impacted by mental health challenges.”

Read the full report here.