(The Lion) — A Canadian doctor warns hasty approvals for Medical Assistance in Dying (MAiD), the government sanctioned assisted suicide program in Canada, are creating a culture of “speedy death.”
Dr. Ramona Coelho, a member of Ontario’s MAiD Death Review Committee (MDRC) and a family physician, sounded the alarm after her committee began releasing its findings late last year.
“In 2016, Canada legalized euthanasia and assisted suicide using the umbrella term MAiD,” Coelho wrote in December 2024. “This was initially presented as an exceptional measure for persons with intolerable suffering at the end of their life. However, our system evolved at an alarming pace, with MAiD expanding far beyond its initial scope.
“In 2023, there were over 15,000 MAiD deaths, pushing the total to 60,000 by the year’s end. Quebec announced their MAiD annual death rate has surpassed 7% – staggering in comparison to initial provincial estimates of 100 requests per year. Meanwhile, recent reports from Ontario’s MDRC raise red flags, warranting a closer look at the unintended yet foreseeable risks tied to the legalization of euthanasia and assisted suicide.”
MAiD became legal in Canada in 2016. Originally, it was restricted to individuals approaching death by natural causes. In 2021 it was expanded to include individuals with physical disabilities and in 2027 it will expand to include individuals with mental illnesses.
The committee’s latest two reports detail irregularities in cases where waivers of final consent were used and where MAiD was provided on the day of, or day after the initial request. The reports raise questions “about whether proper assessments, thorough exploration of suffering, and informed consent were consistently practiced by MAiD clinicians.”
One of the more egregious cases involved a man whose life was taken even though he refused to speak on the day of his appointment. The Alzheimer’s patient, identified as “Mr. B,” reportedly had prior approval for MAiD which included a waiver of final consent. However, on the day of the appointment, his spouse told the providers he had even more confusion than usual. Even though the MAiD provider specifically noted that Mr. B didn’t recognize them and refused to talk to them at all, his life was still ended that day.
Another patient, Mrs. B, an individual in her 80s suffering from complications from surgery, had reportedly chosen palliative care and was discharged to her home. When she requested a MAiD assessment, her assessor noted she preferred palliative care based on personal and religious values. Her spouse took her to the emergency room the very next day, citing struggles with caregiver burnout, and again she was discharged home. When her palliative care was denied, her spouse contacted the MAiD coordination service for an urgent assessment. The new assessor deemed her eligible for MAiD, despite concerns from the first assessor.
The original assessor requested a re-evaluation, questioning the new assessor on the urgency, sudden shift in patient preference and the influence of caregiver burnout, but the request was denied. That evening, a third MAiD provider was brought in and ended Mrs. B’s life without hesitation, according to the report.
“While the federal government has finished its consultation on advance directives for MAiD, experts warn against overlooking the complexities of choosing death based on hypothetical suffering and no lived experience to inform those choices,” Coelho concludes.
“A substitute decision-maker has to interpret prior wishes, leading to guesswork and ethical dilemmas. These cases highlight how vulnerable individuals, having lost the capacity to consent, may be coerced or unduly influenced to die – whether through financial abuse, caregiver burnout, or other pressures – reminding us that the stakes are high – life and death, no less.”
Ultimately, the doctor argues basic human decency requires a more dignified, cooperative approach for individuals nearing the end of their lives, not “guesswork” about what they may or may not have wanted.
“The fundamental expectation of health care should be to rush to care for the patient, providing support through a system that embraces them – not rush them toward death without efforts to mitigate suffering or ensure free and informed consent. If we truly value dignity, we must invest in comprehensive care to prevent patients from being administered speedy death in their most vulnerable moment, turning their worst day into potentially their last.
“We must confront the uncomfortable truths about our society.”
