The third annual report of statistical data concerning euthanasia (the government’s term is MAID, which stands for Medical Assistance in Dying) was released by Health Canada in July of 2022. Since the last report was released, there has been a significant growth in euthanasia (MAID) deaths in Canada. In 2021, euthanasia (MAID) deaths accounted for 3.3% of all deaths in Canada, reflecting a growth rate of 32.4% compared with 2020. 2019 to 2021 yearly data reflects the trend that more men than women seek to be euthanized. The most common reason given by those seeking euthanasia (MAID) as their means of dying is loss of ability to carry out meaningful activities (86.3%) and “the loss of ability to perform activities of daily living” (83.4%). Analogous to the last annual report released on euthanasia, private residences remain the primary setting for the administration of lethal injections, at 44.2%, according to this data from 2021. There has been a 27.7% increase in written requests, namely 12,286, in 2021, compared to the year before.
There have been several changes to the euthanasia legislation since the second annual report on euthanasia, including the removal of the requirement for the patient’s natural to be reasonably foreseeable. The document discusses Non-RFND (non-reasonably foreseeable natural death) cases and RFND “MAID” (reasonable foreseeable natural death) cases. 2.2% of euthanasia deaths in 2021 were Non-RFND deaths. There has been the removal of a so called “safeguard” in these cases, including the removal of the final consent requirement for those with a euthanasia date who are “losing capacity” while they wait. There has also been the removal of the requirement of the pre-euthanasia (pre-MAID) 10-day reflection period.
There are several changes which will be implemented next year. One change which will be implemented in March includes allowing euthanasia solely for those struggling with mental illness, which, initially scheduled to come into effect in March 2023, has been delayed to March 2024. The federal government has been studying possible changes to the law, including Ed Fast’s Bill C-314 which hoped to reverse this implementation.
Euthanasia in Canada is described as “safe and consistent” and “effective” in its delivery in Canada, words Federal Health Minister Duclos used to discuss MAID in the document’s section “Minister’s Message.” In truth, this is far from reality. We see the manipulation of language throughout the document. There is nothing about euthanasia that could improve a patient’s condition. Talking about it as a treatment to be administered as the Third Annual Report does is far from what euthanasia is in reality: the annihilation of a patient’s life at the hands of a medical practitioner who has little to no oversight in his decision.
According to Alex Schadenberg, Executive Director of the Euthanasia Prevention Coalition, not all practitioners follow the official guideline of reporting euthanasia deaths, this being yet another unfortunate reality of euthanasia in Canada and its self-reporting system. Alex says there is a 20% underreporting rate. There is also nothing that would prevent a practitioner from subjectively interpreting the protocols and guidelines, as there is no oversight requirement for the carrying out of euthanasia (June 17, 2023).
The Third Annual Report by Health Canada provides more favorable anecdotal accounts from practitioners of their patients’ death by euthanasia. For example, according to the practitioner report on page 27 of the report, “[The patient] wanted to be pain free and sedated, and to have MAID on his birthday…Family members at the bed bedside respected the patients’ wishes and the MAID went very well. In the presence of his wife and two children, the patient passed away on his birthday, as he wished.” It is portrayed as desirable and made to look like your everyday average event. However, at their core, these stories are stories of euthanasia, of one person killing another person. We are only aware of anecdotal accounts and data actually reported by the practitioner who caused the death which he or she reports to the designated provincial or territorial body or directly to Health Canada.
Examining the raw data, one finds that there was a total of 10,064 ‘assisted deaths’ reported for 2021. Since the federal law was passed in Canada in June 2016, the total number of euthanasia (MAID) deaths as of 2021 stood at 31,664. The 2021 numbers represent a 32.4% increase over 2020 numbers. In 2021, Euthanasia (MAID) deaths were also shown to represent 3.3% of all deaths in Canada. In British Columbia, euthanasia deaths are 4.8% of all deaths and in Quebec, 4.7% of all deaths. The average age of those who were killed in 2021 by euthanasia was 76.3 years old. More men than women were euthanized: 55.3% of men and 44.7% of women ages 65-70. For ages 18-45, 55.4% of men and 44.6% of women.
According to practitioners, loss of autonomy, or ability, was the primary reason given as cause of suffering by patients. The following chart shows the reason cited by those who requested euthanasia.
|Causes of Suffering of those Killed by Euthanasia||Percentage of Patients claiming such a cause|
|Loss of ability to engage in meaningful activities||
|Loss of ability to perform activities of daily living||
|Inadequate control of pain or concern about it||
|Loss of dignity||54.3%|
|Inadequate control of symptoms other than pain (or concern about it)||
|Perceived burden on family, friends or caregivers||
|Loss of control of bodily functions||
|Isolation or loneliness||
|Emotional Distress / anxiety / existential suffering||
|No / poor / loss of quality of life||
|Loss of control / autonomy / independence||
12,286 written requests were received for MAID in 2021, representing a 27.7% increase from the 2020 data. Of these, 9,950 (81.0%) resulted in euthanasia. As for the remaining 2,336 requests (19.0%), euthanasia was not administered for the following reasons: in 1,618 cases (13.2% of written requests) the people who requested MAID died before receiving their lethal injection; in 487 of cases were considered ineligible (4.0%); 231 people withdrew their requests. As for the 4.0% determined to be ineligible for euthanasia (a decrease from 6.1% of written requests in 2020) the following reasons given were:
- A lack of capacity to make medical decisions: 33.1% of cases.
- Meeting the 3 main criteria for ineligibility: the person not experiencing suffering that is intolerable to the person requesting MAID, not being in advanced state of irreversible decline, and the not being able to provide informed consent: 20.7%
- Lack of any serious and incurable illness, disease or disability: 20.1%
- Request was not voluntary: 2.3%
People sought to be euthanized because of various health conditions. Cancer was the main underlying medical condition most associated with euthanasia at 65.6% of cases (6.8% for Non-RFND cases), the most common of which was lung cancer at 23.8% of cases, followed by colorectal cancer (12% of euthanasia deaths). Further, cardiovascular conditions accounted for 18.7% of cases. Respiratory and neurological conditions accounted for 12.4% of euthanasia deaths followed by other conditions (11.5%), multiple comorbidities (10.0%), and organ failure (8.0%).
In 2021 euthanasia was primarily carried out in private residences (44.2% of people’s deaths). The hospital setting was where 28.6% of people’s lives ended by euthanasia. Palliative care facilities accounted for 19.6% of deaths, followed by residential care facilities at 6.1%. Other settings only accounted for 1.5% of euthanasia deaths.
In all of this we see a system of checkboxes: an efficient way to detail the deaths of individuals, and the fact that we even allow for euthanizing people underpins the regime as a whole. But human beings cannot be categorized and thrown away through a series of checkboxes. One practitioner boastfully details the death of her patient: “We assessed the patient with all the rigor that the situation required given the nature of the illness and the particularities related to the amendments to the Act. The 90-day safeguard period was respected, and the patient was reminded at each visit that he could withdraw his request at any time. The patient was previously assessed and aware of all available services and seriously considered them before applying for MAID. The patient has consulted with experts to determine eligibility for MAID, as required by the bill.” Here we see the cold legalism of the euthanasia reporting system. The result is a system with boxes that are very easy to check off.
Euthanasia needs to end, and soon. When we as a country recognize the true dignity of the human person, we’ll soon realize that euthanasia is killing, and not medical care as it is falsely presented to be. When doctors take up the Hippocratic Oath once again, vowing to always help and never to harm, and when we begin to encourage others in the face of illness and in their palliative care options, offering our presence and love, we’ll realize there has never been a need for euthanasia.
Third Annual Report on Medical Assistance in Dying in Canada 2021. Health Canada, July 2022.
Schadenburg, Alex. (2023, June 17). Update on Euthanasia in Canada. Alliance for Life Ontario Conference 2023.