Lancet: Worries grow about Medical Assistance in Dying in Canada.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Paul Webster was published in the Lancet on September 10, 2022 with an article titled: Worries grow about Medical Assistance in Dying in Canada. 

It is significant that a medical journal was specifically interested in uncovering the problems with Canada's euthanasia law.

Webster interview was not biased. Webster also interviewed Helen Long from the euthanasia lobby group, Dying With Dignity Canada.

Webster sets the stage for his article by interviewing Trudo Lemmens, a health law specialist at the University of Toronto who has tracked the impacts of Canada’s medical assistance in dying (MAID) legislation since it was first enacted in 2016. Lemmens reportedly states:

“Even before the law is set to be expanded to include mentally ill patients, we already have worryingly

high numbers of people dying,” says Lemmens, who argues that Canada’s approach is far more permissive than comparator nations, including Belgium and the Netherlands. “We’ve failed to sufficiently safeguard against the medicalisation of ageing.”

Lemmens told Webster that Canada's MAiD numbers are quickly bypassing the deaths in the Netherlands and Belgium. He then says:

Amid this expansion, Lemmens warns that the current numbers of patients dying are already a “red flag”, indicating a possible over- permissiveness on the part of some Canadian physicians who care for patients seeking death.

Lemmens explains the difference between Canada's euthanasia law and the Netherlands and Belgian laws.

Unlike in Belgium and Netherlands, where physicians are required to pursue mental illness treatment options with their patients,” says Lemmens, “this idea has been abandoned in Canada, where patients can simply say they don’t want treatment.”

Lemmens is referring to people who are asking for euthanasia for mental illness alone.

Webster explains that the parliamentary review of the law which was supposed to occur in 2020 - 21 is now happening. He asked about my thoughts concerning the review.

“The parliamentary committee has a very limited mandate,” Schadenberg notes. “We think the MAID law should be fully reviewed, and in the meantime we should go back to the original law passed in 2016.”

Schadenberg says that the Canadian Government’s management of the legal reforms to the 2016 MAID law, which included a decision not to appeal the Quebec lower court decision that paved the way for the decision to greatly expand access to MAID, has created a situation where “it’s becoming easier to get death than treatment”.

Some international observers share the concerns of Lemmens and Schadenberg. Last year, a team of special rapporteurs for the UN warned that Canada’s liberalisation of medically assisted dying posed threats to its older and infirm populations.

I was stating that the MAiD law should be fully reviewed. We do not support the original law, but I was responding to the point of what should happen as they review the law.

Webster also interviewed Helen Long, the President of the euthanasia lobby group Dying With Dignity who told Webster that:

While citing data indicating that people with cancers, as well as those with cardiovascular, neurological, and respiratory diseases, account for around 95% of all medically assisted deaths in Canada, Long argues that existing safeguards within the new law passed in 2021 are sufficient. “We don’t see any evidence of problems,” she insists.

In this context, Long says that she sees the expansion of the law to include patients with mental illnesses as “a good thing”. She anticipates that “the number of people with mental illnesses who seek and obtain MAID will be miniscule”.

Webster finishes the article by interviewing Deborah Wise Harris, Communications Manager for the Canadian Mental Health Association who was wrongly quoted stating that their group originally opposed euthanasia for mental illness but they have changed their position.

The position of the Canadian Mental Health Association remains opposed to euthanasia for mental illness alone (Link to their position) (Link to a recent interview).

Webster asked difficult questions and interviewed me in a fashion that was not biased. I am pleased that the Lancet were interested in the topic and I am also pleased that the article exposes our concerns with Canada's euthanasia law. 

There are many countries that are currently debating euthanasia. They need to examine Canada's experience with euthanasia, reject the concept of euthanasia and provide caring options not killing options for their citizens.