Thursday, August 7, 2025

Legislative and practice problems in Canada’s MAiD regime

Alex Schadenberg
Executive Director
Euthanasia Prevention Coalition


Dr Ramona Coelho and David Shannon have written a critique of Canada's (MAiD) euthanasia law that was published by the Macdonald Laurier Institute on August 6, 2025.

Dr Ramona Coelho
Coelho and Shannon are members of the Chief Coroner of Ontario’s MAiD Death Review Committee (MDRC) that has published reports several reports concerning the oversight of euthanasia in Ontario.

In their article, Coelho and Shannon outline concerns with the current euthanasia practise in Canada and they make concrete proposals for amending the law to ensure greater oversight. This article will share their concerns with the practise of euthanasia in Canada.

David Shannon
The authors first examine how Canada's euthanasia law has developed. They explain that euthanasia was legalized in 2016 and has quickly expanded since then. In March 2021, Canada's government passed Bill C-7 which expanded Canada's euthanasia law. The authors write:

In 2021, Canada legislatively extended eligibility to individuals who have physical disabilities but are not near death (Track 2) and, in the near future, to individuals whose sole underlying medical condition is mental illness. As legislators and MAiD lobbyists campaign for “access” and “choice,” evidence suggests that the safeguards intended to ensure free and informed consent while protecting vulnerable populations from wrongful death often fail or are bypassed.

The authors continue:

Ontario’s MAiD Death Review Committee (MDRC) reports, government data, and investigative journalism illustrate how MAiD can be rushed forward without a thorough exploration of the reversible sources of suffering, robust capacity assessments, or alternative options such as palliative, social, and disability supports. Under some circumstances, MAiD is more accessible than basic care, particularly for those experiencing poverty, isolation, or inadequate medical and social support. This Commentary reviews the failures of current MAiD safeguards and proposes policy changes to address them. These include improving oversight, strengthening consent and capacity assessments, and ensuring access to meaningful alternatives, especially for disabled and marginalized people at risk of wrongful death under the current regime.
The authors explain the changes in Canada's euthanasia law after Bill C-7 was passed. Bill C-7 created a two-track law whereby Track 1 approvals are based on a person having a terminal condition and Track 2 approvals are based on a person having an "irremediable medical condition." Track 1 approvals have no waiting period whereas Track 2 approvals have a 90 day waiting period.

The authors examine the Problems with MAiD - Social suffering, structural coercion, and MAiD as default “care” and write:

Health Canada reports that nearly half of Track 2 MAiD deaths involved suffering from loneliness or isolation, while almost half indicated that they felt like they were a burden. Ontario’s MAiD Death Review Committee (MDRC) found most Track 2 recipients were low-income and 61 per cent were women, a group statistically more likely to attempt suicide yet recover with care. Less than half received mental health or disability supports and less than 10 per cent received housing or income assistance. Many did not name a family member as next-of-kin, suggesting social isolation.

A 2021 University of Guelph study found that during COVID, some disabled people were encouraged to explore MAiD due to lack of resources. And in private leaked MAiD assessor and provider forums, MAiD providers have described ending lives where suffering due to poverty, loneliness, or obesity was driving the request for MAiD.

Though providers must inform applicants of alternatives for relief, there is no obligation to ensure access or assist with navigation. Providers are not required to have expertise in relevant disability or social supports, and applicants are not required to be offered information from people with lived experience who could help them navigate existing systems and offer peer support. In practice, the appearance of choice is often not backed by real alternatives.

The authors comment on Neglect of palliative care/rushed MAiD deaths and write:

Canadians lack adequate palliative care and can subsequently suffer high symptom burden, which can drive MAiD requests. Health Canada reports high levels of palliative care before MAiD deaths but does not track the timing or quality of palliative care. This tracking is self-reported by MAiD providers, which may inflate the appearance of access. For instance, in MDRC Report 2024-4, Mrs. B, denied hospice, died quickly by MAiD after her overwhelmed spouse sought urgent MAiD access. MDRC data shows clustering of same-day and next-day MAiD deaths, suggesting some providers may be more inclined to expedite MAiD over exploring the remediation of suffering.

Dr. David Henderson, a palliative care physician with the Nova Scotia Health Authority, testified that health professionals have effectively been given “a licence to kill” without sufficient safeguards. He testified that MAiD assessments often bypass the root causes of suffering.

While polls show that Canadians prioritize expanding palliative care over MAiD, access to the former remains inadequate while MAiD expands.

The next topic is A lack of free and informed consent/ limited virtual assessments. The authors write:

As early as 2020, Ontario’s chief coroner identified cases where patients received MAiD without well-documented capacity assessments, even though their medical records suggested they lacked capacity. MDRC reports also raise serious concerns about cases where MAiD proceeded despite questionable consent or capacity. These include instances where patients showed signs of cognitive decline or were heavily sedated, or where assessments were rushed or based on minimal interaction. Some relied on prior waivers without confirming whether the patient still wished to die. Some patients were even assessed virtually, raising serious concerns about the integrity of the capacity and evaluation process.

The next topic is CAMAP’s influence on MAiD practice and Health Canada’s carelessness. The authors write:

The Canadian Association of MAiD Assessors and Providers (CAMAP) wields immense influence over clinical MAiD practice through educational curricula. Its work is funded by at least $3.3 million from Health Canada. CAMAP’s materials encourage providers to raise the options of MAiD with eligible patients, shifting the initiative from a patient-led request to a clinician-suggested intervention. One BBC documentary recounted how hospital staff repeatedly raised the option of MAiD to a dying woman. This cultural normalization has spread beyond MAiD specialists: a disabled veteran seeking home supports had a Veterans Affairs caseworker suggest MAiD instead.

CAMAP guidance allows for interpretation of the “reasonably foreseeable natural death” criterion to permit Track 2 patients to decline treatments, worsening their health status to make their death reasonably foreseeable, thereby qualifying them to have their life immediately ended as at least one MDRC reviewed case has documented.

Health Canada has created a “Model Practice Standard for MAiD,” which, among other troubling provisions, includes labelling all clinicians who object to providing MAiD, even in specific cases, as conscientious objectors. This designation can trigger mandatory referral obligations in certain provinces and entrenchs a system that funnels patients toward death. In a recorded CAMAP training session a trainee asks about withdrawing if MAiD is being driven by socioeconomic reasons. The expert affirms the right to withdraw but concludes, “You’ll then have to refer the person on to somebody else, who may hopefully fulfill the request in the end.” This “effective referral” mechanism subverts any pause or stopping MAiD for genuine assessment or care.

This effective referral loophole is exemplified by an Ottawa woman who was referred to a Brampton MAiD provider after multiple local assessors deemed her ineligible for MAiD.

The next topic is Legislative ambiguities and oversight failures. The authors write:

Canada’s MAiD framework suffers from significant legislative ambiguity and lacks real-time oversight. The Criminal Code defines a “grievous and irremediable medical condition” using vague and subjective terms. “Irreversible decline in capability,” “intolerable suffering,” and, for Track 1, a “reasonably foreseeable natural death, “provide no objective medical metrics or standardized thresholds” and so have been open to broad interpretation by MAiD assessors, with no requirement for external validation.

MAiD is governed under the Criminal Code of Canada, so violations such as inducement or failure to meet eligibility and procedural safeguards must be proven beyond a reasonable doubt, a deliberately high legal threshold. Physicians and nurse practitioners can claim a defence of acting in good faith, even if they do make a mistake. This makes accountability for criminal negligence or abuse extraordinarily difficult to establish.

Alan Nichols, who had hearing loss and mild cognitive disabilities, was admitted under the Mental Health Act and was approved for MAiD during his admission, despite having no known terminal illness and over his family’s objections. In another case, Donna Duncan, who sustained a concussion and had been awaiting specialized care, received MAiD within days of her first assessment, despite her adult daughters’ serious concerns. Both families have had no recourse despite endless efforts, including contacting the relevant regulatory and police authorities. Former Justice Minister Lametti has insisted that oversight lies with families to make complaints after a death yet their remains no process to do so.

The next area of concern is how euthanasia is Marketed as “choice,” but international alarm over coercion and suicide contagion. The authors write:

Canada’s MAiD regime is frequently framed as an expression of personal autonomy and choice. Yet a troubling reality exists: vulnerable individuals can be steered toward MAiD in ways that mirror structural coercion and violate established suicide prevention principles.

A patient seeking emergency psychiatric care for suicidality was instead informed about MAiD. Such responses undermine the core principles of suicide prevention where messaging that promotes death and access to lethal means, of which MAiD does both, exacerbates risk of suicide.

A striking example of MAiD’s romanticization is the short film All is Beauty, sponsored by Canadian retailer Simons. It depicts a young woman, Jennyfer Hatch, surrounded by loved ones in peaceful natural settings as she reflects on the beauty of life just before having MAiD. A national news outlet revealed that Hatch had spoken publicly (under a pseudonym) about her struggles to access palliative care that she hoped would make her life better. This marketing campaign transformed a preventable tragedy into aestheticized “choice,” aiming to mask the systemic abandonment that ended her life.

Canada’s increasingly permissive MAiD legislation and practice has also drawn sharp international rebuke. Canada’s MAiD regime broadened rapidly and by 2027 is set to include requests based solely on mental illness. Quebec’s advance directive model has proceeded unchallenged despite breaking federal criminal law. In March 2025, the United Nations Convention on the Rights of Persons with Disabilities (CRPD) condemned Canada’s MAiD expansion as inherently discriminatory and ableist. The Committee called for an immediate repeal of Track 2 eligibility (non-terminal conditions), a moratorium on advance requests and MAiD for mature minors, and urgent reforms to restore protections and real oversight.

I do not believe that euthanasia (MAiD) can ever be "safely" instituted therefore I will not comment on the possibility of improving safeguards. Euthanasia is an act of killing and it is never justified. You can read the original article for this information (Link to the article).

The authors offered great insight into the problems with Canada's euthanasia regime. Canada should be viewed as the canary in the coal mine. Don't follow Canada's lead.

Ramona Coelho, MDCM, CCFP is a senior fellow for domestic and health policy, at the Macdonald-Laurier Institute, an adjunct research professor of family medicine, Schulich School of Medicine and Dentistry, Western University, and the co-editor of Unravelling MAiD in Canada: Euthanasia and Assisted Suicide as Medical Care (McGill-Queen’s University Press, 2025).

David Shannon, CM, OC, OOnt, LLM is a Canadian lawyer and disability/human rights activist. Shannon has advised governments across Canada and is the recipient of both the Order of Canada and Order of Ontario for his contributions to human rights. He is the co-editor of Medical Assistance in Dying (MAiD) in Canada: Key Multidisciplinary Perspectives (Springer, 2023).

Important - Sign the Petition: Roger Foley needs to be fed.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Sign the Petition: Roger Foley needs to be fed. (Petition Link)

I once again visited Roger Foley at the London Health Sciences Centre (LHSC) (Victoria Hospital Campus) to get an update on his care based on the concerning emails that I have been receiving.

Once again, Roger Foley is not being fed.

On June 12, 2025 EPC launched a petition to the Ontario Minister of Health Hon. Sylvia Jones, and LHSC Patient Relations, stating that Roger Foley needs to be fed. At that point Roger had not been fed for five weeks.

LHSC had inserted an IV that provided fluids and some essential nutrients but they were not feeding Roger. After we launched the petition the LHSC agreed to provide a limited feeding for Roger. More recently his IV was removed and the LHSC is only providing water.

Roger lives with Spino cerebellar ataxia type 14, a degenerative neurological condition. Roger is able to be fed normally, with assistance but his condition causes him to have severe photo sensitivity (photophobia) to regular lighting.  

The stand-off between the hospital and Roger concerns the level of lighting. The staff insist that it is not safe to feed Roger without more light but Roger insists that his reaction to the regular lighting is so intense that he requires special lighting. Recently Roger contacted the CNIB who confirmed that he has severe photo sensitivity.
 
It is ridiculous that an Ontario hospital is not feeding a man with a degenerative neurological condition who is capable of eating with assistance. It takes a long time to die by starvation but without nutrition Roger will die.

Roger cannot live on water alone and he couldn't live (long term) with an IV alone.  
 
He is able to eat with assistance. Roger needs to be fed.

Sign and share the Petition: Roger Foley needs to be fed. (Petition Link)

If you live in London Ontario and are willing to visit Roger, contact me at: alex@epcc.ca

Previous articles:
  • Alex Schadenberg and Roger Foley on the cruelty of Canada's euthanasia regime (Link).
  • June 12, 2025 - Roger Foley needs to be fed (Link).
  • Visiting Roger Foley. Join the Roger Foley team (Link).

Irish woman learns about mother's assisted suicide death through WhatsApp

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Eliana Nunes reported for the Sun (UK) on August 5, 2025 that An Irish family was left devastated after allegedly receiving a text from a Swiss assisted dying clinic that their mum was dead and her ashes would be sent by post.

As reported in the Sun:

Maureen Slough, a 58-year-old from Cavan, travelled to the Pegasos clinic on July 8 to seek an assisted death - without her family's knowledge - according to the Irish Independent. 

Maureen reportedly told her family that she and a friend were going to Lithuania.

Her partner, Mick Lynch didn't even know about her impending death. The report states: 

"I was actually talking to her that morning and she was full of life,"

"She said after having her breakfast... she was going out to sit in the sun. Maybe she was heading off to that place. I still thought she was coming home."

Maureen and Megan
The report indicated that her daughter, Megan Royal, received a WhatsApp message from the suicide clinic stating that her mother had died while listening to gospel music by Elvis Presley. The report continued:

The family is shocked that the clinic would accept an application for assisted dying from Maureen, who they say had long struggled with mental illness.

She had also attempted suicide a year prior, after the deaths of her two sisters, according to the family.

Adding to their dismay, the family claims the clinic never informed them of her plans.

Friends are reportedly horrified by the clinic's method of returning the ashes via parcel post.

The report indicated that the family found out Maureen had paid a reported £13,000 to the Pegasos Swiss Association to assist her death.

The report also indicated that there is a dispute about communication. Pegasus claims that Megan (Maureen's daughter) sent a letter to Pegasos accepting her mother's death plan and confirmed it by email. Megan stated that the letter and email were fake.

The report stated that: 

Maureen's brother wants the Foreign, Commonwealth and Development Office, along with Swiss authorities, to conduct an investigation.

"I am working on the assumption that my sister created this email and the clinic’s procedures were woefully inadequate in verification," he wrote.

"The Pegasos clinic has faced numerous criticisms in the UK for their practices with British nationals, and the circumstances in which my sister took her life are highly questionable."

Pegasos claims that they carried out an extensive assessment of Maureen's mental health - including an independent psychiatric evaluation. Pegasos also claims that: Maureen told the clinic she was in unbearable and unrelievable chronic pain and that they received supporting medical documentation from her pain-management consultant.

The report concluded with:

Maureen's family's story is not unique.

Other families have also hit out at Pegasos, claiming they were left in the dark about their loved ones’ plans to go through with assisted deaths.

In 2023, Pegasos reportedly vowed to contact a person's relatives beforehand after 47-year-old teacher Alistair Hamilton - who had no diagnosed illness - died, leaving his family shocked.

However, in 2025, the organisation appeared to break this promise.

Anne Canning, a 51-year-old British mum, who was battling depression after the sudden death of her son 19 months prior, ended her life at the clinic, ITV reported.

Previous articles concerning the Pegasos suicide clinic:

  • Swiss assisted suicide clinic facing lawsuit and questions concerning foreign suicides (Link). 
  • A mother's warning about the death of her son by assisted suicide in Switzerland (Link). 
  • Euthanasia activist, Sean Davison, arrested in London England concerning the death of a 79-year-old woman (Link).
  • Swiss assisted suicide clinic's many controversial deaths (Link)
  • My husbands death made me more opposed to assisted suicide (Link).
  • Swiss study: Legalizing assisted suicide does not lessen the number of common suicides (Link).

EPC-USA's Broad Coalition Participated in the American Academy of Family Physicians conference.

Colleen E. Barry

The cost to attend medical conferences is prohibitive. Consider donating to the EPC - USA (Donation Link).

The American Academy of Family Physicians (AAFP) FUTURE conference held from July 31 - August 2 in brought together medical students and residents from across the nation with family medicine leaders, residency programs and potential employers for three days of family medicine exploration + celebration." Event. Euthanasia Prevention Coalition (EPC) - USA had an Honor and opportunity to participate in the "AAFPFUTURE" Conference. 

Part of EPC-USAs' goals are to educate the public along with professionals on issues related to euthanasia, assisted suicide and their effect on society. We provided educational materials, discussions. Assisted Suicide is fundamentally incompatible with the physician’s role as healer. EPC-USA recognizes that Doctors are the original opponents of assisted suicide.

EPC-USA was grateful with the many discussions as well as a great amount of basic information given to participants, including resources and follow up material from Dr. Sharon Quick, President of "Physicians for Compassionate Care educational Foundation". Dr. Quick has expressed that: 

“A death request is often a plea for help, but legalizing assisted suicide may allow an option to die to transform into a duty to die.”
EPC-USA was able to educate Medical Students and a broad coalition of doctors, medical professionals and attorneys about people who have experienced the direct threat of assisted suicide against themselves or a family member. EPC-USA shared the history of Disability groups such as Not Dead Yet, Second Thoughts and DREDF (Disability Rights Education & Defense Fund), just to name a few who have been at the fore front to stop assisted suicide. 

A monumental past leader of DREDF, Marilyn Golden stated: 

“If these bills pass, some people’s lives will be ended without their consent, through mistakes and abuse.” “No safeguards have ever been enacted or proposed that can prevent this outcome, which can never be undone.”
EPC-USA was able too share the many successes when state coalitions encompassing a broad variety of individuals and groups led their state legislators to understand their concern and opposition to assisted suicide. 

One of EPC-USA’s missions is to combat the growing acceptance of assisted suicide through advocacy and education. The broad variety of individuals and groups includes progressive's as well as conservatives, includes a disability and human justice-based movement to prevent the legalization of assisted suicide and euthanasia and to end these practices where they exist. Assisted suicide cuts to the heart of what kind of society we want to live in.

Discussions with conference participants included physicians explaining that their care of patients, must establish a physician-patient relationship based on mutual trust and respect to be able to render the best care to their patients. Not assisted suicide. 

Many Medical students and residents were very appreciative to see EPC-USA's booth and expressed the concerns that they have with assisted suicide. These medical students expressed their goal of caring for many patients throughout their lives, extending through to their last days of life.

There were residents, medical students and physicians that were surprised to see our booth and expressed confusion. It was a great opportunity for EPC-USA to share basic information, discussion and provide resources from others doctors that have actively taken a stand to help society realize the problems with assisted suicide. These doctors explain that assisted suicide is Not a Therapy or a Solution.

EPC-USA professionals in attendance were so successful that we ran out of educational material and resources including a the story of a doctor working with a patient that qualified for assisted suicide. The doctor knew that the patient was caught up in the hype of the newly passed assisted suicide law in Oregon and was depressed by a new prognosis. The doctor guided the patient out of out the depression. The patient is still alive and well today. EPC-USA also ran out of educational material on a list of coercion and complications cases that is provided by a disability rights group.

Assisted Suicide is not a type of medical treatment. And affects the nature of medical treatment in our society.

Our table at the American Academy of Family Physicians (AAFP) FUTURE conference was an incredible success.

The cost to attend medical conferences is prohibitive. Donate to the Euthanasia Prevention Coalition (EPC) - USA (Donation Link).

Colleen Barry is a nurse and the Chair of the Euthanasia Prevention Coalition (EPC) - USA

Wednesday, August 6, 2025

My story: No to MAiD for Mental Illness.

The following true story was sent to our EPC "Story Contest."

You can visit our "contributor info" (Link) "recent stories" (Link) and "story index" (Link). All formats are welcome, especially short videos. We would be thrilled to receive your story at: story@epcc.ca

By Peter Oliver

My Condition

Peter Oliver
I'm a 61-year-old man and I have experienced depression for more than forty years. It is chronic, meaning that it is a long-term condition and there is no reason to believe it will ever be relieved. It is also constant, meaning that there is never an occasion when I do not feel some level of depression. It is sometimes debilitating, meaning that profound feelings of tiredness, hopelessness, pessimism, despair and self-critical thinking become so overwhelming that, on some occasions, I must withdraw to a darkened room for several hours and sit quietly until these harmful feelings lighten up.

Interventions


Over the last 40 plus years, I have had the support of 4 psychologists and 1 psychiatrist who have provided quite literally 100s of hours of professional support. Medications, exercise, meditation, cognitive-behavioral therapy, supportive community, proper diet, reading, hobbies, journaling and prayer are all part of the regime of interventions that play a role in addressing my condition. Despite the disciplined and sustained attention to these interventions my depression remains constant, chronic and sometimes debilitating.

My Life


My wife and I have been happily married for 30 years, and we have three adult children. All of our children have completed university educations, and they are beginning to establish stable living situations. Two of them experience significant levels of mental distress.

My professional formation includes studies in psychiatric nursing, a philosophy degree, and a Masters degree in pastoral theology. I have worked in a variety of labor positions (farm, factory, construction) have acted as a care aid to a man dying from MS, have been a camp councillor for children who have disabilities, been a teacher's assistant in support of severely disabled children, acted as a pastoral assistant in a Roman Catholic parish, provided chaplaincy services in both provincial and federal corrections, and currently, I am the Executive Director of the Catholic Health Association of Saskatchewan.

Approximately 8 years ago I was diagnosed with colon cancer. This was successfully treated by a partial colectomy. My wife wittily says, he used to have a colon now he has a semicolon (ha, ha).

While still in the hospital and in a particularly vulnerable state, arising from being twenty-five days without food, I was informed that my employment was terminated. Recovery from the surgery and finding a new avenue for employment took a full year.

I include this because it seems important to recognize that mental health challenges are further complicated by other life events.

Family of Origin

My father, a farmer, who worked hard and did his best to love his family, was deeply, chronically and constantly depressed as well. He did not have any of the assistance that I have been privileged to receive. It was a mood disorder which found expression in ruminative behaviour (in hours of swearing throughout the night), rejection of bathing, angry outbursts, and paralyzed communication. These were some of the primary ingredients of my childhood.

He died at 73 (unlike his other 5 siblings who live into their 80s and 90s) and I would submit that depression was a significant contributor to his earlier death.

My mother, born during the second world war, and a person of remarkable grit, struggled mightily with the challenges of my father’s mental health but successfully navigated them, raising six children who have become contributing members of our country in farming, healthcare, the service industry, and pastoral care.

Medical Assistance in Dying (MAiD)

The Government of Canada website on assisted suicide, euphemistically referred to as Medical Assistance in Dying (MAiD) states: 

"Important: On February 29, 2024, legislation to extend the temporary exclusion of eligibility to receive MAID in circumstances where a person's sole underlying medical condition is a mental illness received royal assent and immediately came into effect. The eligibility date for persons suffering solely from a mental illness is now March 17, 2027.”
As of March 17, 2027, I will qualify to be assessed for assisted suicide. The primary issue would be, do I find the depression I experience intolerable? It is fair to say, I could make an excellent case for a positive assessment.

So, allow me be blunt about the implication of these changes.

A positive assessment would mean, the Government of Canada believes that a legitimate response to my condition is to have a medical professional inject a poisonous substance into my arm causing my death.

Sign our EPC petition: No MAiD for Mental Illness (Link).

I Am Offended

With many other people from the mental health and disability community, I AM OFFENDED!  

The Government of Canada, which is charged with the responsibility of fostering the fullness of life for its citizens, is prepared to activate legislation that says, "We agree with you. You would be better off dead!" 

After years of disciplined and constructive action in relation to my condition, am I now to live in a country that invests millions of dollars employing the services of medical professionals who will end the lives of people "whose sole underlying medical condition is a mental illness"? Am I now to live in a country that clearly states in word and action, “some depressed people are better off dead”?

Expectations

What I expect from the government of Canada is a resounding message and actions that say, "We stand on guard for you." We strive to build a nation of courageous people who can meet affliction, ordeal, and privation with fortitude. Where no individual is thought of as “better off dead”. 

As the saying goes, you can't serve two masters. One you will honour and one you will despise. You cannot build a great nation that simultaneously expects its medical professionals to provide healing, hope, and encouragement while also supporting legislation that provides a mandate for doctors and nurses to kill depressed patients. The result is inevitable, our citizen’s respect for people with mental health concerns will erode and our nation will begin to glorify assisted suicide.

As a person whose family has struggled with mental health, whose children strive to meet mental health concerns, and who daily meets the challenges of a mental health condition, this is not what we need and not what we want!

*Sharing a story about your struggle with mental illness is difficult but it is necessary for supporting Bill C-218 that will prevent MAiD for Mental Illness alone.

Sign our EPC petition: No MAiD for Mental Illness (Link).