Euthanasia (MAiD) - Compassion or Neglect?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Euthanasia is abandonment.

The Toronto Star, one of Canada's most liberal newspapers, published an opinion article by Andrew Phillips on October 7 titled: What’s behind these MAID decisions — compassion or neglect?

Phillips, a Toronto Star staff columnist, examines some of the stories from the recent reports from the Ontario Coroners committee that examines the (MAiD) euthanasia reports in Ontario. Philips writes:

Should our public health care system end the life of a man who requests an assisted death mainly because he’s distraught and lonely following the death of his wife? Or a woman who is morbidly obese, refuses all treatment and says she’s lost the will to live?

What about an elderly woman who’s suffering from dementia, whose request to die is brought forward by a family member, and whose final consent for assisted dying involves “squeezing the provider’s hand?” Or a man in his 80s, also diagnosed with dementia, who has been assessed for medical assistance in dying (MAID) while suffering from delirium?

All these cases are included in two recent reports from the MAID Death Review Committee released by the Office of the Chief Coroner of Ontario. Together they raise troubling questions about the decision-making that goes into approving some of the deaths under Canada’s system of assisted dying.

The first report is the review committee’s look at MAID deaths in Ontario during 2024. It addresses the case of a man in his 70s identified as “Mr. C,” who had an essential tremor, a condition that caused his hands to shake.

He was grieving the death of his wife and the tremor “impacted his esteem and self-confidence.” According to the report he “had not been able to create a new life path with meaningful relationships and a sense of purpose … He requested to access MAID due to same.” Some members of the committee worried that his request for MAID “appeared to be primarily motivated by social withdrawal, grief and hopelessness.”

Then there’s Mrs. A, the morbidly obese woman who refused treatment. MAID assessors said her condition could improve with treatment, but they decided her death was “reasonably foreseeable” because she would not accept it and approved her for an assisted death.

Is that compassion, or neglect?

The second report focuses on the 103 people in Ontario who accessed MAID in 2023-24 while suffering from dementia.

The most troubling case is that of “Mrs. 6F,” a woman in her 80s admitted to hospital with “moderately advanced dementia.” A family member told her care team that the woman had expressed a “wish to die,” but after discussions with a MAID provider she decided to move into long-term care.

Four months later a family member again initiated a request for MAID on her behalf. According to the report, Mrs. 6F was assessed by a MAID provider in the presence of a family member. She attempted to sign the consent form but her signature was illegible. A “third-party signer” was engaged to do it for her.

On the day of the procedure, “final express consent was determined based on Mrs. 6F’s ability to repeat the consent question and via squeezing the provider’s hand.”

Some members of the death review committee were clearly troubled by all this. Did Mrs. 6F fully realize what was going on? Was her final consent to her own death properly obtained? Was there family pressure for her to agree to MAID?

In the case of “Mr. 6D,” the man in his 80s who was assessed for MAID while suffering from delirium brought on by an abdominal infection, some committee members raised the obvious question. Can informed consent truly be obtained while someone is in the midst of an acute health situation? “These members noted that Mr. 6D’s decision-making may have been influence by potentially reversible functional impairments associated with his delirium.”

The language is impersonal and detached but behind it is a very real concern among some professionals who are very familiar with the system that something is going quite wrong.

It’s true that the great majority (95.9 per cent) of MAID cases involve people whose deaths are “reasonably foreseeable” and who are suffering from terminal conditions, mainly cancer. Cases like those of Mr. C and Mrs. 6F are comparatively few and far between — which is precisely why the review committee took such a close look at them.

But given the stakes involved — literally life and death — every case is vital.

If the public health system we all have a stake in is killing people because they’re just lonely or troubled, that’s something we should all care about. And if even a few people are being ushered out when there are real questions about whether they’ve fully agreed to what’s happening, that’s even worse.

It’s not just about their “choice.” It’s about what kind of system we’ve all chosen.

It is good that Phillips is honest and calls it killing, because that is what it is. 

Phillips should not feel so sure that the 95.9% of the MAiD deaths that are based on a terminally ill person who are "suffering" are not problematic. Even the case of the woman who was obese and refused treatment was classified as one of the 95.9% since she was classified as having a death that was reasonably forseeable.

Nonetheless, Phillips and the Toronto Star have done a great service to truth by publishing this article that outlines some of the outcomes of legalizing medicalized killing.

Links to more articles on this topic:

• How euthanasia fails Canada's most vulnerable (Link). 
• Euthanasia for Canadians who are not terminally ill (Link). 
• Canadian with dementia euthanized at family's request (Link). 
• Dementia patient died by euthanasia, Family made the request (Link). 
• There were around 16,500 Canadian euthanasia deaths in 2024 (Link).