British Medical Association Requires Doctors to Help Patients Commit Suicide by Dehyrdration.

This article was published by National Review online on August 19, 2026.

Wesley Smith

By Wesley J Smith

The subtitle of the revised and updated version of my book criticizing utilitarian bioethics, Culture of Death, is, “The Age of ‘Do Harm’ Medicine.” Helping patients kill themselves by self-starvation and dehydration — known in euthanasia parlance as VSED (for voluntary stopping eating and drinking) — certainly fits that designation.

Two major medical associations now have endorsed doctors assisting in such suicides by palliating the painful symptoms to help patients go all the way to death. The first was the American Academy of Hospice and Palliative Medicine (AAHPM) in 2023. This is especially notable because the organization shamefully went “neutral” on the legalization of assisted suicide, despite that action being the antithesis of the hospice philosophy enunciated by the great medical humanitarian Dame Cecily Saunders. The AAHPM’s journal also published a piece recently endorsing intentionally undernourishing dementia patients under certain conditions (MCF, or “minimal comfort feeding”) — VSED in slow motion, if you will.

Now, another “do harm” shoe has dropped. The British Medical Association has issued an ethical guidance that requires practitioners to participate in VSED when asked to do so by a patient. While the AAHPM guidance assumes that the act will only be done by terminally ill or seriously ill or disabled patients, the BMA guidance notably acknowledges that even those not in ill health can kill themselves in this slow manner — and that doctors must further the suicide palliatively. From the guidance (my emphasis):

We start from a position of understanding that: – patients with capacity are entitled to make decisions about treatment refusals and about their nutrition and hydration, including to voluntarily stop eating and drinking in order to hasten their death;– there is no requirement in the law that a patient needs to be ill or at the end of life to decide to voluntarily stop eating and drinking in order to hasten their death.

All doctors so requested are expected by the BMA to participate in VSED by assessing patients and easing symptoms; indeed, the guidance asserts that it is an ethical duty for doctors to be complicit in such suicides:

When an adult patient has made the decision to elect to VSED, the doctor’s initial responsibility is to assess the patient to check that: (1) the patient has the capacity to make the decision; (2) the patient’s decision is not a symptom of a mental disorder; and (3) the patient’s decision is being made free from coercion.

If the three criteria above are fulfilled, doctors have a professional duty to provide palliative care and symptom relief to their patient. The doctor’s role is not to consider whether the patient’s decision is rational, reasonable, or sensible. It is not for doctors to decide whether the patient should be permitted to end their life in this way. [Emphasis added.]

It’s one thing to say doctors can’t stop a suicidal patient from self-starvation — although one would think that suicide prevention would be on the table of which there is no mention in the guidance. But it is quite another to require doctors’ participation in such suicides.

A stunted conscientious objection clause is endorsed, but it is an essentially meaningless protection, with complicity in the preparation process still required.

Doctors cannot exercise a conscientious objection to seeing or having an initial consultation with their patient. However, some doctors may wish to exercise a conscientious objection to carrying out the detailed assessments (see section 3) and/or providing symptom relief, such as analgesics or palliative sedation (see section 4). Doctors exercising a conscientious objection must follow professional guidance and ensure that there is someone else available to take over the detailed assessments and the patient’s care without delay or detriment to the patient. This means that, with the patient’s consent, doctors must pass on their assessment and care to another doctor who is willing to provide that support. [Emphasis added.]

In other words, forced procurement of another doctor who is willing to help the patient commit suicide. And if the patient says no or another doctor can’t be found? It would seem that the original physician would have no choice but to provide whatever support is required to get the patient dead.

Suicide nihilism is exerting an ever-stronger gravitational pull in the West, with doctors increasingly expected to wield their expertise as so many death order-takers. The AAHPM’s and BMA’s blessing of physician participation in VSED deepens that darkness and strengthens the culture of death.

Doctor admits to killing patient with mental illness by euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Bill C-218 is a private members bill that is being debated in Canada. If passed Bill C-218 would prevent euthanasia for mental illness alone in Canada.

• Guide to supporting Bill C-218 (Link).
• No MAiD for Mental Illness (Link).

An article that was published in the Toronto Star on December 13, 2025 titled: Should MAiD be extended to include those with mental illness? is a debate between Dr Ellen Wiebe, Canada's most notorious euthanasia killer and Dr John Maher, a psychiatrist and ethicist who focuses on caring for people with severe and persistent mental illnesses.

Dr Ellen Wiebe

Based on the language of the law, if MAiD for Mental Illness alone begins in March 2027, Dr Maher's patient group would possibly qualify to be poisoned to death in Canada. 

The article begins:

Dr. Ellen Wiebe: I believe that Canadians have a right to control their dying proces and that those rights shouldn't be limited by a diagnosis. If someone has a psychiatric illness, they should have the same right to choose MAiD as someone with a physical illness.

Dr John Maher: I oppose MAiD for mental illness because it robs people of hope. It normalizes suicide.

Wiebe: I have done probably 1,000 MAiD assessments. The law says that two clinicians must assess and fine someone eligible for MAiD.

Maher: I know you've done 1,000 but that's my concern; that the criteria are so easily met. I worry that people will go doctor shopping until they get the answer they want.

Dr. John Maher

Dr Wiebe believes that euthanasia should be available for people with psychiatric conditions. The debate continued:

Wiebe: The guidelines say a person is eligible for MAiD when no reasonable treatments remain. What is "reasonable" is decided by the clinician and the patient together. A condition is considered incurable when it's symptoms cannot be sufficiently or enduringly relieved.

Maher: But patients don't know whether their condition is incurable. They can't. They come to you for treatment, for your professional expertise.

Wiebe expresses that there are no clear euthanasia guidelines in Canada. The debate continues:

Wiebe: The issue is that we don't know exactly what causes each psychiatric condition. We know there are genetic factors. We know there are brain structure factors. We know there are brain chemistry factors. The difference between psychiatric illnesses and neurological conditions such as dementia is unclear.

Maher: Psychiatric illnesses are treatable. Dementia is not. They are very different. Dementia is a neuro-degenerative disease. Most psychiatric disorders can be treated. And you cannot predict who will recover and who won't.

I have seen people recover after 20 years of severe psychotic illness. I have treated patients who were told they would never improve, and they did. There is an accumulation of wisdom. And respectfully, you don't have the psychiatric expertise that I do.

Wiebe tries to convince a psychiatrist that she understands psychiatry. Wiebe outlines the euthanasia death of a person with mental illess:

Wiebe: No I use professional guidance. I provided MAiD for mental illness before legislation excluded it. My patient, E.F., had seven years of treatment by numerous psychiatrists for a severe conversion disorder (a psychiatric condtion where a person experiences unexplained physical symptoms.)

Maher: Yes, a very shocking case that she got approved; a woman whose suffering was real but whose illness was psychiatric, not terminal.

Wiebe: The issue was how much more she had to suffer. She had the right to say, "I am not suffering anymore."

Maher: Agreed. Our laws allow patients to refuse treatment, unlike in Belgium, the Netherlands and Luxembourg, where doctors must ensure that all reasonable medical and psychiatric treatments have been attempted and proven ineffective before assisted dying can be considered.

Wiebe: For E.F. I reviewed extensive psychiatric documentation. I was satisfied she met the criteria for MAiD. She suffered from 5 physical conditions (including migranes, digestive failure, and limited mobility) that together caused unbearable suffering and tried every treatment that was considered possibly effective.

Maher: You may believe she did, but I know psychiatrists who reviewed the case and were shocked by the treatments that were not attempted.

You have said that you would provide MAiD to people on wait-lists for treatment, by assessing their suffering at that point in time. But the law says patients must have an irremediable condition. That condition is not met if someone does not wait for treatments that may help.

We have a system that doesn't provide adequate care. Only one in three Canadians receive adequate mental-health care in a timely manner, and only one in five children.

Maher points out that the psychiatric euthanasia case that Wiebe carried-out was shocking. The debate continued:

Wiebe: People who choose MAiD want death to be certain. They do not want secrecy. They want to be able to invite their friends. For E.F. we had 10 family members and friends present to support her, tell her how proud they were and give her hugs. That is not suicide.

Maher: I acknowledge that patients with mental illnesses are suffering. These are terrible diseases. But if someone is taking steps to arrange their own death - that is a suicidal plan.

If you are going to offer someone death, you rob them of hope. If you are going to say, "There is nothing more we can do," then it should be true.

Wiebe wants to assure us that E.F.'s death was supported by her family but Maher points out that she was robbed of hope. The debated continued:

Wiebe: MAiD providers must determine whether a patient has the capacity to make a sound medical decision. Patients must be able to understand the consequences of both treatment and refusing treatment.

We are not talking about life or death. We are talking about dying now or dying later.

For mental health cases, I am more likely to need additional corroboration. I would also consult psychiatrist colleagues when I have questions.

It is concerning that Wiebe would suggest that these are not cases of life or death, the debate continued:

Maher: Many people suffering from mental illnesses are pushed to the fringes of society, facing both stigma and poverty. Many people I work with survive on food banks and live in bedbug  and cockroach infested rooms. You walk into these places and think, this cannot be Canada. To then offer them death deeps their vulnerability.

Wiebe: Most of our assisted dying patients are wealthy, well-educated and in charge of their lives.

We do have some vulnerable people, and it factors into our assessment. I look at people in the places you describe, with cockroaches, and ask myself; if the patient were rich, would he want to live longer? I cannot make him rich, and he has a horrible illness causing unbearable suffering, so I let him make his decision.

Maher states that many of his patients, with mental illness, live in poverty, while Wiebe states that most of her killings are wealthy people. The debate continues:

Maher: I understand your goal of relieving suffering. I understand your goal of respecting what patients want. But what confuses me is how you can offer MAiD to people with mental illness who could recover and live long, full lives. How are you able to do that?

Wiebe: I think providing MAiD for people with mental illnesses will be similar to Track 2 cases now (where death is not reasonably foreseeable). When I see someone with chronic fatigue or chronic pain, I need to know they have tried accepted treatments. I will be doing the same when the time comes for mental illness. I have learned from providers in Belgium, where assessments take at least a year, and I hope we will be doing those kind of assessments here.

I have experience with mental illness in my practice and also in my family. My stepson has suffered from schizophrenia for 20 years. He doesn't always make decisions that his parents approve of, but I respect his rights.

Maher completes his part of the debate stating that killing people with mental illness essentially means killing people that may recover and may have years to live a full life while Wiebe responds by saying that MAiD for Mental Illness alone is the same as Track 2 euthanasia, that kills people who are not terminally ill.

Canadian man tried to have his incompetent wife killed by euthanasia, against her consent.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Roxanne Egan-Elliott reported that Justice Bradford Smith removed a Canadian man’s power to make health-care decisions for his 77-year-old wife with advanced Alzheimer’s after the court learning that the man intended to end her life and then take his own.

The article that was published by the Times Colonist on December 23, 2025 reports that a woman known as E.W. was diagnosed with Alzheimer's in 2017 and her husband has pushed to have her killed by euthanasia, without her consent. The article states:

E.W. was assessed as eligible for medical assistance in dying in 2020, but by September 2021, a doctor determined in a second assessment that she was ineligible because her condition had progressed to a point that she no longer had sufficient insight into dementia to consent to MAID.

E.W. also told the doctor at that point that she was not interested in receiving MAID in circumstances related to worsening memory or confusion, the court decision says.

Her husband, T.W., is a “strong advocate” for MAID and has told various people that if he and E.W. are eligible for MAID, they intend to receive it.

He has also told family, friends and Island Health staff that if his wife becomes ineligible, he intends to end her life and take his own, the decision says.

Clearly, her husband was considering murdering his wife and then dying by suicide.

The court heard that E.W. never agreed to her husbands "death plan." Egan-Elliott reported:

“On the contrary, E.W. was understandably upset by it,” and told their daughter that T.W. “was trying to kill her,” the decision says.

Island Health increased the frequency of its wellness checks and clinical assessments of E.W. after receiving a report from the doctor who assessed E.W. for MAID that she had said she was not ready to die, and that if her husband learned she was ineligible for MAID, he planned to carry out the death plan, which he referred to as “dignicide.”

The article reports that in January 2022 that Island Health obtained emergency powers to remove E.W. from the couple's home and to place her in a long-term care facility for protection.

Egan-Elliott reported that the husband continued to inappropriately treat his wife. He would call the care facility every day, against her wishes, at 6:30 am to wake her up, she was often dressed in tattered clothing and shoes, that TW provided, including worn-out men's work boots, that he insisted that she wear, and more.

Justice Bradford Smith decision stated:

“Having regard to what is in E.W.’s best interest and her lack of cognitive capacity, I find that the only currently tenable solution that will protect E.W. from risk of death or grievous harm is to remove T.W.’s authority as her personal representative,”

Isabel Grant, a law professor at the University of British Columbia’s Peter A. Allard School of Law, told Lisa Steacy for CTV news on December 22 that:

“The death plan is contrary to our murder laws. And I think it’s really important not to have us talk about the murder of elderly people as some slightly improper form of MAID. That’s not what it is. It’s murder. Just because she has a disability does not transform this into something else. This case demonstrates how our MAID regime has normalized death as a response to disability for the elderly."

Steacy also reported Grant as stating:

Grant also said she finds it troubling the decision does not indicate that any moves were made by any authorities to limit or prevent T.W.’s contact with his wife in light of his seemingly unabashed professions of his intent to kill her, or that there was any discussion about how or whether his actions would warrant a criminal investigation or charge.

The relationship between T.W. and E.W. is also one with all the hallmarks of coercive control—a form of intimate partner violence that Canada is taking steps toward criminalizing, Grant pointed out.

In that context, Grant said the repeated references to T.W. advocating for MAID for his wife, his apparent attempts to find a way consent to it on her behalf, and his plan to kill her if MAID was not available are particularly troubling.

Grant's concerns are correct. E.W.'s life was directly threatened by her husband. E.W. has Alzheimer's and needs support, but her husband is not only controlling her but doing so in an abusive manner.

E.W. not only needed her husband removed as her medical decision maker but he should be barred from seeing her as a protection for her. The husband is abusive and is willing to kill her.

This article might be seen as proving that the law protected E.W. from her husband but considering that Québec has approved euthanasia by advanced request and the federal government is considering expanding euthanasia to advanced request, the situation may have been different if advanced requests were permitted.

I have published several articles about domestic murder/suicide over the years (Articles Link).

Belgian Bioethics Committee supports eugenic euthanasia for advanced dementia

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Alex Schadenberg

The Belga News Agency reported today that The Belgian Advisory Committee on Bioethics released an advisory report that supports euthanasia for people with advanced dementia.

Approval for euthanasia, which is killing a person by lethal poison, has moved from the terminally ill, to the chronically ill, to people with mental illness, to children and newborns and now to the incompetent.

Clearly The Belgian Advisory Committee have bought into a eugenic ideology based on the belief that some human lives are not worth living, and can be killed.

The Belga News Agency reported that:

At present, someone with advanced dementia cannot legally obtain euthanasia in Belgium. The current law requires that a person be mentally competent when requesting euthanasia, or that a prior living will or advance directive has been drawn up that applies when the patient is in a state of irreversible loss of consciousness – a coma.

This means that people with dementia can currently only request euthanasia if they are still sufficiently mentally competent. In 2024, 56 people with dementia in our country received euthanasia.

The Belga News Agency reported that Patrick Cras, vice-chairman of the Committee stated:

“It is not a black-and-white assessment, but doctors do feel that procedures for people with dementia have been carried out ‘too early’ because it will no longer be legally possible to do so later,”

The Committee therefore recommends extending the euthanasia law to include people who “are conscious, but whose mental competence and ability to express their wishes have been irreversibly impaired by illness or accident.”

In 2024 there were almost 4000 euthanasia deaths, which was almost a 64% increase since 2020. Belgium is known for having a high rate of unreported euthanasia deaths. Several years ago Dr Marc Cosyns stated that he does not report euthanasia deaths and studies show that Cosyns isn't alone in not reporting his deaths.

Euthanasia was sold to the public as being for mentally competent, terminally ill adults who were freely capable of consenting.

When Belgium expanded their euthanasia law, in February 2014, to include children, it was clear that eugenics was driving the force. Child euthanasia undermines the "safeguard" that a person is fully competent and capable of consenting.

By extending euthanasia to people with advanced dementia, the concept of being competent and consenting is completely ignored. These decisions are based on a decision that some human lives are not worth living.

The new eugenics is similar to the old eugenics, except that the new eugenics cloaks itself in the language of autonomy and choice, even when autonomy and choice are impossible.

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).

How euthanasia fails Canada's most vulnerable:

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Ramona Coelho

Dr. Ramona Coelho, who is a Family Physician; a Senior Fellow of Domestic and Health Policy at the Macdonald-Laurier Institute and a Member of Medical Assistance in Dying Ontario (MAiD) Death Review Committee (MDRC); wrote an important article concerning the most recent report MDRC report that was published by the MacDonald Laurier Institute on October 2, 2025.

As stated already, the Ontario MDRC Committee examines euthanasia (MAiD) reports in Ontario and have published several reports outlining the actual experience with euthanasia in Ontario. Coelho explains the recent MDRC report that examined euthanasia for dementia and compares that report to the previous reports that looked at evaluating incurability, same day euthansia deaths, and euthanasia for people who are not terminally ill.

Coelho begins her article by outlining Canada's euthanasia law and then she explains some of the information from the MDRC reports by writing:

This week, the Ontario Chief Coroner’s MAiD Death Review Committee (MDRC) released its latest report. The MDRC reviews selected provincial cases, and the committee, whose members have diverse viewpoints, contributes expertise to help the Chief Coroner formulate recommendations to clinicians and public authorities. As a member of the MDRC and a physician who cares for marginalized patients, I have serious concerns. Social vulnerability—poverty, housing insecurity, insufficient accommodations, and, in my view, systemic discrimination—combined with a superficial approach to alleviating suffering, can lead to MAiD deaths. The MDRC cases illustrate what the disability community has highlighted from the beginning—that people can be driven to choose MAiD not by their medical conditions, but by system failures, leading to the conclusion that their suffering is unbearable. Barriers to palliative care, inadequate home supports, and discriminatory attitudes send patients the message that their lives are less valuable—and that MAiD may be their most accessible option.

Coelho explains the significance of the latest MDRC report that looked at euthanasia for dementia:

The latest report focuses on dementia. While dementia cases comprise a small number of MAiD deaths, they elicit more family concerns. Consider these cases: one man with Alzheimer’s and delirium received MAiD during an acute illness while facing long-term care placement after losing his caregiver. In another case, family members raised MAiD requests on behalf of a patient with advanced dementia. These highlight the risks of coercion in an already vulnerable population. The patient with advanced dementia was assessed in a single meeting with family present, with only a limited evaluation of cognitive impairments documented. In general, informed consent is often impossible in such situations. Yet in this case, MAiD was administered.

Coelho then assesses the findings in the recent report:

In my view, similar patterns emerge across cases: capacity assessments can be inadequate, requests are sometimes accepted based on fear of future suffering rather than current suffering, and neglect—not medical decline—can drive both suffering and the administration of death. Clinician bias, where disability or cognitive decline is equated with diminished worth, creates an environment in which life-ending decisions can be made without sufficient scrutiny or attempts to address suffering. The MDRC report found that only 13.6 percent of dementia patients who died by MAiD received palliative care beforehand, meaning most never accessed treatments proven to ease suffering linked to fears that often fuel the wish to die.

Coelho then compares the report on dementia to the previous report on evaluating incurability:

Consider last month’s report: Mrs. A, isolated, severely obese, depressed, and disconnected from care, refused treatment and social support but requested MAiD; instead of re-engaging her with care, clinicians deemed her incurable because she refused all investigations, and her life was ended. Mr. B, a man with cerebral palsy in long-term care, voluntarily stopped eating and drinking, leading to renal failure and dehydration; he was deemed eligible for Track 1 because his death was considered “reasonably foreseeable.” No psychiatric expertise was consulted despite psychosocial distress. Mr. C, a man in his seventies with essential tremor, requested MAiD primarily due to emotional suffering and bereavement. In my view, Mrs. A’s case illustrates how assessors may deem suffering irremediable without an accurate prognosis or appropriate care; determinations of incurability must never be based on patient neglect. Mr. B highlights that clinicians can seemingly allow for broad interpretations of “reasonably foreseeable natural death,” while Mr. C demonstrates that essential tremor, though incurable, does not usually constitute a serious decline, and his suffering was largely due to bereavement. While Health Canada provides guidance on what constitutes a grievous and irremediable condition, incurable or irreversible decline in capability, and reasonably foreseeable natural death—including stating that someone cannot refuse all treatments to render themselves eligible for MAiD—there are no straightforward medical definitions, allowing MAiD clinicians broad interpretive leeway with seemingly no consequences to date.

Coelho further compares the recent report to the April MDRC report that examined same day euthanasia deaths:

In April 2025, MDRC reports highlighted how assessments can be rushed and MAiD given in place of palliative care. Mrs. B, in her 80s, preferred palliative care, but adequate support, such as hospice, was denied. Instead, she underwent MAiD the same night her spouse, overwhelmed by caregiver burnout, urgently contacted the MAiD coordination service. Similarly, Mr. B, a man with Alzheimer’s, was euthanized under a waiver of final consent after he no longer recognized the MAiD provider, yet no effort was made to re-engage him to determine if he was still suffering or wanted to die before the lethal infusion was administered. Another patient, Mr. C, deemed to have lost capacity by his treating team, was roused and nodded in response to questions; this was considered sufficient evidence of capacity, and MAiD was administered.

Coelho provides information on an earlier report that looked at euthanasia for people who are not terminally ill.

Cases from Track 2 MDRC reports, involving patients outside the end-of-life context, also reveal systemic failures, which I have previously written about in this forum. Individuals with complex medical, mental health, and social needs—including untreated psychiatric conditions, disabilities, trauma, and unsuitable housing—ended their lives through MAiD. Access to essential supports was limited. Patients were more likely to be poorer and women—groups already facing social injustice—and were less likely to name family as next of kin, often relying instead on friends, lawyers, or healthcare providers, highlighting isolation.

Coelho ends her article by outlining the lack of oversight and writes:

MAiD is often framed as a matter of individual choice. But autonomy is compromised when people lack housing, palliative care, disability supports, or protection from coercion. What appears as “choice” can be masked despair, shaped by systems that frequently fail. The United Nations Committee on the Rights of Persons with Disabilities, in March 2025, found Canada’s MAiD regime discriminatory and ableist. While MAiD was meant to relieve intolerable suffering when no alternatives remained, it instead puts vulnerable people at risk, becoming a path of least resistance when barriers to care exist, preying on fear of being a burden and often overlooking supports that could genuinely alleviate suffering.

I have always stated, in the past, the problem with euthanasia and assisted suicide (MAiD) is that concerns the killing of people and Canada's law permits doctors and nurse practitioners to kill people at a vulnerable time in their life. 

Canadian with dementia Euthanized at Family’s Request

This article was published by National Review online on October 2, 2025

Previous article: Dementia patient died by euthanasia. The family made the request (Link).

Wesley Smith

By Wesley J Smith

Euthanasia/assisted suicide “protective guidelines” don’t really protect against abuse. They mostly serve as window dressings to make people comfortable with killing the sick. And soon after legalization, the vaunted protections are redefined by activists and the media as “barriers” to death, which become the pretext for loosening the already slack guidelines. The speed at which that happens varies, but the pattern rarely fails.

Here’s an example. In Canada, a person is supposed to explicitly request and consent to being killed by a lethal jab. But a dementia patient was recently euthanized at the request of her family. From the National Post story:

A frail women in her late 80s with dementia received MAID after a family member brought forward a request for an assisted death, a new report reveals. The woman’s life was ended after a MAID provider deemed the woman had given her final expressed consent to proceed, based on her ability to repeat a question and squeeze the provider’s hand.

My mother died of Alzheimer’s. I could have easily maneuvered her into a situation where she would have seemed to have consented to assisted suicide. These patients are so vulnerable and what they think or feel one minute often changes dramatically in the next.

Back to the story:

The case is among half a dozen flagged in the latest report from the Office of the Ontario Chief Coroner’s MAID Death Review Committee. Together they’re raising questions around how MAID is being approved for people with dementia, including whether people are receiving MAID without proper assessments to determine if they have the capacity to consent to death.

Of course they are. And I predict nothing will be done about it. That’s the usual pattern.

Adding to the insult, dementia patients are not receiving proper levels of palliative care in Ontario:

“What really stuck out to me is that people with dementia are choosing MAID for feelings like loss of dignity, perceived burden, emotional distress and fear,” said family physician and committee member Dr. Ramona Coelho.

Palliative care can help people grappling with such existential suffering, she said. Yet the report found only 13.6 per cent of people with dementia who died by MAID in Ontario in 2023 and 2024 received palliative care, compared to 82.3 per cent of people who received MAID for other causes.“If MAID is not to be the path of least resistance, but really the choice, then when people are scared and they need care, they should be accessing that care,” Coelho said.

But euthanasia becomes the easier path once we objectify the lives of patients and demote them from full equality into a killable caste.

This is bad. Imagine how much worse it will be when people can sign advance directives in Canada ordering themselves killed when they become incompetent, as they currently can in Netherlands and Belgium. It can even lead to a forced exit.

Legalizing euthanasia/assisted suicide profoundly changes societal values at a fundamental level. Canada is our closest cultural cousin. Cultural devolution will happen here, too, if we don’t hit the brakes on legalizing assisted suicide.

Previous article about this story:

• Dementia patient died by euthanasia. The family made the request (Link). 

Dementia patient died by euthanasia. The family made the request.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Sharon Kirkey was published by the National Post on October 1, 2025 reporting that an Ontario dementia patient died by euthanasia (MAiD) even though the request was made by the family. Kirkey wrote:

A frail woman in her late 80s with dementia received MAID after a family member “brought forward” a request for an assisted death, a new report reveals.

The woman’s life was ended after a MAID provider deemed the woman had given her final expressed consent to proceed, based on her ability to repeat a question and squeeze the provider’s hand.

This case was featured in the recent report from the Ontario MAiD Death Review Committee (MDRC). Kirkey explains:

The case is among half a dozen flagged in the latest report from the Office of the Ontario Chief Coroner’s MAID Death Review Committee. Together they’re raising questions around how MAID is being approved for people with dementia, including whether people are receiving MAID without proper assessments to determine if they have the capacity to consent to death.

Dr Ramona Coelho

Dr Ramona Coelho, a family physician and a member of the MDRC told Kirkey:

“What really stuck out to me is that people with dementia are choosing MAID for feelings like loss of dignity, perceived burden, emotional distress and fear,”

“If MAID is not to be the path of least resistance, but really the choice, then when people are scared and they need care, they should be accessing that care,”

Kirkey reported that 103 people with dementia died by euthanasia in 2023/2024:

"According to the MAID death review committee’s newest report, Navigating MAID with Persons with Dementia, 103 assisted deaths were reported in Ontario in 2023 and 2024 where dementia was identified as the primary condition contributing to suffering. Those deaths represented  about one per cent of all MAID deaths over the same period.

Kirkey continued by further explaining the circumstances of the case:

Among the anonymized cases highlighted is that of Mrs. 6F, the woman in her late 80s diagnosed with moderately advanced dementia.

Nine months before accessing MAID, Mrs. 6F was admitted to hospital after falling several times at her retirement home. She needed help with most basic activities of daily living, according to the report, including supervision while eating. She had a tendency to overfill her spoon and choke.

“At one point during her admission, Mrs. 6F reportedly expressed a ‘wish to die’ to a family member,” the report reads. “This was communicated to her care team, who initiated a referral for MAID.”

“Mrs. 6F’s expression of a wish to die was interpreted by a family member as a potential request for MAID.”

After a discussion with a MAID provider, Mrs. 6F chose to move into long-term care, and decided not to pursue an assisted death.

However, four months after her transition to long-term care, “Mrs. 6F reportedly renewed her request for MAID” and the MAID process was navigated by a family member, the committee reported.

“At this point, Mrs. 6F was largely bedbound and experienced additional physical symptoms including dyspnea (shortness of breath) and pain.

“She also suffered from psychological and existential distress related to her increasing dependency and cognitive decline,” according to the report.

The MAID provider assessed her eligibility over a single interaction, and with a family member present.

In addition to her physical and functional decline, “the provider also noted that Mrs. 6F experienced ‘marked existential suffering’ and was ‘clear she did not want to continue to live as she (was).'”

There were communication challenges during the eligibility assessment. The provider said the process was “managed in a way that worked for her.” There was little documented details of her cognitive impairments like short-term memory loss, insight or judgement. Mrs. 6F tried to sign the consent form, but her signature was illegible. “A third-party signer, a member of the MAID provider’s clinical staff, was engaged,” according to the report.

MAID was scheduled for one week after two assessors determined Mrs. 6F met the eligibility criteria. “On the day of the provision, Mrs. 6F was reportedly overwhelmed by the presence of additional visitors,” the committee said. The extra visitors were asked to leave “to ensure a calm environment.

“Final express consent was determined based on Mrs. 6F’s ability to repeat the consent question and via squeezing the provider’s hand.”

While most committee members felt that Mrs. 6F “appeared to be able to communicate a choice (i.e. by agreeing or squeezing a hand)” others said communication via repeating a question “is not an indication of understanding or appreciating a healthcare decision,” particularly without supporting documentation of a person’s cognitive capabilities and decision-making.

Some members were also concerned about the reliance on a family member “to facilitate the MAID process, illustrating potential opportunity for undue influence,” according to the report.

“While (committee) members acknowledged that family members may have an increased role in assisting persons with dementia in navigating the MAID process,” the committee said, “MAID practitioners should prioritize direct engagement with the person requesting MAID to the greatest extent possible,” document their “own words and reasoning” wherever possible and evaluate “possible sources of external pressure.”

Concerns were also raised that Mrs. 6F’s overwhelmed response to having so many people in her room the day MAID was provided potentially signalled “her lack of understanding of the circumstances of the MAID provision.”

Kirkey outlines other cases in her article such as a man who had been living with Alzheimer’s disease for about 10 years was approved for MAID

Kirkey completed her article by stating:

The cases suggest “people are accepting very limited, and under the threshold, of what a normal capacity assessment would be, especially for this (dementia),” Coelho said.

But while some members said the threshold for determining capacity for MAID should be high, given the gravity of such a life-ending decision, others said it shouldn’t exceed the thresholds applied in other health-care circumstances.

Links to other articles concerning euthanasia and dementia (Articles Link).