Dr Paul Saba: No to euthanasia for mental illness.

Dr Paul Saba - Parliamentary Press Gallery Speech for the Euthanasia Prevention Coalition in support of Bill C-218, the bill that will prevent euthanasia for mental illness alone, on October 28, 2025. Dr Saba's speech begins at 15 minutes 25 seconds.

Sign the petition supporting Bill C-218 (Petition Link).

People with only a mental disorder may be euthanized as of March 2027. 

This, despite the overwhelming evidence that people with mental disorders can be treated, and that most psychiatrists cannot determine which patient has an irremediable (irreversible and treatable) condition. 

From a legal standpoint, those with mental disorders requesting medical assistance in dying (MAID), do not meet the condition of free and informed consent because the desire to die is in most cases a symptom of mental illness. 

Bill C-218 which will be debated later this year in Ottawa, will stop euthanasia (MAID) for people with mental health disorders as the sole criterion and must be supported by our members of parliament who value life. 

Le projet de loi C218 mettra fin à l’adoption de l’euthanasie (AMM) des personnes atteintes de troubles de santé mentale comme seul critère. Dans la plupart des cas, le désir de mourir est un symptôme de maladie mentale. 90% des personnes qui mettent fin à leurs jours sont atteintes d'un trouble mental au moment de leur suicide. 

La plupart des personnes qui ont tenté ou réussi à se suicider ne veulent pas mourir; ils veulent plutôt échapper à leur détresse émotionnelle Selon une étude de la Harvard School of Public Health, 90% personnes ayant tenté de se suicider sans succès ne se sont pas suicidées après le traitement. Avec le bon traitement, le suicide a disparu. 

La plupart des personnes atteintes de troubles mentaux ont besoin du soutien de psychiatres, de psychologues et de travailleurs sociaux. Beaucoup vivent dans des situations financières et sociales précaires. Ils ont besoin d’un soutien financier, notamment d’un logement abordable et d’une sécurité alimentaire. 

Le système social et de santé canadien est déficient pour les personnes ayant des problèmes de santé mentale. Au Québec, le délai moyen d'attente entre la référence à un psychiatre et le traitement est de 5 mois. 

Les psychologues sont rares et rarement accessibles dans le système public. Il est temps que les députés fassent preuve de solidarité et soutiennent les personnes atteintes de troubles de santé mentale. 

Ils ont besoin de soins, de traitements et de soutien. Ils ne doivent pas être euthanasiés (AMM). Les parlementaires doivent mettre fin à l’aide médicale à mourir pour les personnes atteintes de troubles mentaux. 

Ils doivent voter en faveur du projet de loi C-218 et non pour l’euthanasie des personnes ayant des problèmes de santé mentale. 

Picture: (Gordon Friesen, Alex Schadenberg, Dr Paul Saba and Kelsi Sheren) 

Euthanasia Prevention Coalition. Resources to protect your life.

Euthanasia Prevention Coalition works to protect your life.

1. New Product: The I Oppose Killing People T-Shirt provides a clear message for those who are not afraid of saying that killing people is wrong. 

Order the T-shirt from EPC for $30 plus shipping (Order Link) or email us at: office@epcc.ca or call us at: 1-877-439-3348. 

2. The Life-Protecting Power of Attorney for Personal Care will protect your life when you cannot make medical or personal care decisions for yourself.

This is a legal document that enables you to appoint someone you trust to make medical and personal care decisions for you when you become incompetent to make decisions for yourself (language differs based on jurisdiction). This uses normal language to make clear statements about euthanasia, assisted suicide and medical treatment options and guides medical practitioners and the person you have appointed to make medical and personal care decisions in a manner that protects your life.

The Life Protecting Power of Attorney has available specific formats for jurisdictions with special requirements, such as British Columbia and Saskatchewan.

Canadians can purchase the Life-Protecting Power of Attorney from EPC for $10 + taxes.
Americans can purchase US State versions from EPC-USA for $15 (Purchase link) or contact EPC at: 1-877-439-3348 or office@epcc.ca.

3. New Product: The Do Not Ask Me about euthanasia card. I am not interested! card is designed for people who are in hospital and don't want to be harassed by doctors who will ask if you want to die by (MAiD) euthanasia.

EPC will send you a Do Not Ask Me about euthanasia card for free or with a donation by simply contacting us by email: office@epcc.ca or call us at: 1-877-439-3348.

4. The Do Not Kill Me wallet card is available from EPC upon request or with a donation. The card provides further protection when sign and date, with a witness, on the back of the card.

EPC will send you the Do Not Kill Me wallet cards by contacting us by email: office@epcc.ca or at: 1-877-439-3348.

5. EPC urges our supporters to write a straight forward letter to your physician explaining that you oppose euthanasia and assisted suicide and have that letter added to your medical file.

6. Euthanasia Prevention Coalition yearly friendship fee is $30 (individual) or $50 (group). Link to pay for your friendship online.

EPC asks you to share your personal stories related to euthanasia or assisted suicide. Many people have family or friends who died by euthanasia or assisted suicide under questionable circumstances. By sharing your story, you open the door to other people sharing their story.

Media Advisory: No to MAiD for Mental Illness.

Gordon Friesen

Media Advisory: No to MAiD for Mental Illness.

Press Conference: Tuesday October 28, 2025 at 11:00 a.m.

Location: Parliamentary Press Gallery – Room 135B West Block

The Euthanasia Prevention Coalition (EPC) is hosting a press conference on October 28 at 11 a.m. in the Parliamentary Press Gallery.

Speakers: Gordon Friesen, EPC President, Paul Saba, Montréal Family Physician, Alex Schadenberg, EPC Executive Director, and Kelsi Sheren, Combat veteran, CEO and mental health expert.

Alex Schadenberg

The press conference will focus on why Bill C-218, the private members bill that will prevent the implementation of euthanasia, or “medical assistance in dying” (“MAiD”), for mental illness alone, needs to be passed into law.

Gordon Friesen will speak about the lived experience of people with disabilities with relation to euthanasia in Canada.

Alex Schadenberg will speak about what is happening with euthanasia in Canada and explain why Bill C-218 must be passed into law.

Kelsi Sheren

Kelsi Sheren will speak about her experience as a veteran who required treatment for Post-Traumatic Stress Disorder (PTSD) after returning from combat in Afghanistan. Euthanasia for mental illness threatens her life as she would qualify if it were already permitted.

Dr Paul Saba will explain that 90% of people who attempt a suicide and receive treatment do not want to die. Most psychiatrists do not support euthanasia for mental illness because of their concern for their vulnerable patients. It is also impossible to decide whether a mental health condition is irremediable.

Dr Paul Saba

Contact Alex Schadenberg at 519-851-1434 or email: alex@epcc.ca

Participation in the question and answer portion of this event is in person or via Zoom, and is for accredited members of the Press Gallery only. Media who are not members of the Press Gallery may contact pressres2@parl.gc.ca for temporary access.

Seuls les membres de la tribune parlementaire peuvent participer à la période de questions et réponses, qui aura lieu sur place et via Zoom. Les médias qui ne sont pas membres de la tribune parlementaire peuvent communiquer avec pressres2@parl.gc.ca pour obtenir l'accès temporaire.

More articles on this topic:

• Bill C-218 introduced to prevent MAiD for Mental Illness (Link). 
• Support Bill C-218. No to MAiD for Mental Illness (Link). 
• Supporting Bill C-218 - I am so thankful to be alive (Link). 
• I got better. Support Bill C-218 prevent MAiD for Mental Illness (Link). 
• My story: No to MAiD for Mental Illness (Link). 
• Patti's story. Support Bill C-218. (Link).

Victoria Australia Assisted Dying Expansion Bill

Alex Schadenberg

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

Victoria Australia, like Canada, currently permits both euthanasia and assisted suicide. Therefore, the Victoria law already permits doctors to kill their patients by lethal injection or by prescribing the same lethal poison cocktail that the person would self-administer.

When Victoria Australia debated euthanasia and assisted suicide in 2017, in order to get support for the bill, they agreed to several "safeguards" including a 6 month terminal illness prognosis, which is similar to most US assisted suicide laws, and the requirement that doctors cannot initiate the discussion around euthanasia.

Similar to Canada where euthanasia and assisted suicide were legalized in 2016 under the term (MAiD), the provisions of the law were expanded in 2021 by eliminating the "terminal illness" requirement, eliminating the 10-day waiting period and permitting euthanasia for mental illness as the sole criteria, a provision that the Canadian government has delayed until March 17, 2027.

Every jurisdiction, that is currently debating euthanasia or assisted suicide, need to realize that nearly every jurisdiction that have legalized these acts, within a few short years, have expanded their laws.

How does the Victoria Assisted Dying Amendment Bill expand the law?:

• Currently doctors are not able to ask a patient if they want an assisted death, only patients can initiate the conversation. This bill enables doctors to initiate the question of an assisted death.
• Currently health practitioners who have a conscientiously objection don't need to refer or provide information, this bill requires them to refer or provide information to patients.
• Currently a person qualifies for an assisted death if they have a terminal prognosis of less than six months, this bill expands approval to people with a terminal prognosis of 12 months for all conditions.
• Currently a third medical assessment is required for neurodegenerative patients, this bill will reduce it to two medical assessments.
• Currently the two requests for an assisted death must be at least 9 days apart, the bill will reduce the second request to at least 5 days from the first request.
• Currently a person must be a citizen or permanent resident to be approved for an assisted death, this bill will not require the person to be a citizen or permanent resident but to have lived in Australia for at least 3 years.
• Currently a person must be a resident of the state of Victoria, this bill adds a "compassion" exemption to people who live in New South Wales or South Australia. This is a funny change since both New South Wales and South Australia permit euthanasia.
• This bill changes practitioner eligibility to make it easier for qualified doctors to participate.
• This bill simplies the permit to participate and creates a new administrative practitioner role to enable medical professionals who are not doctors to participate in the act.
• This bill allows interpreter flexibility when accredited ones are unavailable. In other words, the stringent requirement that someone fully understands the nature of the act has been weakened.

So let's be clear, Victoria Australia's euthanasia and assisted suicide law came into effect in June 2019.

The expansion bill changes the law by not requiring a person to be terminally ill but rather to have a terminal condition. People with a terminal condition and have a "12 month prognosis" are not dying and with treatment may recover or live a much longer life. Doctors cannot effectively determine a 12 month prognosis.

The expansion bill allows medical professionals to sell death. In Canada, MAiD teams approach peopl who have not offered any interest in being killed, but because of their medical condition, they are being harrassed into considering MAiD.

The expansion bill enables medical professionals who are not doctors to participate in the act. The same expansion is happenig in other jurisdictions based on the fact that very few doctors are willing to be killers, so they expand the catagory of who can be a killer.

In nearly every jurisdiction that has legalized euthanasia and/or assisted suicide, soon after, expand their law. Expansions are either done legislatively, as in Victoria Australia, or through interpretation of the law or both.

If your jurisdiction is debating euthanasia and assisted suicide, don't accept the arguement that the bill will not expand, if legalized. The language of the legislation to legalize these acts is determined by what it will take to legalize, not by what they intend, in the long term. Victoria Australia is a prime example since it tightened its original bill, to legalize the acts, and is, a few short years later, expanding the legislation, to enable more killing.

UK assisted suicide bill makes coercion and deception easier.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Aine Fox reported for the Independent (UK) on October 23, 2025 that a retired judge is concerned that the UK assisted suicide bill, that has already passed in the House of Commons and is now being debated in the House of Lords, will make coercion easier because the coroner will not investigate these deaths:

Retired Judge Thomas Teague told peers at a House of Lords select committee that the current draft legislation to legalise assisted dying risks making coercion easier and for some cases to ” slip through” if coroners are not involved as the default.

Fox reported that:

The Terminally Ill Adults (End of Life) Bill currently states that an assisted death would not be classified as an “unnatural death” and therefore would not require automatic investigation by a coroner.

The Royal College of Pathologists and Mr Teague have previously voiced their opposition to this element of the Bill and both gave further evidence to peers on Thursday.

Teague is concerned that the language of the law will lead to coercion, pressure and deception.

He warned that categorising assisted deaths, which he said “are in reality, deaths by suicide”, as natural deaths could have the “unfortunate and unintended consequence of tending to obscure and conceal those risks, and of making it easier for persons who want, for example, to exercise coercion or pressure or deception to do so”.

Teague stated that the assisted suicide bill reversed 200 years of scrutiny.

He said clause 38 of the Bill as it stands was effectively reversing part of a system for scrutinising deaths that had been 200 years in the making and described the proposed approach as “frankly absurd”.

Fox reported that Dr Suzy Lishman form the Royal College of Pathologists agreed with Teague:

Dr Suzy Lishman, from the Royal College of Pathologists, when asked about whether it would be safe to remove coronial oversight, told the committee: “No, I don’t believe it would be safe.”

The House of Lords Select Committee is examining the Kim Leadbeater assisted suicide bill. The House of Lords Committee will make recommendations and possible amendments before they to to a final vote on the bill.

More information about the UK assisted suicide bill (Articles Link).

Assisted-Suicide Slippery Slope Keeps Slip-Sliding Away

This article was published by the National Review online on October 22, 2025.

By Wesley J Smith

When assisted suicide is first proposed for legalization, we are assured by death activists that strict guidelines will protect against abuse. But they don’t mean it. Once the laws pass, the supposed protections — which are always flaccid to begin with — are soon redefined by activists and the media as “barriers,” et voila, the laws are soon loosened. It’s all a con, but people seem to fall for it every time.

This pattern can be seen vividly playing out in Victoria, Australia. The state was the first in that country to legalize assisted suicide, and now the government is making more people eligible for legally hastened death. From the premier’s announcement:

The new legislation will remove unnecessary barriers to accessing VAD, improve clarity for practitioners, strengthen safety measures and make the system fairer and more compassionate.

See what I mean? “Strengthen safety,” (!!!) and “fairer and more compassionate,” really just means more people can become dead much sooner.

Here are some of the particulars:

There are 13 proposed amendments to the legislation, with proposed key changes to include:

• Removing the ‘gag clause’ so that registered health practitioners are allowed to raise VAD with their patients during discussion about end of life options

Doctors bringing up assisted suicide. Can you imagine anything more destructive of hope?

• Requiring registered health practitioners who conscientiously object to provide minimum information.

Doctors are often promised they can opt out. But then, the attacks on medical conscience begin.

• Extending the prognosis requirement (life expectancy limit for eligibility) from six months to 12 months.

Doctors often can’t accurately know who will die within six months. Having a one-year window just opens the door to more people to kill themselves who might not have died of their condition at all.

• For people with neurodegenerative diseases (like motor neurone disease), they’ll no longer need a third prognosis if their expected lifespan is between six and 12 months.

The second and third opinions are often provided by doctors recommended by euthanasia organizations.

• Introducing a new administering practitioner role to expand the workforce able to support VAD.

I suspect this means nurse practitioners will be able to participate in hastened death — as is allowed in other jurisdictions, including some here in the U.S. — because there can never be enough assisted suicide.

The premier excuses his loosening of eligibility requirements and other aspects of the law by claiming the changes are necessary to catch up with the slacker assisted-suicide laws in other Australian states. Talk about a race to the bottom!

The ultimate destination for all of this will be the creation of a fundamental right to be made dead, regardless of the reason, i.e., death on demand. Indeed, German and Estonian courts have already created a fundamental right to commit suicide and receive assistance in that act for whatever reason, or, for that matter, no reason at all.

In this, I am reminded of the Paul Simon lyrics:

Slip slidin’ away
Slip slidin’ away
You know the nearer your destination
The more you’re slip slidin’ away.

Links to previous articles about Victoria Australia's euthanasia law (Articles Link).

The assisted suicide lobby is promoting suicide tourism.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A recent assisted suicide lobby information article asks the question: Can I travel to use Death with Dignity?

As many of our supporters are aware, Oregon and Vermont expanded their assisted suicide laws by removing the assisted suicide law residency requirement and allowing anyone from anywhere to die by assisted suicide in those states.

The recent assisted suicide lobby article is encouraging people from jurisdictions that prohibit assisted suicide to become suicide tourists and die by assisted suicide in Oregon or Vermont.

The article includes links for out-of-state- residents to contact assisted suicide organizations in Oregon and Vermont as well as contact information for a national organization that will provide advice for suicide tourists.

The assisted suicide lobby is promoting suicide tourism to encourage more out-of-state residents to die by assisted suicide in Oregon and Vermont.

In March 2025 I published an article outlining the Oregon assisted suicide statistics. In 2024 in Oregon there were:

• 607 poison prescriptions written, which was up from 433 in 2022.
• 376 reported assisted suicide deaths up by 71 from 305 in 2022.
• 23 of the 376 reported assisted suicide deaths were out-of-state residents.

In the article I explain that there were likely more assisted suicide deaths in Oregon in 2024 based on Oregon doctors often sending in late reports and possible problems with under-reporting.

Since the Oregon Health Authority (OHA) determines the number of assisted suicide deaths based on the reports they receive, therefore, if a doctor does not submit a report to the OHA there is no way to know if there was an out-of state assisted suicide death. As the 2024 OHA report states:

Previously, residence information was collected from the patient’s death certificate. However, for patients who die outside of Oregon and are not Oregon residents, OHA has no way to obtain notice of those deaths.

Since the OHA does not receive a death certificate for a non-resident assisted suicide death, therefore it cannot be determined if there were only 23 out-of-state residents who died by assisted suicide in Oregon in 2024.

It must be noted that the assisted suicide bill that passed in the New York state Assembly and Senate that has not been signed by New York Governor Kathy Hochul, does not have a residency requirement and would allow suicide tourism in New York.

When a person dies without family to take care of a funeral, the state becomes financially responsible for dealing with the body. Suicide tourism would exacerbate this problem.

Contact New York Governor Kathy Hochul (Contact Link) or call her at: 518-474-8390 and urge her to veto the assisted suicide bill and prevent assisted suicide tourism in New York.

How Caregivers Can Sustain Themselves While Caring for Others

This article was published by Compassionate Community Care on October 14, 2025.

By Bob Shannon - seniorsmeet.org

Caregiving isn’t just a role. It becomes a rhythm that takes over your time, your thoughts, your body—and, if you’re not careful, your future. Many caregivers lose themselves while supporting others. But that doesn’t have to be the cost. With clear habits and hard-won boundaries, you can protect your energy, preserve your identity, and stay strong for the long haul.

Boundaries Are the First Line of Protection

Most caregivers are wired to say yes. But endless yeses quickly become exhaustion in disguise. One of the hardest and most necessary things you can do is establish your limits early and enforce them often. You don’t need to wait until you’re burning out to course-correct. Simple habits like using specific time blocks, defining “off-limits” hours, and being honest about your capacity help you stay present without overextending. What you’re building is not selfish distance, it’s maintaining boundaries that allow you to keep showing up without falling apart. No guilt required.

Reset in Moments, Not Just Days

Self-care doesn’t have to wait for a free weekend or perfect conditions. In fact, if that’s your bar, it’ll rarely happen. What works better are fast, repeatable resets that fit into your day without disrupting it. A breath routine. A stretch before a phone call. Sipping tea with no screen. These are not luxuries, they’re life rafts. Caregivers benefit most when they don’t wait for burnout to rest. By allowing yourself micro-doses of self-care, you can keep your stress from boiling over and make recovery a built-in part of your rhythm instead of a last resort.

Physical Maintenance Is Not Optional

You’re not a machine, but your body is your only vehicle. If it goes down, everything else follows. Caregivers often deprioritize meals, movement, and sleep; not out of laziness, but because their time feels hijacked. It’s a trap. You’re not more helpful when running on fumes; you’re just closer to collapse. Start simple. Add one walk a day. Prep basic meals in batches. Give yourself permission to sleep uninterrupted when possible. Even small, nourishing rituals can stabilize your energy and reduce the cognitive drag that comes from constant fatigue. These aren’t wellness perks. They’re maintenance basics.

Breaks Are Not Failure—they’re Fuel

Let’s be clear: Taking a break does not mean you’re slacking. It means you’re strategic. Too many caregivers operate like they’re in a permanent sprint. But you can’t sprint a marathon. Scheduling downtime isn’t indulgent, it’s survival. Look into rotating off days, even if they’re just partial. Ask relatives to cover for a few hours. Check local resources that offer coverage. Look into scheduling respite care intervals. Even short windows to unplug give your nervous system a chance to reset. When you rest with intention, you return more available, more calm, and more human.

Reconnect With What You Loved Before the Role

When you’re deep into caregiving, everything else can vanish: hobbies, humor, spontaneity. What you used to love feels far away. But losing access to joy isn’t just sad, it’s dangerous. It leads to numbness. You don’t need hours of free time to remember what makes you feel alive. You just need one reconnection point. Revisit a hobby you paused. Try a version that fits your time now. Sketch instead of paint. Journal one sentence. Listen to the music you used to obsess over. You can start finding joy through creative hobbies that don’t demand perfection or performance, just presence. Joy is a skill, not a luxury.

Connection Isn’t Bonus Support—It’s Core Infrastructure

Caregiving can make you feel invisible. Like no one sees how hard it is, or how heavy it feels to carry. That isolation is corrosive. But it’s not inevitable. Other caregivers are walking the same road, and connecting with them doesn’t just provide emotional relief, it gives you practical shortcuts, reminders, and a sense of normalcy. Don’t wait to be invited. Seek it out. Whether it’s a Facebook group, a local meetup, or a text thread with someone who gets it, peer caregiver communities can change everything. You don’t have to explain the basics. They already understand. That understanding can be oxygen.

Protecting Your Future Is Part of Self-Care

If caregiving has stalled your professional growth, it doesn’t mean your momentum is gone, it just means the path forward looks different now. Many caregivers use this period to refocus, not retreat. That can include new skills, certifications, or full degrees. And thanks to online education, this kind of planning doesn’t require walking away from your caregiving role. For example, earning an accredited MSN program online allows caregivers to study at a pace that fits their lives. It also opens doors into nursing education, administration, informatics, and advanced practice careers—roles with more autonomy, stability, and growth over time.

Caregiving will change you. It will stretch you, drain you, and demand more than seems fair. But it doesn’t have to erase you. When you learn to invest in your own sustainability—through boundaries, small rituals, nutrition, rest, joy, connection, and growth—you build a life that includes caregiving, not one consumed by it. This isn’t about becoming a better helper. It’s about staying whole. You are not the backup plan in someone else’s crisis. You are a full human who matters, and your future deserves the same care you give others every day.

George Clooney, Annette Bening to star in Pro-Assisted-Suicide movie

This article was published by National Review online on October 17, 2025.

Wesley Smith

By Wesley J Smith

Two A-List Hollywood actors will star in a pro-assisted-suicide movie. From the Hollywood Reporter story:

George Clooney and Annette Bening will star in In Love, an adaptation of Amy Bloom’s New York Times best-selling memoir In Love: A Memoir of Love and Loss that is to be directed by Paul Weitz. . . .

With In Love, Bloom wrote about how her she slowly lost her husband to Alzheimer’s, how the two made the decision to travel to Switzerland to end his life, and the struggle to move forward as a widow. The book was an affirmation of love and the power of relationships. It was also named TIME Magazine’s No. 1 best nonfiction book and included on their list of 100 must-read books.

Of course! To Big Time Hollywood, adjacent glitterati, and much of the mainstream media, truly loving someone with Alzheimer’s means being willing to help them become dead rather than caring for them as long as they live.

This is almost trite. How many pro-euthanasia movies/TV episodes have there been? It’s hard to keep count. How many anti-assisted-suicide/pro-care projects? Honestly, I can’t think of one even though there are plenty of dramatic stories illustrating the abuses and dangers just waiting to be told.

R. Emmett Tyrrell Jr., founder of the American Spectator magazine, coined a term kulturesmog, meaning “ideas that are incompatible with traditional American social, cultural, and economic ideals.” That term sure seems apt here.

Built to Coerce: Canada’s Laboratory of Euthanasia

This article was published by The Pulse on October 14, 2025. The Pulse is the research publication for the Catholic Medical Association.

By Yuriko Ryan, DBe, MA, HEC-C

One summer morning my husband and I stepped into a Catholic hospital through a main entrance we both knew well. It was where he was born, where he practiced almost daily as a family physician for 35 years, where we returned to countless specialist visits, outpatient appointments, palliative care meetings with dear friends, and the joy of welcoming babies in the maternity ward. For us, the hospital was a constant holy presence, an unwavering witness to the dignity of life.

Previous articles about the Shoreline Space (Articles Link).

But this visit brought something unexpected into view. On the left wall, a new mural of muted mountains and shoreline scenes quietly caught our attention. There were no familiar reminders – no mission statement and no donor plaques. The absence felt unsettling and eerie. Beside the mural was a locked door, labeled not with Providence or St. Paul’s Hospital but with the name of the regional health authority and Shoreline Space. Outside it, elderly patients unsuspectingly sat in wheelchairs, on walkers, or on chairs, waiting for their ride in a handicapped-accessible van. This was the wall and the door to the euthanasia clinic, conjoined to our Catholic hospital. The mural and the doorway together became more than décor – they became a map of contested moral space.   

Canada – Laboratory of Euthanasia

Canada has transformed into a real-world testing ground for euthanasia – what the law calls medical assistance in dying (MAiD). Initially permitted only in cases of suffering with terminal illness, [i] MAiD has rapidly expanded through court challenges framed as rights. Law makers and healthcare systems have responded with unexpected enthusiasm by widening eligibility to include patients with chronic conditions, disabilities, mental illness, frailty, and various perceived sufferings.

By the end of 2024, around 90,000 Canadians had died by MAiD since it became legal in 2016.[ii] In 2023, MAiD deaths accounted for 4.7% of all Canadian deaths,^[iii] making it the fifth leading cause of death nationwide. The pace of growth is nearly the same proportion the Netherlands reached after twenty years.[iv] Today, MAiD requests are rarely denied. [v]

Article: There were around 16,500 euthanasia deaths in 2024 (Link).

Spatial Ethics

Spatial ethics, despite their significance to environmental and behavioral psychology,[vi] [vii] [viii] [ix] and moral theology, including principles such as cooperation with evil,[x] have received scant attention. Yet the arrangement of care spaces profoundly shapes our moral imagination and our moral discourse. Hospitals and hospices are not the only ones facing spatial ethics issues. Risks to patients or individuals residing in long-term care homes and other congregate housing settings may be elevated due to the shared use of common areas and, frequently, rooms among clients. They may not be able to express their concerns adequately due to their cognitive decline, serious chronic illness and comorbidities, lack of care advocates, language barriers, and loneliness and isolation. For patients with disabilities, frequently, the limited access to home care, disability support and services in their own communities result in unwanted hospitalization. And MAiD assessments are more readily available in hospitals. These care spaces may implicitly communicate to vulnerable populations that their lives are burdensome.

Built To Coerce

When my poster Built to Coerce: Ethics of Imposed Euthanasia (MAiD) Provision in a Catholic Hospital Space received recognition at the Catholic Medical Association conference, the moment was bittersweet. The award affirmed the urgency of examining how legal and healthcare structures can pressure Catholic and other mission-driven organizations, medical professionals, and patients toward euthanasia through spatial arrangements. Yet the recognition could not erase the grief that such coercion exists, nor the weight of knowing that euthanasia clinics are being embedded in contested care settings across the country, reshaping not only the geography of care but the very meaning of healthcare itself.

Meanings of Healthcare Space

Traditionally, healthcare spaces served as operational, missional, and moral actors. The euthanasia clinic I described is located immediately inside a main entrance of our Catholic hospital. Its placement – on the main floor, adjacent to high-volume outpatient specialty clinics and diagnostic labs and visible along corridor sightlines – functions as an operational and missional signal for the regional health authority and the government. It implicitly states who matters and who is deemed peripheral. Despite a pre-existing agreement signed two decades earlier, denominational healthcare organizations now face human-rights legal challenges and mounting pressure to provide euthanasia onsite in exchange for a license to operate and receive public funding. This forced presence demands collective moral reflection and renewed missional rigor – not only for Catholic healthcare organizations but for any organization striving to remain a witness to the dignity of life.    

On the Ground

British Columbia – our province – has the second-highest per capita rate of MAiD deaths across the country.[xi] By 2023, MAiD deaths had already surpassed deaths from illicit drug overdoses.[xii]In 2024, MAiD accounted for 6.7% of all deaths in BC.[xiii] [xiv] Of the 3,000 MAiD deaths in 2024, nearly 90 % were seniors aged 65 and over. 35% died by MAiD for “Other Conditions” – not cancer or cardiovascular diseases –, with frailty being the leading cause under the “Other” category. MAiD has become a solution to old age. In 2024, approximately 40% of all MAiD deaths in BC occurred in private residences.[xv] Their last breaths in the air of family spaces risk shared memories being tainted. Spatial ethics issues surrounding MAiD now touch every care and housing setting.[xvi]

It is not difficult to imagine how frail seniors reach such decisions, surrounded by cues embedded in care spaces. In hospitals, they overhear conversations about MAiD in multi-occupancy rooms or find pamphlets left at their bedside. In hospices, if MAiD is openly celebrated next door, the space begins to speak to the minds of the dying. Stand alone MAiD suites are also appearing in business complexes, without clear signage, mission statements, or donor plaques – eerily similar to Shoreline Space. One is built in direct view of a community dialysis clinic, remains unmarked with smoky windows, passed daily by unsuspecting patients and office workers.

A Warning to the World

Canada is a warning to the world as an experimental laboratory of euthanasia. When healing and killing share a wall, corridor, and a roof, they become each other’s gatekeepers, and the very meaning of healthcare space is at stake. An unsuspecting patient walking past a MAiD clinic is not only a Canadian story. It is a parable of what hospitals, hospices, and nursing homes elsewhere may soon confront. Built to Coerce was not only the title of a poster; it is the reality inscribed in our healthcare architecture. The question is not whether pressures will come – they already exist. The question is where we will find the courage to preserve spaces where life is reverenced before the geography of care is irresistibly altered.

Build to Care, Not to Coerce  

If Catholic healthcare is to remain a witness to the dignity of life, then MAiD-free zones cannot be left to chance, convenience, or the whim of those who promote euthanasia.  Catholic Medical Association members and all who serve in healthcare are called to remain a constant presence and an unwavering witness to the dignity of life, safeguarding spaces that are theoretically sound, theologically rooted, and morally grounded. Let us call our brothers and sisters, regardless of vocation, to build to care, not to coerce.

Dr. Yuriko Ryan is a bioethicist and gerontologist based in Vancouver, Canada. She serves on the Catholic Medical Association’s Ethics Committee and the International Ad-hoc Committee. Her writing explores the moral contours of artificial intelligence, aging, and end-of-life care, appearing in Momento, her weekly bioethics newsletter, and feature articles for AI and Faith. Through her lectures, publications, and committee work, she advocates for human dignity across all stages of life, guided by a Catholic lens. 

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[i] The Government of Canada. Medical Assistance in Dying: Overview. Accessed August 1, 2025.Accessed August 30, 2025. https://www.canada.ca/en/health-canada/services/health-services-benefits/medical-assistance-dying.html

[ii] Schadenberg, Alex. (September 29, 2025). Accessed September 30, 2025. Euthanasia Prevention Coalition Euthanasia Prevention Coalition: There were around 16,500 Canadian euthanasia deaths in 2024, 5% of all deaths.

[iii] Health Canada. (2024, December 11). Fifth annual report on medical assistance in dying in Canada, 2023 (Cat. No. H22-1/6E-PDF; ISBN 2563-3643). Accessed September 30, 2025.  https://www.canada.ca/en/health-canada/services/publications/health-system-services/annual-report-medical-assistance-dying-2023.html

[iv]   Regional Euthanasia Review Committees. (March 25). Accessed September 30, 2025. Annual reports (English, Spanish, French and German) | Regional Euthanasia Review Committees

[v] Th Fifth Annual Report on Medical Assistance in Dying in Canada, 2023 – Canada.ca

[vi] Kahana, Eva. “A congruence model of person-environment interaction.” Aging and the environment: Theoretical approaches (1982): 97-121.

[vii] Bell, Paul A., T. Green, Jeffrey D. Fisher, and Andrew Baum. Environmental psychology. New Jersey, 2001.

[viii] Ajzen, Icek. “The theory of planned behavior.” Organizational behavior and human decision processes 50, no. 2 (1991): 179-211.

[ix] Stamps, Arthur E. Psychology and the aesthetics of the built environment. Springer Science & Business Media, 2013.

[x] Meany, Joseph. Referral as Formal Cooperation with Evil – F.I.A.M.C.

[xi] See Health Canada’s 5^th annual report.

[xii] BC Coroners Service. Unregulated Drug Deaths – BC. Notes: 2588 deaths due to unregulated drug deaths in 2023. In the same year, 2,759 MAiD deaths were reported.

[xiii] BC Medical Assistance in Dying (MAiD) Statistical Report 2024. Accessed September 28, 2025. bc-medical-assistance-in-dying-statistical-report-2024.pdf

[xiv] Statistics Canada. Accessed September 30, 2025. Estimates of the components of natural increase, quarterly

[xv] BC Medical Assistance in Dying (MAiD) Statistical Report 2024. Accessed September 28, 2025. bc-medical-assistance-in-dying-statistical-report-2024.pdf

[xvi] Angus Reid Institute (December 12, 2024). Division over aspects of assisted dying, including MAiD-free spaces. Accessed August 10, 2025.  https://angusreid.org/wp-content/uploads/2024/12/2024.12.12_MAID_free_discretion.pdf