euthanasia in Canada

Euthanasia was previously prohibited under the Criminal Code as a form of culpable homicide.{{Cite web |title=CE PRODUIT EST INTROUVABLE |url=https://www.editionsyvonblais.com/detail-du-produit/etude-comparative-france-quebec-sur-les-decisions-de-fin-de-vie-le-droit-sous-le-regard-de-lethique-collection-minerve |website=www.editionsyvonblais.com |access-date=14 August 2019 |archive-date=14 August 2019 |archive-url=https://web.archive.org/web/20190814095350/https://www.editionsyvonblais.com/detail-du-produit/etude-comparative-france-quebec-sur-les-decisions-de-fin-de-vie-le-droit-sous-le-regard-de-lethique-collection-minerve |url-status=dead }}{{Citation |last=Kluge |first=Eike-Henner W. |title=Assisted Suicide: Canadian Perspectives |page=83 |year=2000 |editor-last=Prado |editor-first=C. G. |contribution=Assisted Suicide, Ethics and the Law: The Implication of Autonomy and Respect for Persons, Equality and Justice, and Beneficence |place=Ottawa, Canada |publisher=University of Ottawa Press}}

The prohibition was overturned in a February 2015 decision by the Supreme Court of Canada in Carter v. Canada (Attorney General), which ruled that the Criminal Code provisions that make it a crime to help a person end their life violate the Canadian Charter of Rights and Freedoms and that eligible adults with grievous and irremediable medical conditions are entitled to an assisted death. The Court delayed its suspension of invalidity for a period of 12 months, to allow Parliament the opportunity to amend its laws if it so chose.[http://scc-csc.lexum.com/scc-csc/scc-csc/en/item/14637/index.do Carter v. Canada (Attorney General)], 2015 SCC 5 at para 128 In January 2016, the Court granted an additional four-month extension to the suspension to allow for further time. As an interim measure, it ruled that provincial courts can now begin approving applications for euthanasia pursuant to the criteria in the Carter decision. On 6 June 2016, the suspension of invalidity expired and the law was struck down. On 17 June 2016, a bill to legalize and regulate euthanasia passed in Canada's Parliament.BBC News, [https://www.bbc.com/news/world-us-canada-36566214 Canada's parliament passed assisted suicide bill] 18 June 2016. Canada's current law makes euthanasia available only to residents eligible for Canadian healthcare coverage.{{Cite web |date=16 June 2016 |title=Medical assistance in dying |url=https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html |archive-url=https://web.archive.org/web/20230529064640/https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html |archive-date=29 May 2023 |access-date=31 May 2023 |website=www.canada.ca |publisher=Government of Canada}}

The previous law's requirement that a natural death must be reasonably foreseeable and that the medical condition be grievous and irremediable medical condition had been controversial for how it limited the original Supreme Court of Canada ruling, mandating that euthanasia be made available to all adults with grievous and irremediable medical conditions. The British Columbia Civil Liberties Association (BCCLA) challenged the constitutionality of the previous law because it excluded people with long-term disabilities and those with "curable" medical conditions whose only treatment options people may find unacceptable.{{Cite web |title=Archived copy |url=https://bccla.org/wp-content/uploads/2016/08/2016-06-27-Notice-of-Civil-Claim.pdf |url-status=dead |archive-url=https://web.archive.org/web/20170116172809/https://bccla.org/wp-content/uploads/2016/08/2016-06-27-Notice-of-Civil-Claim.pdf |archive-date=16 January 2017 |access-date=14 January 2017}} The BCCLA argued these medical conditions should qualify under the court's definition of grievous and irremediable.{{Cite web |title=Assisted-dying legislation faces new legal challenge in B.C. - British Columbia - CBC News |url=http://www.cbc.ca/news/canada/british-columbia/bccla-assisted-dying-legislation-1.3654220 |url-status=dead |archive-url=https://web.archive.org/web/20170115170210/http://www.cbc.ca/news/canada/british-columbia/bccla-assisted-dying-legislation-1.3654220 |archive-date=15 January 2017 |access-date=14 January 2017}} The BC Supreme Court and the Quebec Supreme court in Truchon ruled in 2019 that the law could not limit euthanasia only to individuals whose death was reasonably foreseeable.{{cite web |last1=Tiedemann |first1=Marlissa |title=Medical Assistance in Dying in Canada After Carter v. Canada |url=https://lop.parl.ca/sites/PublicWebsite/default/en_CA/ResearchPublications/201943E |website=Library of Parliament |access-date=18 May 2024}}

The current law prohibits mental illnesses as being considered as a grievous and irremediable condition, but this prohibition was initially set to expire on 17 March 2023. On 2 February 2023, the Canadian government introduced legislation to extend the temporary exclusion of eligibility in circumstances where a person's sole underlying medical condition is a mental illness for a period of one-year, until 17 March 2024.{{Cite web |date=2 February 2023 |title=Delay of eligibility for medical assistance in dying for persons suffering solely from mental illness proposed by Ministers of Justice and Health |url=https://www.canada.ca/en/department-justice/news/2023/02/delay-of-eligibility-for-medical-assistance-in-dying-for-persons-suffering-solely-from-mental-illness-proposed-by-ministers-of-justice-and-health.html}} In 2024, this was further delayed until 2027.{{cite web |last1=Taylor |first1=Stephanie |last2=Osman |first2=Laura |title=Liberals delay expansion of assisted dying eligibility until 2027 |url=https://calgary.citynews.ca/2024/02/01/assisted-dying-canada-liberal-government-delay-decision-2027/ |website=City News Calgary |date=February 2024 |publisher=The Canadian Press |access-date=1 February 2024}} After this date, persons with a mental illness can be eligible for medical assistance in dying, subject to any further amendments to the law or any new regulations.{{cite web |date=13 May 2022 |title=Final Report of the Expert Panel on MAiD and Mental Illness |url=https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/expert-panel-maid-mental-illness/final-report-expert-panel-maid-mental-illness.html}}

Canada's euthanasia law includes some legal safeguards aimed at preventing abuse and ensuring informed consent. Neither the legal witness nor the physicians involved can have any legal or financial interest in the outcomes of the patient. Consent must be repeatedly expressed, not implied, including in the moment right before death. Consent can be revoked at any time, in any manner. There are no consequences for backing out and there are no limits to how often it can be requested. Doctors are permitted to suggest euthanasia to patients, regardless of whether the patient has already said that they do not want it. To receive euthanasia, patients experiencing disease, disability or terminal illness must sign a written request expressing their wish to end their life in front of one independent witness who can confirm it was done willingly free of coercion. Next, two physicians and/or nurse practitioners must independently confirm their written agreement that the patient has an incurable grievous and irremediable medical condition that is in an advanced state of irreversible decline, and that the patient is capable of receiving and willing to receive euthanasia. If their death is not reasonably foreseeable, a medical expert in the underlying medical condition must sign off on the request, their assessment must take at least 90 days, and they must be informed about and decline all other forms of treatment, including palliative care.{{Cite web |last=Canada |first=Health |date=2022 |title=Medical assistance in dying |url=https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html |access-date=14 July 2022 |website=www.canada.ca}}

Canada's law is consistent with many other nations that allow euthanasia in requiring at least two physicians to confirm the details of a diagnosis.{{Cite news |url=https://www.bbc.com/news/world-34445715|title=What different countries say about assisted dying |first=Penney |last=Lewis |work=BBC News |date=6 October 2015}} Canada's law no longer requires the presence of a terminal illness, unlike many other countries where euthanasia is only legal in those circumstances. Canada's law is more restrictive than those of Belgium and the Netherlands in that it does not permit minors access to euthanasia. Canada does not yet allow it on the grounds of mental illness, a practice allowed in the Netherlands, Belgium, and Switzerland, until at least 17 March 2027.{{Cite news|url=https://www.usnews.com/news/best-countries/articles/2024-03-05/canada-backtracks-on-euthanasia-for-the-mentally-ill|title=Canada Backtracks on Allowing Euthanasia for the Mentally Ill |first=Brianna |last= Navarre |work= U.S. News & World Report |date= 5 March 2024 |access-date=7 May 2024}} Canada's law is less restrictive in that it does not require a patient to have exhausted all other treatment options, unlike Belgium and the Netherlands. While Belgium allows advanced directives in all circumstances, such advance directives in Canada may only be used if the patient's death is reasonably foreseeable.{{cite journal |pmid = 19069729 | issue=3 | title=[Advance directives: the legal situation in Belgium] | journal=Bull Soc Sci Med Grand Duche Luxemb | pages=305–310 | last1 = Herremans | first1 = J| year=2008}} Canada is the only country that allows nurses to administer the drugs used for euthanasia.

On 15 June 2012, in a case filed by Gloria Taylor, the Supreme Court of British Columbia ruled that provisions in the Criminal Code prohibiting euthanasia were unconstitutional as they apply to severely disabled patients capable of giving consent. The lower court ruled that the Criminal Code provisions "infringe s. 7 [and s. 15 ] of the Charter, and are of no force and effect to the extent that they prohibit physician-assisted suicide by a medical practitioner in the context of a physician-patient relationship". Moreover, the court found that the relevant sections were legislatively overbroad, had a disproportionate effect on people with disabilities, and was "grossly disproportionate to the objectives it is meant to accomplish."{{cite news |last=Greer |first=Darryl |date=18 June 2012 |title=B.C. Supreme Court Kills Assisted-Suicide Ban |newspaper=Courthouse News Service |url=http://www.courthousenews.com/2012/06/18/47546.htm |access-date=6 July 2012}} The case reached the Supreme Court of Canada in Carter v. Canada (Attorney General). The court ruled that the law banning euthanasia of terminally-ill patients (based on the Rodriguez v British Columbia (Attorney General) decision) was unconstitutional, and violated Section 7 of the Canadian Charter of Rights and Freedoms.{{cite web |url= https://scc-csc.lexum.com/scc-csc/scc-csc/en/item/14637/index.do |title=Supreme Court Judgments |author= |date=6 February 2015 |website=Supreme Court of Canada |publisher=SCC/CSC |access-date=2 January 2016}} The Supreme Court issued a 12-month suspended declaration of invalidity.{{Cite web|url=https://www.npr.org/sections/thetwo-way/2015/02/06/384292996/canadians-have-a-right-to-assisted-suicide-high-court-says|title=Canadians Have A Right To Assisted Suicide, High Court Says|website=NPR.org|date=6 February 2015 |last1=Chappell |first1=Bill}} As a result of the decision, euthanasia was expected to be made legal for "a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition".[http://eol.law.dal.ca/?page_id=238 End-of-life law and policy in Canada]. University of Dalhousie The court decision includes a requirement that there must be stringent limits that are "scrupulously monitored". This will require the death certificate to be completed by an independent medical examiner, not the treating physician, to ensure the accuracy of reporting the cause of death.{{cite news |author=Guichon |author2=Alakija |author3=Doig |author4=Mitchell |author5=Thibeault |name-list-style=amp |date=28 December 2015 |title=Assisted dying: Four problems, one simple solution |url=https://www.theglobeandmail.com/globe-debate/assisted-dying-four-problems-one-simple-solution/article27924838/ |newspaper=Glove and Mail |location=Toronto, Canada |access-date=2 January 2016}}

{{Infobox legislation

| short_title =

| long_title = An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)

| citation = S.C. 2016, c. 3

| enacted_by = Parliament of Canada

| royal_assent = 17 June 2016

| bill_citation = C-14, 42nd Parliament, 1st Session

| bill_date =

| introduced_by = Jody Wilson-Raybould

| 1st_reading = 14 April 2016

| 2nd_reading = 4 May 2016

| 3rd_reading = 31 May 2016

| 1st_reading2 = 31 May 2016

| 2nd_reading2 = 3 June 2016

| 3rd_reading2 = 15 June 2016

}}

As required by the 2015 Supreme Court decision, Justice Minister Jody Wilson-Raybould tabled a bill in parliament in April 2016 to amend the Criminal Code to allow euthanasia.{{cite news|title=Doctor-assisted dying bill restricted to adults facing 'foreseeable' death|url=http://www.cbc.ca/news/politics/canada-physician-assisted-death-law-1.3535193 |date=14 April 2016 |access-date=28 April 2016|agency=CBC}} Bill C-14 "create[s] exemptions from the offences of culpable homicide, of aiding suicide and of administering a noxious thing, in order to permit medical practitioners and nurse practitioners to provide medical assistance in dying and to permit pharmacists and other persons to assist in the process".{{cite web|title=Bill C-14: An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)|url=https://openparliament.ca/bills/42-1/C-14/|website=openparliament.ca|access-date=28 April 2016}} The bill restricted euthanasia only to mentally competent adults with "enduring and intolerable suffering" and in cases where death is reasonably foreseeable. It also mandated a 10-day reflection period.

After the House of Commons passed Bill C-14 that would allow for euthanasia, it was debated in the Senate in mid-June 2016. Initially, that chamber amended the bill, expanding eligibility for euthanasia. However, when it became apparent that the elected House of Commons would not accept the amendment, a final vote was held on 18 June. At that time, a majority agreed with the restrictive wording provided by the House of Commons indicating that "only patients suffering from an incurable illness whose natural death is 'reasonably foreseeable' are eligible for a medically assisted death", as summarized by the Toronto Star. Some opponents to the law indicate that the Carter v. Canada (Attorney General) decision was broader, including desperately ill individuals and not only those who are terminally ill or near death. The House of Commons did accept a few Senate amendments, such as requiring that patients be counseled about alternatives including palliative care and barring beneficiaries from acting in the euthanasia. Senators such as Serge Joyal who disagree with the restrictive wording believe that the provinces should refer the issue to the Supreme Court of Canada for an opinion in order to preclude the need for individuals to proceed with such an Appeal and incur the significant expense of doing so.{{cite news |last=McCharles |first=Tonda |date=17 July 2016 |title=Assisted dying to become law after Senate backs Liberals' bill |url=https://www.thestar.com/news/canada/2016/06/17/senate-votes-not-to-send-assisted-dying-bill-back-to-mps.html |newspaper=Toronto Star |location=Toronto, Canada |access-date=18 July 2016}} There was also a debate on the issue of suicide in Indigenous communities with MP Robert-Falcon Ouellette (Liberal) voting against the government on C-14. This was the first instance of a government backbencher voting against their party. Ouellette believes that large-scale changes to social norms like euthanasia should move very slowly because the impacts will be felt differently across Canada and societies.{{cite web|title=Robert-Falcon Ouellette questions impact of doctor-assisted dying on Canada's Indigenous Peoples|last=Hoffman|first=Kristy|url=https://www.cbc.ca/news/canada/manitoba/robert-falcon-ouellette-doctor-assisted-dying-indigenous-communities-canada-1.3537217|work=CBC News|access-date=28 September 2018|date=15 April 2016|archive-url=https://web.archive.org/web/20160415215324/https://www.cbc.ca/news/canada/manitoba/robert-falcon-ouellette-doctor-assisted-dying-indigenous-communities-canada-1.3537217|archive-date=15 April 2016}}

On 11 September 2019, the Superior Court of Quebec declared that restricting euthanasia to those whose death is reasonably foreseeable violated the Charter's guarantee to "life, liberty, and security of the person" as well as the Charter's guarantee of "equal protection" under the law.{{Cite CanLII |litigants=Truchon c. Procureur général du Canada |year=2019 |num=3792 |court=qccs }}{{Cite web |last=Government of Canada |first=Department of Justice |date=21 October 2020 |title=Introduction - Legislative Background: Bill C-7: Government of Canada's Legislative Response to the Superior Court of Québec Truchon Decision |url=https://www.justice.gc.ca/eng/csj-sjc/pl/ad-am/c7/p1.html |access-date=15 July 2022 |website=Department of Justice Canada}} The ruling declared the reasonably foreseeable clause in the federal euthanasia legislation to be unconstitutional. Neither the Attorney General of Canada or the Attorney General of Quebec appealed the decision.

The federal government passed Bill C-7 on 17 March 2021.{{Cite web |title=Government Bill (House of Commons) C-7 (43-2) - Royal Assent - An Act to amend the Criminal Code (medical assistance in dying) - Parliament of Canada |url=https://parl.ca/DocumentViewer/en/43-2/bill/C-7/royal-assent |access-date=15 July 2022 |website=parl.ca |language=en-ca}} The new legislation relaxed or eliminated some of the safeguards for patients whose deaths were reasonably foreseeable, notably removing the 10-day waiting period, requiring only a single independent witness, and removing the requirement to offer palliative care. The legislation also introduced a new avenue for those whose death was not reasonably foreseeable to access euthanasia, conditional on the approval of medical practitioner who specialized in the underlying condition, a 90-day assessment period, and discussion on all other available treatment methods. The legislation also included a sunset clause that would allow people with mental illnesses to be eligible for euthanasia two years after the legislation passed. This clause has been particularly controversial due to the perceived difficulty of receiving informed consent from individuals suffering from a mental illness, particularly when the mental illness is already associated with suicide ideation.{{Cite web |title=Oh, Canada! Your New Law Will Provide, Not Prevent, Suicide for Some Psychiatric Patients |url=https://www.psychiatrictimes.com/view/canada-law-provide-not-prevent-suicide |access-date=15 July 2022 |website=Psychiatric Times |date=June 2021 |language=en}} However, multiple studies show that the majority of people with mental illnesses do not lack the mental competence or the capacity to make treatment-related decisions.{{cite journal |pmid=17906238 | year=2007 |last1=Okai | first1=D. |last2=Owen |first2=G. |last3=McGuire |first3=H. |last4=Singh |first4=S. |last5=Churchill |first5=R. |last6=Hotopf |first6=M. |title=Mental capacity in psychiatric patients: Systematic review |journal=The British Journal of Psychiatry: The Journal of Mental Science |volume=191 |pages=291–297 |doi=10.1192/bjp.bp.106.035162 |s2cid=7819093 |doi-access=}}{{cite journal |url=https://pubmed.ncbi.nlm.nih.gov/28624976/ |pmid=28624976 |year=2018 |last1=Rooney |first1=W. |last2=Schuklenk |first2=U. |last3=Van De Vathorst |first3=S. |title=Are Concerns About Irremediableness, Vulnerability, or Competence Sufficient to Justify Excluding All Psychiatric Patients from Medical Aid in Dying? |journal=Health Care Analysis |volume=26 |issue=4 |pages=326–343 |doi=10.1007/s10728-017-0344-8 |s2cid=4054272}}{{cite journal |pmc=6099778 |year=2018 |last1=Dembo |first1=J. |last2=Schuklenk |first2=U. |last3=Reggler |first3=J. |title="For Their Own Good": A Response to Popular Arguments Against Permitting Medical Assistance in Dying (MAID) where Mental Illness is the Sole Underlying Condition |journal=Canadian Journal of Psychiatry |volume=63 |issue=7 |pages=451–456 |doi=10.1177/0706743718766055 |pmid=29635929}}{{cite journal |url=https://jme.bmj.com/content/48/11/929.abstract |pmid=33849958 |year=2022 |last1=Bahji |first1=A. |last2=Delva |first2=N. |title=Making a case for the inclusion of refractory and severe mental illness as a sole criterion for Canadians requesting medical assistance in dying (MAiD): A review |journal=Journal of Medical Ethics |volume=48 |issue=11 |pages=929–934 |doi=10.1136/medethics-2020-107133 |s2cid=233233285|url-access=subscription }} This expansion in access to medical assistance in dying was originally planned for March 2023 before being postponed by one year to 17 March 2024.{{cite web |last1=Lavery |first1=Irelyne |title=Feds looking to delay expansion of assisted dying: 'Need to get this right' |url=https://globalnews.ca/news/9352016/medically-assisted-death-maid-expansion-lametti-announcement/ |website=Global News |access-date=4 May 2023}} It was further postponed to 2027.{{cite web |last1=Baxter |first1=David |title=Medically assisted death for mental illness delayed until 2027: minister |url=https://www.globalnews.ca/news/10265616/maid-expansion-delayed-2027/ |website=Global News |access-date=16 May 2024}}

A panel was established by the government to study potential issues and safeguards with implementing medical assistance in dying for people whose sole medical condition was a mental illness.{{cite web |title=Canada's medical assistance in dying (MAID) law |url=https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html#e |website=Government of Canada |date=17 March 2021 |access-date=29 April 2023}} A report of this process was given to parliament on 6 May 2022. The panel had nineteen recommendations that could be implemented without amending the Criminal Code. Some arguments addressed to the panel suggested that there was no evidence that safeguards and protocols could be adequate and thus the panel's mandate could not be fulfilled. The panel concluded that despite these uncertainties, people could still voluntarily wish to request medical assistance in dying and thus its mandate could be fulfilled.{{cite web |title=Final Report of the Expert Panel on MAiD and Mental Illness |url=https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/expert-panel-maid-mental-illness/final-report-expert-panel-maid-mental-illness.html |website=Government of Canada |date=13 May 2022 |access-date=29 April 2023}} One member of the panel, Ellen Cohen, resigned for ethical reasons. Cohen believes that the issues faced by those in poverty or seeking housing was not adequately considered by the rest of the panel.{{cite news |last1=Cohen |first1=Ellen |title=Why I resigned from the federal expert panel on medical assistance in dying |url=https://www.theglobeandmail.com/opinion/article-expert-panel-maid-mental-illness/ |website=Globe and Mail |date=14 October 2022 |access-date=7 May 2024}} A person can simultaneously seek medical assistance in dying while waiting for other treatments.{{cite web |title=9 things to know about medical assistance in dying for mental illness |url=https://www.ctvnews.ca/w5/9-things-to-know-about-medical-assistance-in-dying-for-mental-illness-1.6242690 |website=CTV News|date=23 January 2023}} Proponents of including mentally ill patients regard the delays as discriminatory. Opponents are sceptical that mental illness is irremediable or concerned about endangering vulnerable individuals.{{cite news |last1=Navarre |first1=Brianna |title=Canada Backtracks on Allowing Euthanasia for the Mentally Ill |url=https://www.usnews.com/news/best-countries/articles/2024-03-05/canada-backtracks-on-euthanasia-for-the-mentally-ill |date=March 5, 2024}}

In 2024, a lawsuit about the legality of delaying expansion of euthanasia to those with a mental disorder was filed due to the belief that denying it on these grounds is discriminatory and violates the Charter of Rights and Freedoms.{{cite web |title=Canada's assisted-dying law faces constitutional fight for excluding mental disorder |url=https://www.ctvnews.ca/canada/canada-s-assisted-dying-law-faces-constitutional-fight-for-excluding-mental-disorder-1.7006167 |website=CTV News |date=19 August 2024 |access-date=20 August 2024}} A separate charter challenge was also filed in 2024, on the grounds that the track 2 criteria causes premature deaths of disabled people and euthanasia should be limited to those with reasonably foreseeable deaths.{{cite web |title=Disability rights groups launching Charter challenge against MAID law |url=https://www.cbc.ca/news/politics/maid-charter-challenge-1.7334653 |website=CBC News |access-date=2 October 2024}}

There have been 60,301 MAID deaths reported in Canada since the introduction of legislation in 2016. In 2023, 15,343 MAID provisions were reported in Canada, accounting for 4.7% of all deaths in Canada. This represents a growth rate of 15.8% over 2022. The average age of individuals at the time MAID was provided in 2023 was 77.6 years. In 2022, the underlying medical conditions included cancer (63%), cardiovascular (18.8%), other at 14.9% (can be frailty, diabetes, chronic pain, autoimmune), respiratory (13.2%), and neurological conditions (12.6%).{{Cite web |date=2023-10-26 |title=Fourth annual report on Medical Assistance in Dying in Canada 2022 |url=https://www.canada.ca/en/health-canada/services/publications/health-system-services/annual-report-medical-assistance-dying-2022.html |access-date=2023-11-27 |website=www.canada.ca}} 75% of MAID recipients received palliative care and of the MAID recipients who required, but did not receive, palliative care 80.5% had access, a level similar to the three previous years.{{Cite web |date=2024-12-11 |title=Fifth annual report on Medical Assistance in Dying in Canada 2023 |url=https://www.canada.ca/en/health-canada/services/publications/health-system-services/annual-report-medical-assistance-dying-2023.html |access-date=2025-01-24 |website=www.canada.ca}}

Before euthanasia was made legal in Quebec in June 2014,{{cite web |last=Shingler |first=Benjamin |date=22 December 2015 |title=Quebec's top court rules assisted dying law can go ahead |url=http://www.cbc.ca/news/canada/montreal/quebec-assisted-dying-euthanasia-law-1.3375853 |access-date=5 January 2016 |website=CBC News |publisher=CBC/Radio Canada |quote="Quebec's Court of Appeal has maintained the province's right to allow terminally ill patients the choice to die with medical help, the first law of its kind in Canada."}} the Quebec College of Physicians had declared that it was prepared to cross the line on the debate over euthanasia and proposed that it be included as part of the appropriate care in certain particular circumstances.{{Cite web |last=Séguin |first=Rhéal |date=16 July 2009 |title=Quebec physicians tentatively propose legal euthanasia |url=https://www.theglobeandmail.com/news/national/quebec-physicians-tentatively-propose-legal-euthanasia/article1220196/ |access-date=27 July 2016 |website=The Globe and Mail}} The Canadian Medical Association (CMA) describes euthanasia as "one of the most complex and ethically challenging issues facing Canadian physicians".{{cite web |title=Medical Assistance in Dying |url=https://www.cma.ca/medical-assistance-dying |access-date=22 September 2021 |website=Canadian Medical Association |language=en}} Before the legalization of euthanasia, the organization stated that it is not up to them to decide on the issue of euthanasia, but the responsibility of society. The organization also reported that not all doctors were willing to help a terminally-ill patient die.{{Citation |last=Whiting |first=Raymond |title=A Natural Right to Die: Twenty-Three Centuries of Debate |page=41 |year=2002 |location=Westport, Connecticut}}

A 2015 survey indicated that 29% of Canadian doctors surveyed would consider providing euthanasia while 63% would refuse.{{cite journal |last1=Vogel |first1=Lauren |date=2015 |title=Many doctors won't provide assisted dying |journal=Canadian Medical Association Journal |volume=187 |issue=13 |pages=E409–E410 |doi=10.1503/cmaj.109-5136 |issn=0820-3946 |pmc=4577361 |pmid=26323700}} However, the belief in late 2015 was that no physician would be forced to do so.{{cite web |date=27 December 2015 |title=Canadian doctors express mixed opinions on assisted dying |url=http://www.ctvnews.ca/health/canadian-doctors-express-mixed-opinions-on-assisted-dying-1.2715008 |access-date=2 January 2016 |website=CTV News |publisher=Bell Media |agency=The Canadian Press}} The extent of conscientious objection to providing euthanasia continues to be debated on issues such as whether objecting physicians must refer patients to a doctor who is willing to provide euthanasia and whether institutions have a right to refuse to provide euthanasia services; at present doctors are required to make effective referrals.{{cite journal |last1=Sumner |first1=L. W. |date=2020 |title=Conscientious refusal to provide medically assisted dying |journal=University of Toronto Law Journal |volume=71 |issue=1 |pages=1–31 |doi=10.3138/utlj-2020-0053 |s2cid=225245227}}{{cite journal |last1=Carpenter |first1=Travis |last2=Vivas |first2=Lucas |date=2020 |title=Ethical arguments against coercing provider participation in MAiD (medical assistance in dying) in Ontario, Canada |journal=BMC Medical Ethics |volume=21 |issue=1 |pages=46 |doi=10.1186/s12910-020-00486-2 |pmc=7271423 |pmid=32493374 |doi-access=free}} Catholic hospitals often refuse to provide healthcare that goes against the institution's tenets, such as abortion or euthanasia.{{cite web |last1=Fraser |first1=Laura |title=When it comes to physician-assisted death, could religious hospitals ethically refuse? |url=https://www.cbc.ca/news/health/physician-assisted-death-catholic-1.3468567 |website=CBC News |access-date=18 May 2024}}

A 2023 survey by the Angus Reid Institute showed 61% of Canadians supported the current version of the legislation, while 31% supported extending euthanasia to mental disorders.{{Cite news |date=February 13, 2023 |title=Canadians supportive of assisted dying law but wary of mental health expansion: poll |url=https://globalnews.ca/news/9479497/canada-assisted-dying-mental-health-poll/ |access-date=17 April 2024 |work=Global News}} A poll conducted by Leger in the summer of 2022 regarding further liberalization of Canada's euthanasia laws found that 51% of Canadians supported expanding euthanasia to mature minors, with 23% opposed and 26% being unsure. 65% supported advanced directives in the face of a worsening cognitive condition, with 14% opposed and 22% being unsure. 45% supported expanding eligibility for euthanasia to include individuals with serious mental illnesses, with 23% opposed and 32% being unsure of their position.{{Cite web |last=Leger |date=7 July 2022 |title=Attitudes Towards Medical Assistance in Dying (MAID) |url=https://2g2ckk18vixp3neolz4b6605-wpengine.netdna-ssl.com/wp-content/uploads/2022/07/PostMedia_MAID_July2022.pdf |access-date=20 July 2022 |archive-date=5 November 2022 |archive-url=https://web.archive.org/web/20221105023340/https://2g2ckk18vixp3neolz4b6605-wpengine.netdna-ssl.com/wp-content/uploads/2022/07/PostMedia_MAID_July2022.pdf |url-status=dead }}

In 2021, the United Nations Human Rights Council's special rapporteur on the rights of persons with disabilities criticized Bill C-7 and assisted death in general, for undermining both disabled people's equal right to live and their ability to autonomously access support to continue living. In 2025, a UN report recommended disqualifying non-terminal patients from being eligible for euthanasia.{{cite web |last1=Raaj |first1=Aarjavee |title=United Nations report says Canada should repeal MAID for people with non-terminal illness |url=https://www.ctvnews.ca/health/article/united-nations-report-says-canada-should-repeal-maid-for-people-with-non-terminal-illness/ |website=CTV News |access-date=6 April 2025 |date=April 6, 2025}}

An estimated 25% of disabled Canadian adults live in poverty. Money available through social programs differs across provinces but is often below the poverty threshold: New Brunswick offers the least at $705 per month and Alberta offers the most at $1,685 per month.{{cite web |last1=Leffler |first1=Brennan |last2=Dimain |first2=Mariane |title=How poverty, not pain, is driving Canadians with disabilities to consider medically-assisted death |url=https://globalnews.ca/news/9176485/poverty-canadians-disabilities-medically-assisted-death/ |website=Global News |access-date=7 May 2024}} In an August 2023 paper, Medical Assistance in Dying, Palliative Care, Safety, and Structural Vulnerability, the authors argued that while socioeconomic deprivation drives mortality to a large degree, it does not drive medical assistance in dying to any substantial degree.{{Cite journal |last1=Downar |first1=James |last2=MacDonald |first2=Susan |last3=Buchman |first3=Sandy |date=September 2023 |title=Medical Assistance in Dying, Palliative Care, Safety, and Structural Vulnerability |url=https://www.liebertpub.com/doi/abs/10.1089/jpm.2023.0210 |journal=Journal of Palliative Medicine |volume=26 |issue=9 |pages=1175–1179 |doi=10.1089/jpm.2023.0210 |pmid=37404196 |s2cid=259333477 |issn=1096-6218|url-access=subscription }} Another 2023 paper, The Realities of Medical Assistance in Dying in Canada, concluded that "The Canadian MAiD regime is lacking the safeguards, data collection, and oversight necessary to protect Canadians against premature death."{{Cite journal |last1=Coelho |first1=Ramona |last2=Maher |first2=John |last3=Gaind |first3=K. Sonu |last4=Lemmens |first4=Trudo |date=2023-07-18 |title=The realities of Medical Assistance in Dying in Canada |journal=Palliative & Supportive Care |volume=21 |issue=5 |language=en |pages=871–878 |doi=10.1017/S1478951523001025 |issn=1478-9515 |pmid=37462416 |s2cid=259948084 |doi-access=free}}

In certain cases, family members are not informed that their relative has died through MAID, as individuals have a right to medical privacy. While standard reviews of MAID cases may be conducted,{{cite web |title=This family learned loved one had medically assisted death only after she was gone |url=https://www.cbc.ca/radio/whitecoat/this-family-learned-loved-one-had-medically-assisted-death-only-after-she-was-gone-1.6380470 |website=CBC Radio |access-date=18 May 2024}} Canada's process has been criticized for lacking regional panels and oversight processes that other countries with legal euthanasia provide.{{cite news |last1=Anderssen |first1=Erin |title=A complicated grief: Living in the aftermath of a family member's death by MAID |url=https://www.theglobeandmail.com/canada/article-maid-death-family-members-privacy/ |website=The Globe and Mail |date=18 January 2023 |access-date=17 May 2024}}

After the repeal of the reasonably foreseeable requirement in Bill C-7, writers for The Spectator, Jacobin, and Global News have argued that many might opt into euthanasia because of poverty.{{Cite web |last=Zhu |first=Yuan Yi |date=2022-12-31 |title=Most-read 2022: Why is Canada euthanising the poor? |url=https://www.spectator.co.uk/article/most-read-2022-why-is-canada-euthanising-the-poor/ |access-date=2024-07-26 |website=The Spectator |language=en-US}}{{Cite web |title=The Canadian State Is Euthanizing Its Poor and Disabled |url=https://jacobin.com/2024/05/canada-euthanasia-poor-disabled-health-care |access-date=2024-07-26 |website=jacobin.com |language=en-US}}{{Cite web |title=How poverty, not pain, is driving Canadians with disabilities to consider medically-assisted death - National {{!}} Globalnews.ca |url=https://globalnews.ca/news/9176485/poverty-canadians-disabilities-medically-assisted-death/ |access-date=2024-07-26 |website=Global News |language=en-US}} Critics believe that a lack of social spending structurally places these people in poverty, and then introduces MAID as a way out, citing issues like insufficient welfare for disabled people and unconstitutionally long waiting times for healthcare as evidence that those who are disabled and impoverished do not have enough support to survive.{{Cite web |title=Chaoulli v. Quebec (Attorney General) - SCC Cases |url=https://decisions.scc-csc.ca/scc-csc/scc-csc/en/item/2237/index.do |access-date=2024-07-26 |website=decisions.scc-csc.ca}} An analysis piece from The Spectator, their most popular article in 2022, stated that the Canadian government sees MAID as a more economical alternative to investments in social programs and welfare. The Canadian Parliamentary Budget Officer released a report claiming the old MAID policies will save Canada $86.9 million per year and that Bill C-7 will save an additional $62 million per year.{{Cite web |date=October 20, 2020 |title=Cost Estimate for Bill C-7 "Medical Assistance in Dying" |url=https://pbo-dpb.gc.ca/web/default/files/Documents/Reports/RP-2021-025-M/RP-2021-025-M_en.pdf |access-date=2024-07-26 |website=Office of the Parliamentary Budget Officer}} There have also been intersectional issues raised with MAID relating to higher rates of poverty in marginalized communities, lack of social support, and ableism and racism in the medical community.{{Cite web |last=Ghobrial |first=Adrian |date=22 January 2021 |title=Marginalized communities concerned about changes to assisted-dying laws |url=https://toronto.citynews.ca/2021/01/22/marginalized-communities-concerned-about-changes-to-assisted-dying-laws/ |access-date=31 July 2024 |website=City News Toronto}}

Bill C-7 has been criticized as discriminatory towards disabled people. A letter from the United Nations Human Rights Council's Special Rapporteur on the rights of persons with disabilities, the Independent Expert on the enjoyment of all human rights by older persons, and the Special Rapporteur on extreme poverty on human rights raised concerns that the bill would not adhere to "international human rights standards".{{Cite web |date=3 February 2021 |title=Mandates of the Special Rapporteur on the rights of persons with disabilities; the Independent Expert on the enjoyment of all human rights by older persons; and the Special Rapporteur on extreme poverty and human rights |url=https://spcommreports.ohchr.org/TMResultsBase/DownLoadPublicCommunicationFile?gId=26002 |access-date=26 July 2024 |website=spcommreports.ohchr.org}} They believe that the bill potentially violates the right to life of disabled people, that provisions of the bill are not consistent with Canada's obligation to equality and non-discrimination, and that the bill perpetuates negative stereotypes about disabilities. In a paper from August 2023 authored by a member of the law faculty at the University of British Columbia, Legislated Ableism: Bill C-7 and the Rapid Expansion of MAiD in Canada, the author argues that the expansion of MAID through Bill C-7 conflicts with the Canadian constitution, violating s.7 and s.15, which pertain to equal protection under law and anti-discrimination.{{Cite journal |last=Grant |first=Isabel |date=24 August 2023 |title=Legislated Ableism: Bill C-7 and the Rapid Expansion of MAiD in Canada |url=http://dx.doi.org/10.2139/ssrn.4544454 |journal=SSRN|doi=10.2139/ssrn.4544454 |url-access=subscription }}

In addition to broader criticism of MAID, the handling of certain cases have been subject to media coverage. These include:

• In 2017, a mother of a young woman with cerebral palsy was told by a doctor that not applying for MAID was "selfish". Her daughter was in the room when the conversation took place and described the experience as traumatic.{{cite web |last1=Bartlett |first1=Geoff |title=Mother says doctor brought up assisted suicide option as sick daughter was within earshot |url=https://www.cbc.ca/news/canada/newfoundland-labrador/doctor-suggested-assisted-suicide-daughter-mother-elson-1.4218669 |website=CBC News |access-date=23 August 2024}}
• In 2018, Roger Foley was being treated for cerebellar ataxia at an Ontario hospital. Foley alleged that his only options were to be forcibly discharged from the hospital and then treated by an organization that had previously failed to provide him adequate care or apply for MAID. Foley hired a lawyer for a charter challenge.{{cite web |title='The solution is assisted life': Offered death, terminally ill Ont. man files lawsuit |url=https://www.ctvnews.ca/health/the-solution-is-assisted-life-offered-death-terminally-ill-ont-man-files-lawsuit-1.3845190 |website=CTV News |date=15 March 2018 |access-date=17 May 2024}} In 2024, his lawsuit against this hospital was dismissed with the presiding judge noting "It makes very serious allegations in the form of bare conclusions, without pleading material facts to support those allegations" as well as "These submissions were irrelevant and ... also betray the fundamentally political nature of many of Mr. Foley’s complaints." {{Cite web |last=Centa |first=Robert |date=2023-12-19 |title=Foley v. Victoria Hospital London Health Sciences Centre, 2023 ONSC 7155 (CanLII) |url=https://www.canlii.org/en/on/onsc/doc/2023/2023onsc7155/2023onsc7155.html}}{{Cite web |last=Centa |first=Robert |date=2024-09-09 |title=Foley v. Victoria London Health Sciences Centre, 2024 ONSC 4978 (CanLII) |url=https://www.canlii.org/en/on/onsc/doc/2024/2024onsc4978/2024onsc4978.html}}
• In 2019, Alan Nichols successfully applied for MAID while being hospitalized for suicide ideation. The reason given on his application was hearing loss.
• In September 2021, Rosina Kamis, a 41-year-old Malaysian-born woman, applied for MAID citing fibromyalgia as the reason. However, in conversations and recordings shared with friends, she mentioned financial hardship and social isolation as additional factors influencing her decision.{{cite web |title=Do You Want To Die Today? Inside Canada's Euthanasia Program |url=https://www.aljazeera.com/program/fault-lines/2023/11/17/do-you-want-to-die-today-inside-canadas-euthanasia-program |website=Al Jazeera |date=17 November 2023 |access-date=6 November 2024}}{{cite journal |last=Raikin |first=Alexander |title=No Other Options |website=The New Atlantis |issue=71 |date=16 December 2022 |url=https://www.thenewatlantis.com/publications/no-other-options |access-date=21 April 2025 |pages=3–24}}{{cite web |last=Brooks |first=David |title=The Outer Limits of Liberalism |url=https://www.theatlantic.com/magazine/archive/2023/06/canada-legalized-medical-assisted-suicide-euthanasia-death-maid/673790/ |website=The Atlantic |date=4 May 2023 |access-date=21 April 2025}}{{cite web |last=Schreiber |first=Miranda |title=The Lobby Group That Owns the Conversation around Assisted Deaths |url=https://thewalrus.ca/dying-with-dignity-lobby/ |website=The Walrus |date=12 January 2024 |access-date=21 April 2025}}
• In February 2022, an anonymous Torontonian suffering from extreme chemical sensitivity syndrome with the pseudonym Sophia had a medically assisted death after failing to find affordable housing that was free from tobacco smoke and other chemicals.{{Cite web |date=2022-04-13 |title=Woman with chemical sensitivities chose medically-assisted death after failed bid to get better housing |url=https://www.ctvnews.ca/health/woman-with-chemical-sensitivities-chose-medically-assisted-death-after-failed-bid-to-get-better-housing-1.5860579 |access-date=2023-02-03 |website=CTVNews |language=en}} This case was addressed by her health care provider in testimony provided to the Special Joint Committee on MAID, and was referenced in their final report.{{Cite web |date=February 2023 |title=Medical Assistance in Dying: Choices for Canadians |url=https://www.parl.ca/Content/Committee/441/AMAD/Reports/RP12234766/amadrp02/amadrp02-e.pdf |website=Parliament of Canada}}
• In October 2022, a man from St. Catharines applied for MAID when facing homelessness.{{cite web |title=Ontario man applying for medically-assisted death as alternative to being homeless |url=https://ottawa.citynews.ca/2022/10/14/ontario-man-applying-for-medically-assisted-death-as-alternative-to-being-homeless-5953116/ |website=CityNews |date=14 October 2022 |access-date=17 May 2024}} After receiving $60,000 from a GoFundMe campaign, he was able to find a place to live and withdrew his application.{{cite web |last1=Barker |first1=Matthew |title=St. Catharines man who was about to access medical assistance in dying saved through generosity of others |url=https://www.stcatharinesstandard.ca/news/niagara-region/st-catharines-man-who-was-about-to-access-medical-assistance-in-dying-saved-through-generosity/article_6b6b6233-c4d5-54d0-bb06-96236e80123d.html |website=St. Catharines Standard |date=21 November 2022 |access-date=17 May 2024}}
• In November 2022, an anonymous active Canadian Forces member has alleged he was offered MAID when seeking assistance regarding PTSD and suicidal thoughts.{{cite news

| last = Passifiume

| first = Bryan

| date = 24 November 2022

| title = Another Canadian Forces member alleges Veterans Affairs offered assisted death as 'support'

| url = https://nationalpost.com/news/second-canadian-forces-member-alleges-veterans-canada-offered-medically-assisted-death-during-support-call

| work = National Post

| location =

| access-date = 11 December 2022

}}

• In December 2022, Paralympian and veteran Christine Gauthier testified that a Veterans Affairs Canada employee offered her MAID as an option when she was fighting for the installation of a wheelchair lift or ramp at her house.{{cite news

| last = Brewster

| first = Murray

| date = 1 December 2022

| title = Former paralympian tells MPs veterans department offered her assisted death

| url = https://www.cbc.ca/news/politics/christine-gauthier-assisted-death-macaulay-1.6671721

| work = CBC News

| location =

| access-date = 11 December 2022

}} Subsequently, VAC claimed they found no record that MAID was offered as an option to Gauthier and that it found four such cases, all involving a single now-suspended case manager.{{cite news

| last = Brewster

| first = Murray

| date = 5 December 2022

| title = Veterans Affairs says it has no proof former paralympian was offered assisted death

| url = https://www.cbc.ca/news/politics/medical-assistance-death-maid-veterans-christine-gauthier-1.6674747

| work = CBC News

| location =

| access-date = 11 December 2022

}}

• In August 2022, Vancouver Coastal Health asked patients seeking mental healthcare for suicidal ideation if they would like to consider MAID, which the patients experienced as undermining their access to suicide prevention care; the hospital stated the suggestion was a method of assessing suicide risk.{{cite news |last1=Woo |first1=Andrea |title=Vancouver hospital defends suggesting MAID to suicidal patient as risk assessment tool |url=https://www.theglobeandmail.com/canada/british-columbia/article-maid-suicide-patient-vancouver/ |website=The Globe and Mail |date=9 August 2023 |access-date=10 August 2023}}
• In February 2024, a 27-year old woman with autism was scheduled for euthanasia in Alberta. Her father sought a temporary injunction through the justice system to prevent her death.{{cite web |last1=Grant |first1=Megan |title=Father asks court to stop 27-year-old daughter's MAID death, review doctors' sign-off |url=https://www.cbc.ca/1.7140782 |website=CBC News |access-date=20 August 2024}} The injunction was initially granted, but the father later dropped his appeal.{{cite news |last1=Martin |first1=Kevin |title=Father of autistic woman seeking Medical Assistance in Dying abandons appeal |url=https://calgaryherald.com/news/local-news/father-woman-medical-assistance-dying-abandons-appeal |access-date=2024-01-24 |work=Calgary Herald |date=2024-06-12}}

• Euthanasia Prevention Coalition
• Suicide legislation
• Maurice Généreux – Canadian physician that was convicted for providing assisted suicide
• R v Latimer – murder trial in which the defendant claimed that the murder was a mercy killing

{{Reflist|2}}

• [https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html/ Medical assistance in dying - Government of Canada]
• [http://www.cbc.ca/news/canada/british-columbia/doctor-physician-assisted-death-1.3709834 CBC Radio Interview about providing physician-assisted death] Canadian Broadcasting Corporation
• [https://www.dyingwithdignity.ca/ Dying with Dignity], advocacy group for euthanasia
• [https://carenotkill.ca/ Care not Kill], advocacy group against euthanasia

Category:Law of Canada

Category:Suicide in Canada

Category:Death in Canada