Canada is preparing to expand its medical assistance in dying (Maid) programme to include people with mental illness, a move that has intensified scrutiny over whether the country's euthanasia laws have gone too far. The change, expected this year, follows previous expansions that already allow assisted dying for those with chronic physical conditions, even if non-life-threatening.
Dr Madeline Li, a psychiatrist at Toronto's Princess Margaret Hospital who has overseen hundreds of Maid cases, recalled her first patient in 2016, a woman in her mid-60s with ovarian cancer. 'It was like stepping off a cliff,' she said. She now worries that making death too readily available could disadvantage vulnerable people and let society off the hook for addressing social failures.
Canada legalised assisted dying in 2016 after a Supreme Court ruling that banning it violated dignity and autonomy. That year, just over 1,000 people received an assisted death. By 2021, the number had risen to 10,064, representing 3.3% of all deaths in the country.
The 2021 expansion, prompted by a court challenge from two people with degenerative diseases, made Canada one of a few countries, alongside Belgium and the Netherlands, to allow assisted dying for those without a terminal illness. Psychiatric applications were delayed for two years to allow for safeguards.
Critics include three UN human rights experts, who warned in a 2021 letter that the expanded law could devalue the lives of disabled people. Reports of some Canadians opting for assisted death partly due to unaffordable housing have also raised concerns. Supporters, like Dr Stefanie Green, argue that offering the choice is 'objectively therapeutic' and relieves patients' anxiety about dying.
