Canada has become well-known around the world for its program of euthanasia. Depending upon perspective, some believe this makes Canada laudably progressive and others shockingly regressive. Though it is only relatively recently that euthanasia has become legalized in Canada, it has quickly surged to become the fourth or fifth most common cause of death. In this article, I want to simply lay out some of the facts about euthanasia in Canada and suggest where it is headed.
In Canada, what used to be termed “assisted suicide” or “physician-assisted dying” now goes by “Medical Assistance in Dying,” which is shortened to the acronym MAiD (or MAID). This is the preferred term for various reasons, not least that it sounds harmless and helpful, that it frames euthanasia as a medical procedure, and that it suggests the procedure merely assists in a process that is already underway.
“Euthanasia is the practice of administering a lethal drug and dose to a patient by a physician. The lethal combination of drugs is injected intravenously. The express aim of this action by the doctor is to cause the patient’s death. Euthanasia is ‘voluntary’ when it is requested by the patient; it is ‘non-voluntary’ when it is administered to an incapacitated patient; it is ‘involuntary’ when it is administered against the wishes of the person.” To this point, MAiD in Canada is legal only when it is voluntary, but, as I explain below, that may soon change. (Link)
MAiD first became legal in Canada in 2016. At that time, it was available only to those whose natural death was reasonably foreseeable and who wished to be relieved of unbearable suffering. It was expanded in 2021 to be made available to those whose natural death was not reasonably foreseeable. These two avenues are now referred to as track 1 and track 2. The great majority of those who die this way (96%) are made eligible through track 1.
To be eligible for MAiD, a person must: be eligible for government-funded health insurance in Canada; be 18 years of age or older and have decision-making capacity; have a grievous and irremediable condition; have made a voluntary request for MAiD that was not a result of external pressure; give informed consent to receive MAiD after having received all information needed to make this decision, including a medical diagnosis, available forms of treatment, and options to relieve suffering (including palliative care). To have a “grievous and irremediable medical condition,” a person must: have a serious illness, disease, or disability; be in an advanced state of decline that cannot be reversed; experience unbearable physical or mental suffering from an illness, disease, disability, or state of decline that cannot be relieved under conditions that the person considers acceptable.
A significant majority of Canadians strongly or somewhat support MAiD. Merely 13% strongly or somewhat oppose it. The most common justifications are dignity and autonomy, so that those who are ill or who otherwise wish to die ought to be able to die with dignity (rather than suffering the worst effects of their illness) and ought to be able to choose the time and place of their death. As I have argued elsewhere, euthanasia is an intuitive good to most Canadians. (Link)
Of those who receive MAiD, the vast majority are Caucasian (around 96%, compared to 67% of the population) and the average age is 76 years old. More women than men die this way (57% vs 43%). (Link)
As of the end of 2024, around 76,000 Canadians had died via MAiD. The annual growth rate is currently around 7%, but its legalization is still recent enough that the numbers have not stabilized. The Baby Boomer generation is increasingly reaching the age where many people pursue MAiD, so there is good reason to believe the rate will increase substantially. At some point around the middle of 2026, Canada’s 100,000th person will be euthanized. Canada has probably had more deaths by euthanasia than any other country in the world. (Link)
In 2024, Canada was scheduled to expand MAiD to those whose sole condition is mental illness. However, because the government had not yet satisfactorily created appropriate safeguards, the implementation date was delayed until March 2027. Most people believe it is likely that eligibility will, indeed, expand at that time. For now, the sticking point is the matter of gaining consent from those who suffer from mental disorders.
One of the reasons most often offered to justify the expansion of euthanasia to those with mental health issues is that without it, people may kill themselves. (Link) (Link)
The Province of Alberta has recently put forward a bill that will restrict MAiD in Alberta to its current limitations, prohibit its promotion in medical facilities, permit conscientious objection by doctors and hospitals, and establish better oversight of the program. (Link)
MAiD accounts for between 5% and 6% of Canadian deaths. However, MAiD is not permitted to be officially listed as a cause of death. Rather, the official cause of death is the underlying ailment that made the individual eligible for MAiD. There is no clarity yet on how a cause of death will be listed when the underlying cause may be non-deadly, like depression.
The organization most responsible for advancing the euthanasia agenda in Canada is Dying with Dignity. Its future goals include extending MAiD to “mature minors,” perhaps as young as 12 years of age, permitting advance requests for MAiD, removing all “obstructions” related to religious convictions, and combating Alberta’s new restrictions. (Link)
MAiD is supported by all the major political parties, albeit to varying degrees. The ruling Liberal Party of Canada is adamantly in favor and, to this point, has been responsible for passing all of the laws related to it. If, as most people believe, euthanasia is to be expanded next year to people whose sole condition is mental illness, the Liberal Party will also be primarily responsible for advancing and passing that legislation. The leaders of the opposition Conservative Party of Canada are also in favor of MAiD, though with more substantial restrictions. Minority parties like the New Democratic Party and Bloc Québécois are likewise in favor of expanding it.
MAiD is performed by giving the recipient a sequence of drugs. “First, a sedative tranquilizing agent is injected to relieve anxiety and to have the patient fall into a light sleep. Then, an intravenous anesthetic agent is administered (in a very high dose) to put the patient into a coma and to take away the brain’s drive to breathe. Third, a paralytic agent is administered to prevent the breathing muscles from contracting so that the patient ceases to breathe. Finally, an intravenous dose of local anesthetic or potassium chloride is administered to stop the patient’s heart from beating.” (Link)
The acceptance of euthanasia tends to follow a set pattern. Craig A. Carter explains: “Once the idea becomes embedded in our consciousness that we can protect ourselves against pain by choosing assisted suicide, the nature of assisted suicide itself begins to change in our minds. It goes from (1) absolutely wrong and unthinkable to (2) a possibility to be taken seriously to (3) a solution to a problem to (4) a positive good.” Canada has very much followed this pattern so that today a majority of Canadians consider it a positive good. (Link)
The widespread embrace of MAiD is leading to new rites, such as funerals or celebrations of life, that happen before a person dies. Friends and family members are invited to participate in a party or “living funeral” that takes place a short time before the individual is euthanized. (Link)
There have been many news reports of misuse or abuse of MAiD. Just a few of the headlines include:
- Family sues after man allegedly got medically assisted death during day pass from hospital
- People choosing MAiD because they can’t afford to live (Video)
- Here’s why critics believe hundreds of medically assisted deaths shouldn’t have happened
- Struggling Canadian veteran offered medically assisted death by VAC employee (Video)
- Quadriplegic Ontario woman considers medically assisted dying because of long ODSP wait times
- She went to the hospital with suicidal thoughts. A clinician raised medically-assisted death
- Assisted dying ‘abused’ in Canada, admits group that helped legalise it (This article is behind a paywall, but it describes a man who was euthanized for hearing loss and tells of doctors who may be coercing their patients to pursue MAiD.)
To this point, doctors are not required to euthanize patients, though they are required to provide an “effective referral,” which involves referring patients to a doctor who will begin the process of MAiD. To this point, doctors who object to MAiD on ethical grounds have generally been able to find workarounds for the requirement to provide effective referrals that will satisfy their conscience. Most expect the law will soon demand doctors actively participate in MAiD. Should this happen, many Christian doctors may need to resign from their positions or expect to be fired. Similarly, religious hospitals are currently not required to participate in MAiD, but this matter is soon to go before the courts. (Link)
Christians object to MAiD on a number of grounds, each of which begins with the conviction that human beings are created by God, uniquely made in his image, and greatly loved and valued by him. As humanity’s Creator, he alone has the right to number our days and, therefore, forbids the taking of human life—including our own. “Christians are not alone in valuing life; many Jews, Muslims, and other people of goodwill also affirm the intrinsic goodness of human life. But there is a distinctly Christian conviction at work here, and it is bedrock to our faith: Every human being, from conception to death, is created by God, loved by him, and stands under his protection. ” See Why Christians Oppose Euthanasia for a helpful summary of the Christian position.
Other arguments against MAiD stress that it preys upon those who are most vulnerable; that it introduces a cold calculus into a medical system in which a human life is measured against the cost of keeping a person alive; that it contradicts the very purpose of medicine, which is to keep patients alive rather than hastening their deaths; that it marginalizes and stigmatizes the weak and disabled; and that it inevitably begins a slippery slope in which it will become not only more common, but also expected, and it will extend to a greater number of people (e.g. mature minors, people who have not given consent, and so on).
To this point, most Canadians either know someone who has died through MAiD or know someone who plans to. Churches are having to address the matter since many professed Christians have not been provided with a biblical perspective on the matter and, therefore, assume it is an acceptable means to end suffering and hasten an inevitable death.
Those who pursue MAiD will sometimes ask friends or family members to be present at their death. Those who are opposed to the practice are then faced the moral dilemma of whether they should participate through their presence in an act they believe is sinful. As far as I know, there has been no substantial writing that expresses a Protestant conviction on this matter. The Roman Catholic Church has expressed that its adherents must not be present, lest presence imply complicity. (Link)
Canada is increasingly used as a negative example of the practice gone amok, and in that way, may be slowing the growth of euthanasia in other countries. For example, as the U.K. recently debated permitting euthanasia, Canada was used as a negative example that may have helped sway the vote. (Link)
Resources
Here are a few resources that may be useful to better understand euthanasia in general or the Canadian situation in specific.
- Care Not Kill is an initiative of ARPA Canada (Association for Reformed Political Action). It offers information about euthanasia in Canada and provides guidance and opportunities to advocate for the cause of life.
- Canada Is Killing Itself, a long-form article from The Atlantic, is a thorough examination of the situation in Canada that aptly describes ways in which MAiD has been expanding far beyond its original boundaries.
- Death and Dying: A Catechism for Christians by Dr. Ewan Goligher and pastor Kyle Hackmann is a very helpful question-and-answer document that makes the case against euthanasia.
- How Should We Then Die?: A Christian Response to Physician-Assisted Death by Ewan C. Goligher is written by a Canadian doctor who has been on the frontlines of the battle against MAiD. (My review)
- Between Life and Death: A Gospel-Centered Guide to End-Of-Life Medical Care by Kathryn Butler offers a distinctly Christian perspective on end-of-life care.
- Christian’s Pocket Guide to Understanding Suicide and Euthanasia: A Contemporary and Biblical Perspective by D Eryl Davies is a brief book on both suicide and euthanasia.
