The government of Canada has no plans to stop allowing medical assistance in dying (MAID) for people without reasonably foreseeable deaths, Health Canada told Canadian Affairs this week.
Health Canada’s response comes after the Nov. 28 release of its annual report about MAID deaths in Canada.
The report says there were 16,499 MAID deaths in 2024, accounting for five per cent of all deaths in Canada that year.
“MAID is no longer this exceptional procedure to facilitate the dying process,” said Trudo Lemmens, a law professor at the University of Toronto who has studied MAID extensively.
In 2024, most MAID deaths — nearly 96 per cent — involved cases where the patients were suffering and had serious and incurable illnesses, diseases or disabilities that would lead to reasonably foreseeable deaths. This is known as Track 1 MAID.
The other deaths — of 732 individuals — involved cases where people were suffering and had incurable diseases, illnesses or disabilities but did not have reasonably foreseeable deaths. This is known as Track 2 MAID.
Human rights experts have said Track 2 MAID makes it easier for people with disabilities to die than live and violates international human rights laws.
In March, the United Nations told Canada to stop Track 2 MAID, and to not expand eligibility for it further, including a planned 2027 expansion to people whose only medical condition is a mental illness.
The federal government told Canadian Affairs it has no plans to stop Track 2 MAID.
“The government of Canada is not currently planning to repeal Track 2,” a Health Canada spokesperson said in a Dec. 3 emailed statement.
Data concerns
Since MAID was legalized in 2016, more than 76,000 Canadians have died by MAID, with the number of deaths increasing each year.
However, Health Canada’s report notes the annual rate of increase is declining. There were about seven per cent more MAID deaths in 2024 than in 2023, whereas the rate increased by more than 30 per cent each year between 2019 and 2021.
“While the data suggests that the number of annual MAID provisions is beginning to stabilize, it will take several more years before long-term trends can be conclusively identified,” Health Canada’s report says.
The number of Track 2 MAID deaths increased by 17 per cent in 2024, the report adds.
“Seventeen per cent [increase] is not stabilized,” said Krista Carr, CEO of Inclusion Canada, an organization that works with people with developmental disabilities.
MAID patients can voluntarily report if they have a disability. According to the report, 31 per cent of Track 1 MAID patients and 61.5 per cent of Track 2 patients said they did.
However, not everyone who has a disability will say they have one, says Lemmens, of the University of Toronto. People who have recently acquired disabilities or have disabilities because of aging may not consider themselves disabled, he says.
According to definitions of disability in human rights laws, everyone who qualifies for Track 2 MAID has a disability, says Carr from Inclusion Canada.
“One hundred per cent of Track 2 recipients had a disability,” she said.
Health Canada’s report also said most MAID patients live in higher-income neighbourhoods. However, Track 2 patients are slightly more likely than the rest of Canadians to live in lower-income neighbourhoods.
Helen Long, the CEO of Dying With Dignity Canada, a charity that advocates for MAID access, says this shows MAID does not disproportionately impact vulnerable people.
“At a high level, people across Canada who receive MAID do not disproportionately come from lower-income or disadvantaged communities,” Long said in an emailed statement.
But some say Health Canada does not collect adequate data to determine if MAID patients are socially disadvantaged.
Postal code data “does not actually tell you what suffering that person in front of us is seeking MAID for,” said Dr. Sonu Gaind, a psychiatry professor at the University of Toronto.
Doctors should ask patients if poverty is prompting their requests for MAID, he says.
“We’re not collecting the data we need,” he said.
‘Meaningful opportunities’
The Health Canada report lists MAID patients’ self-reported causes of suffering. Doctors ask MAID patients about specific causes of suffering, and patients can report more than one cause.
For both Track 1 and Track 2 patients, the most frequently reported causes of suffering were the loss of the ability to engage in meaningful activities and to perform tasks of daily living. Loss of independence and loss of dignity were the third and fourth most common causes of suffering.
As in past years, most MAID patients were seniors.
Dr. Marnin Heisel, a clinical psychologist who specializes in seniors’ mental health, said seniors commonly report feeling like they do not “fit in with society.”
Heisel runs groups with retired men, helping them find meaningful activities. His research has shown that seniors who report high levels of meaning in life are less depressed and have fewer thoughts of suicide.
“We need to provide meaningful opportunities for people who are facing serious or life-threatening conditions,” he said.
Concerns about loneliness
Loneliness was cited as a factor in nearly 22 per cent of all Track 1 cases. That number rose to 44 per cent for Track 2 patients. Similar numbers were reported in Health Canada’s 2023 report.
In this year’s report, Health Canada noted that many have raised concerns about loneliness being a factor in MAID deaths. It referenced a December 2024 Canadian Affairs article about the topic.
In response to these concerns, Health Canada conducted a further analysis of data about loneliness among MAID patients.
It found that, in 2024, MAID patients who cited loneliness as a cause of suffering had more causes of suffering than people who did not list loneliness. But no one listed loneliness as their only source of suffering, the report says.
The report also says that people with chronic or lifelong medical conditions are more likely to experience loneliness.
Some experts caution that the report downplays concerns about loneliness influencing people’s requests for MAID.
The fact that people with chronic conditions are more likely to experience loneliness “doesn’t diminish the fact that people say that [loneliness is] a source of their intolerable suffering that leads them to have MAID,” Lemmens said.
“It’s a serious finding.”
Emotional distress
The report also shows a significant increase in the number of MAID patients suffering from emotional distress.
In 2024, nearly 58 per cent of Track 1 patients listed emotional distress, up from about 39 per cent the year before.
Meanwhile, 63 per cent of Track 2 patients listed emotional distress, up from 35 per cent the year before.
This may show an increase of people with mental illnesses and physical illnesses and disabilities requesting MAID, says Gaind, the psychiatry professor.
But “it could reflect a normalization of what people think it’s OK and suitable to have MAID for,” he said.
The increase in MAID patients reporting emotional distress could mean MAID assessors are focusing more on that during assessments, says Lemmens.
“[MAID] has become a [way] to address broader struggling,” he said.
“We have to ask ourselves whether that’s a healthy and a safe thing — that in our society, we say the appropriate way to deal with that is ending [someone’s] life.”
If I am in a position to opt for MAiD, and I sincerely hope I am, the decision will be between me and a professional, certainly not a politician.
I’m glad that Canada is humane enough to allow MAID. It should be an option in all countries.
One of our neighbors with an incurable, advancing medical condition recently took advantage of MAID. It was his choice and he passed with dignity. His family was very happy he had the MAID option as opposed to continued pain and suffering as his condition worsened.
I live in the US and am thankful that MAID is not legal in my state. I’ll do everything possible to make sure that this doesn’t happen. Yes, my late husband died due to complications of frontotemporal degeneration and my late father and late mother-in-law died due to complications of Alzheimer’s disease. They lived in a different state, where it is also illegal. None of their deaths were “undignified”, nor they they bankrupt anyone.
You’ll do “everything possible to make sure this doesn’t happen” in your U.S. state, apparently because your personal experience persuades you that what worked for you and your disabled and dying relatives damn well ought to work for everyone. Even though legislating morality — plain English for what you intend — is a bad-faith hustle, never mind a violation of the church/state division in the U.S. You would do well to live and let live … or rather, live and let others die as they see fit.
As a person of age 83 , I’m please to see that the Canadian Government strongly supports MAID. I have been living with chronic pain for the last 55 years after enduring 13 surgeries, 50% major and 50% minor. Knowing that with age, I expect to continue to fall apart and there will be a time that I will request MAID. When enough is enough.
This article talks a lot about senior’s being lonely and that may be a contributing factor toward their end of life decision. I live alone and yes there are times that I’m lonely, but this has never a reason that I would consider the use of MAID.