As we enter the new year, let’s take a look at a recent update to Canada’s Medical Assistance in Dying (MAiD) ledger book. New data sheds much needed light on a topic so broiled in hysteria and unforced errors to seem like some sort of deranged game of political and health-care tennis.
According to the fresh statistics,15,343 people died by assisted suicide in Canada in 2023. There are, on close inspection, a few notable points worth talking about.
At the outset, a note on oversight. This is the 5th Annual Report on MAiD in Canada, and for all the federal government’s problems, the fact that there is at least some sort of record keeping on this very new and very necessary medical procedure is a small, good thing.
The zealots and conspiracy theorists and misinformation experts on this topic would have a much easier time distorting and contorting facts were there less oversight. With this issuance of data, let’s celebrate how it positions the arguments in this country.
And on the facts of the matter, let’s run the list. It is a curious list, almost seeming to have been made up to confuse the confused on the question.
First, track: 95.9 per cent of those who received MAiD did so under Track 1 provisions (the track that stipulates death be “reasonably foreseeable”). As a small reminder here, slightly more than 15,000 people died by MAiD in Canada in 2023. Recent statistics report that roughly 85,000 Canadians die from cancer every year. ALS takes the lives of roughly 1,000 per annum in Canada.
Just 4.4 per cent of those who received MAiD through Track 2 (made by a person whose natural death is not reasonably foreseeable) had been living with their illness for a year or less, compared with 10 times that number in Track 1.
Second, diversity: The report states that recipients of MAiD “do not disproportionately come from lower-income or disadvantaged communities” and goes on to say that recipients “live in neighbourhoods across the income and marginalization spectrum as well as in urban, rural and remote communities.” This was the first year where self-identification measures like race were collected, and there are limitations to such analysis, but the report also highlights that of those who received MAiD, 96 per cent were Caucasian (70 per cent of the country reports being Caucasian, according to Statistics Canada).
Third, empty requests: Of the 19,660 MAiD requests, 2,906 patients died before receiving MAiD; 915 were deemed ineligible; and 496 withdrew their consent to the procedure.
Perhaps most curious of all is the change in rate of utilization. Just a 15 per cent jump year over year, according to the new numbers. That’s just half of what was observed in years prior.
There are several reasons why the growth in utilization may be showing signs of stabilization.
For one, social acceptance of MAiD, when it comes to the more straightforward case of terminal illness ravaging a competent mind, has likely risen over the years, and we may therefore be witnessing the beginning of a plateau in utilization. Perhaps this is related to more of MAiD being out in the open, and a more vocal case being made by its benefactors in recent years. Stories like that of the late Audrey Parker, a Nova Scotian whom I had the pleasure of meeting, and who received MAiD in 2018, have played undeniable roles in amending MAiD provisions and normalizing autonomous choice at the end of life.
Another reason for the decreasing rate of utilization likely relates to the other side of the equation – the doctors. See one, do one, teach one, the old medical school pedagogic paradigm screams. Under the current provisions, doctors are less fearful of being sued for involvement in the practice than they might have been in 2016 and the years since. This was, to some extent, a natural apprehension given the scope of the change in landscape due to Carter. Stabilization of such impacts takes time.
We have yet to see how the cookie will crumble when it comes to MAiD for sole mental illness.
Similarly, the clear implementation of fee codes in recent years likely improved access. This is a point vulnerable to parasitic thought and argument against the right to a life worth living, and the right to death, but it is also a possible point explaining the numbers, nonetheless.
All in all, the dramatic decline in the rate of growth in utilization, whatever its causation, is vindicating to those who never bought the weakest argument raised against access to MAiD – the slippery slope.
In sum, these numbers should give pause to the extremists who spent the better part of a decade hollering about that steep slippery slope and the boogeyman that was rushing toward the true north strong and free.
We can’t be sure what it is that future statistics will show. We have yet to see how the cookie will crumble when it comes to MAiD for sole mental illness.
But for now, the numbers correctly capture what thinking people across Canada thought of that weaselly and opportunistic slippery slope argument in the very first place.
Namely, that it was little more than ideological pseudo ethics. It is a good thing that the law has now caught up to the constitution and the rights it ensures to everyday people in Canada. That constitution, is, thankfully, more forceful than capricious medical or sociocultural norms across the stretches of time.
And as we wander into the vastness of a new year, why not point to a little cheer on this rather gloomy seeming discussion about death.
The United Kingdom, our commonwealth friend, appears poised to enhance its societal freedoms by legalizing MAiD for terminal illness.
In a British television interview leading up to a crucial vote on the motion, Labour MP Kim Leadbeater said: “We’ve got the benefit in this country of looking at what other countries have done …”
Leadbeater would go on to issue a sloppy and unwise slander on the Canadian system:“I’m not looking at the model that is going on in Canada. I’m looking at those other jurisdictions where this is done well”.
But the MP, like Canada in Carter, was right the first time.
