How Canada is transforming assisted death safeguards

In Canada, medical assistance in dying or MAiD eligibility is set to change in March 2024, removing the exclusion for those suffering with severe mental illness. Since 2016, terminal patients in Canada who were near the end of life have had the constitutional right to end their life with the assistance of a physician. That changed in 2021 when Canada removed the stipulation that the patient must be terminal. In the same year, Canada estimated over 10,000 patients ended their life via MAID. The update to the law has caused a serious debate over the ethics of this procedure.

At the heart of the matter is a discussion over whether current safeguards are enough. In this unique look at the intersection of ethics and medicine, Alok sat down with Dr Stephanie Green (MD), President of the Canadian Association of MAiD Assessors and Providers (CAMAP) and Kerry Bowman (PhD), a Bioethicist from the University of Toronto to better understand how the update to the provision impacts Canadian patients looking to access MAID. The Vitals team will explain the detailed realities of how medically assisted death works today and examine what safeguards are in place to protect the patients.

Let’s Connect:

Find our experts and hosts:

::Dr. Alok Patel, MD ::
Twitter: @AlokPatelMD
IG: @alokpatelmd

::Dr. Stefanie Green, MD ::

:: Kerry Bowman, PhD::

00:00 Intro: MAID and mental illness inclusion
01:56 What is medically assistance in dying
02:57 Euthanasia vs physician assisted suicide
03:44 Eligibility
04:34 Eligibility without a terminal diagnosis
05:22 Dr. Jack Kevorkian’s lasting impression on MAID today
06:56 Canadian support for MAID
07:52 What’s the tension about changing the safeguards
12:55 Alok’s final thoughts
13:24: PBS Audience Survey

[elsieoneill]

Giving the government this much control over who can live and die is never a good idea. That is about and simple as it can be put.

[OofusTwillip]

My father's medically assisted death (due to mesothelioma) was the most incredibly humane, gentle death imaginable. As he drifted into the deepest sleep of all, we physically felt a peacefulness wrap itself around the whole house.

Why do animals deserve the mercy of a peaceful, quick, assisted death to release them from their suffering, but humans don't?

[shellbacksclub]

How can u be of sound mind to want this if ur mentally ill?

[liannevallabh]

The problem is where do we draw the line? Who said all doctors are ethical? This is a noble idea, but people aren't all noble, including doctors.

[zahisunohr]

I‘ve seen so many people in my life that wanted to pass but couldn’t (thus having to painfully do it themselves) because it would be illegal to safely assist them which is just sad in my opinion.
I really hope this becomes available in my country one day

[informationtransmitter]

This is one of best things to ever happen to Canada. We've got along way to do to ensure access on request for everyone without requirement for terminal illness. Eventually we will succeed.

[tombakersfield]

Should be legal for consenting adults to

[Nayukhuut]

I get that I am apparently a minority in my own country, but I am not sure I like MAID being extended to those with mental health issues. I am on disability for mental health issues right now, and with the constant rise of essentials such as rent, food, etc, it really feels like the government is happier to help us die than to help us live (and I really would rather live). If your only choices are die painlessly, or live freezing out on the streets... well, it isn't much of a choice. :(

I am all for letting people choose, but that means providing the supports to choose life as well, and not just the supports to choose death.

[shellbacksclub]

My uncle who i love more than anything is currently battling the debilitating results of CJD. Nobody should have to live thru this if there's another way.

[sandragalati]

Great presentation. I am proud to be an Oregonian whose state recognizes a person sovereign right to choose life on one’s own terms.

[vegetableautopsy]

As a species we struggle with even this pathetic amount of decency.
If someone doesn't want to live (considering what some are reconciled to call, "the new normal") don't enforce it. People die, but we always have to enforce and inflict suffering on the way there for some perverse 🐎 💩 reason or another.
Considering that on an individual level you're constantly in danger(from the moment of birth), No one should be standing in the way of the Exit.

[maryhauser]

The only ones that should be using MAID is the Canadian Federal Liberal Government , starting with Trudeau.

[xivinrah]

Death is not dark. Death is as beautiful as birth. Life is the only aspect of existence we have the capacity to influence… sometimes even shape, though that comes with great power and good fortune. Death is what allows many of us to truly separate from a body bruised, battered, and cluttered with memory… both traumatic and euphoric. Regardless of which end of the spectrum you experience life through, it is very very intense. Even more so for those who are highly sensitive.

The notion that death is dark is a misnomer. Life is continuous. The body isn’t and the body is the only aspect of our present existence that experiences death. But separation from this body and all of its ailments… to be one with the universe again, there is no greater fulfillment. Ask anyone who had a near death experience.

[anastrixnoodles]

It's weird doctors helping in taking away someone's life that isn't terminally ill. Maybe sooner than they think a cure will be in clinical trials for them and they won't be there to try it. Wouldn't a doctor rather not do it? When does the "do not do harm" line end? isn't taking a life that has any glimpse of hope harmful?

[NotSoNormal]

When I am in a depressive episode, I am not of sound mind. I am afraid that during an epsode I would be given the green light to die instead of the treatment that I need. What safeguards are in place to save me when unwell instead of just letting me die? What if our health insurance offers assisted death, but not medications or other treatment options? Because for profit health care benefits if a patient dies instead of having to provide continued treatment.

[carsonchan]

This option is pragmatic. The government is broke and have been relying on money printing to run its deficit welfare program for the past 20 years now.
I can't imagine there being free healthcare forever; especially so by the time I am old enough to need it.

A clean painless death in old age seems like a very good option. Don't even have to worry about retirement funds.

[Jennyzhou-xt]

as a chinese, today I make an appointment for a doctor, and tomorrow i get to see the speacialist. I do not unserstand why in Canada, need to wait for so long time. But the bad thing in China is that the sickness like cancer treatment is not free, it can lead to bankcrupcy😂.so many poor people choose to die instead of getting treatment

[Atreyufolife]

my meds sto working and I struggle making doctor's appointments let me go out how I want.

[Dan-kxlp]

Anyone promoting MAID should first have to go through the program entirely before pushing it on others....there problem solved

[TheSilverlady]

Wasn’t long ago a doctor took an oath to “do no harm”. Many seeking assisted dying are doing so because there is no help. If I am denied my post cancer pain control after radiation melted massive nerves in my left ganglion area causing “electrocutions” every day! The stigma and the prejudice when a cancer patient in agony is treated like a drug addict is evil. Perfect, y good effective medications available to control this pain. I had to sell my paid in full humble home in the town I was born in (finally home) and move 800 km north to a Nurse Practitioner who doesn’t label patients and treat case by case as it should be. My cancer related radiation induced nerve damage is so well documented. But the doctors down in Chatham and Sarnia refused to take my urgent need for continued pain control after my doctor retired. Cancer patient forced to sell and move is wrong!! I miss my big yard, my apple trees, the friends I had made etc etc. Narcotics do have a proper place in medical care of severe pain. Nerves melted and will never stop misfiring. 18 months of horrible nerve block needles into my head, 4 surgeries to cut ablate external nerves, a wire stim implant couldn’t stop the tazzering. Even brain surgery could not stop the electrocutions surgeon said the ganglion was a melted mess like chewed bubblegum he could not identify which nerve was which. No options left but medication. My condition is called “suicide disease” because the level of pain is unbearable but my cause is not typical it was radiation melting burning the nerves and my teeth were turned to putty and all removed. I was only 47 years old. Well the oncologist who assured me radiation was harmless was wrong he needs to go back to school! Oncology was supposed to be his specialty and I trusted him. My life was destroyed teeth gone, massive nerves in my brain destroyed, and I am legally blind. Radiation is not harmless. If my meds are ever denied someone better be ready to “put me out of my misery”. If my pain go 9/10 or 10/10 I will be screaming crying begging to die. Our animals get better merciful end of life.