Though legalized euthanasia and assisted suicide are discouraged in many countries, in Canada, Medical Assistance in Dying (MAiD) has been available since 2016. Since its legalization, the restrictions on MAiD eligibility have continuously been loosened; in 2019 it was made available to those with severe chronic, but non-terminal physical ailments, and in 2021 the law was modified to include those with chronic mental illnesses. Now, a report from the National Post reveals that doctors are being encouraged to suggest assisted suicide and euthanasia to their patients.
According to the Post, a guidance document created by CAMAP (Canadian Association of MAiD Accessors and Providers) and published in early 2019 states that as part of the informed consent process, doctors have a professional obligation to discuss MAiD as an option when it’s “medically relevant.” While that document was intended for use under the early MAiD guidelines when it was only legalized for people who were terminally ill, it’s still being pushed today.
Canada’s MAiD law states that no healthcare professional commits an offense “if they provide information to a person on the lawful provision of medical assistance in dying.” CAMAP said there is no provision in the law that prohibits clinicians from initiating the discussion of MAiD. It remains illegal, however, to counsel someone to die by suicide.
There are also no restrictions concerning who brings up the topic of MAiD with someone who is eligible, as long as that professional does not intend to convince or persuade a patient into choosing assisted death.
CAMAP recommends the timing for informing a patient about euthanasia should be at the discretion of the doctor. The group says it would be inappropriate to suggest at the same time as given a difficult diagnosis. “However, once options for all treatment options including cessation of treatment are presented to the patient, it would be appropriate to disclose the availability of MAiD.”
Dr. Konia Trouton, CAMAP’s vice president, said, “We have to make sure that people are aware of their options. Awareness is not the same as coercing them or pushing them in that direction.”
CAMAP also indicated that not providing information about MAiD in a “timely manner” to someone who might be eligible for medically assisted death can create harm.
Providing euthanasia as a treatment option causes great concern for many ethicists, especially if a patient does not suggest the idea of MAiD on their own. Some believe the patient could misinterpret the “option” and choose to have their life ended prematurely based on the insinuation that ending their life is a valid option.
University of Toronto bioethicist Kerry Bowman said, “Some people, no matter how well-handled your conversation, may infer that it’s essentially a suggestion. They would also definitely infer that they have the strong potential to meet eligibility criteria, or you wouldn’t be offering it.”
According to Forbes, in its first six years, 40,000 people will have died through MAiD, with only 4% of requests being rejected for not meeting the criteria. This raises important concerns about the requirements and approval process.
Trudo Lemmens, a professor of health law and policy at the University of Toronto said, “The fact that this [MAiD] has been presented as ‘This has to be on the table because it’s part of informed consent,’ reflects, overall, an attitude that has developed in the Canadian context. It’s being sold as a normal medical practice.”
