Expansion of the euthanasia law in Canada and its consequences

The Canadian law on medically assisted dying, known as MAiD (Medical Assistance in Dying), was significantly expanded in 2021 to include individuals with incurable but not necessarily terminal illnesses. Although euthanasia was initially permitted only for patients whose death was "reasonably foreseeable," the expansion allowed euthanasia for individuals suffering from persistent pain or disabilities, regardless of the terminality of their condition. This expansion has significantly increased the number of people eligible for MAiD, raising numerous ethical dilemmas among doctors, patients, and the public.

One of the key aspects of the Canadian euthanasia program is the process for approving requests. Each person must submit a written request that is then reviewed by two independent doctors or nurses. For individuals with non-terminal conditions, there is a mandatory minimum assessment period of 90 days, during which patients must be informed about other ways to alleviate suffering. However, despite these requirements, many questions and challenges arise in practice.

Controversial cases and challenges in practice

Doctors and nurses involved in the MAiD program often face difficult decisions and moral dilemmas. For example, one frequently discussed case involved a middle-aged worker who sustained ankle and back injuries that prevented him from returning to work. The financial support he received from the government was not sufficient for a dignified life, leading him to consider euthanasia. Doctors on private forums discussed his case, and many agreed that he met the legal criteria due to severe pain and social isolation. However, many were also concerned that financial reasons were a key factor in his decision, raising serious ethical questions.

Moreover, cases of homelessness have also sparked considerable controversy. One doctor shared the story of a patient with a severe lung disease whose suffering largely stemmed from the fact that he was homeless and owed money. The patient refused long-term care as he believed that living in a nursing home would be unbearable. After lengthy discussions and assessments, the patient was ultimately euthanized, raising questions about whether his suffering was truly unbearable due to illness or social conditions.

Social and economic impact on euthanasia decisions

Data from Ontario has shown that individuals seeking euthanasia who were not terminally ill often came from poorer communities with high levels of material deprivation and dependence on government assistance. This data suggests the possibility that poverty may be a factor in the decision to choose euthanasia, raising concerns about potentially unequal access to euthanasia among different social groups. In Ontario, more than three-quarters of individuals who were euthanized, without an imminent death, had been receiving disability assistance prior to death.

While Canadian officials assert that social support or lack of healthcare cannot ever be a reason for approving euthanasia, reality suggests otherwise. One anonymous report from the Ontario Ministry of Public Safety shared with doctors highlighted several cases where mandatory safeguards had been compromised. In one case, a patient with high blood pressure, a stroke, and blindness expressed a desire for euthanasia due to a loss of hope for improvement in quality of life. The case raised concerns as the procedure was scheduled according to the preferences of the patient's partner, rather than solely based on the patient's voluntary decision.

Ethical dilemmas and lack of transparency

There are concerns about a lack of transparency in euthanasia cases that raise ethical doubts. While MAiD is intended as a last-resort option for patients with unbearable suffering, there are increasing cases suggesting that euthanasia is offered to individuals in difficult socio-economic situations, but not necessarily in the terminal phase of illness. Critics argue that this trend may lead to "slipping," where euthanasia begins to be viewed as a solution to social problems rather than remaining a medically justified option.

When the euthanasia law was legalized, doctors and nurses established private forums to discuss complex cases while respecting patient privacy. However, due to the growing presence of such discussions, some experts question whether there should be more transparency regarding how decisions about euthanasia are made. As researcher Kasper Raus from the University of Ghent emphasized, the question of who is entitled to euthanasia is not only a medical issue but also a social one. "This is a procedure that ends human life, so we must carefully monitor all changes regarding who receives it," Raus said, warning that without adequate oversight, the practice could significantly drift from the original reasons for which it was legalized.

Community reactions and the future of the MAiD program

Numerous organizations advocating for the rights of individuals with disabilities, such as Inclusion Canada, warn of the dangers that the expansion of the euthanasia law poses for individuals with disabilities. In one recorded case, a physiotherapist offered the option of euthanasia to a woman who sought help for a bruise on her hip. Such cases raise significant concern as they indicate the possibility that euthanasia is offered even when other options for alleviating suffering are available. Critics argue that this approach sends a message to individuals with disabilities that their lives are not worth living, which is deeply problematic from ethical and human rights perspectives.

Despite all the criticisms, Canadian officials continue to assert that "strict safeguards" have been established in the MAiD program to protect every human life. However, numerous ethical dilemmas raised on private doctor forums, as well as data indicating the disproportionate representation of marginalized groups among those seeking euthanasia, suggest that the practice of euthanasia in Canada still requires further analysis and potential reforms to ensure fairness and equality in the application of the law.