By Alex Schadenberg
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Health Canada recently released the Third Annual Report on Medical Assistance in Dying in Canada (2021). The data is gathered from the reports submitted by the medical or nurse practitioners who carried out the euthanasia death. There is no requirement that a third party or neutral person submit the reports to ensure their accuracy.

Comparing the Third Annual report (2021) to the Second Annual Report (2020), the report states that there were: 10,064 assisted deaths in 2021 up from 7603 in 2020, 5661 in 2019, 4480 in 2018, 2838 in 2017 and 1018 in 2016.

The report indicates that the number of assisted deaths increased by 32.4% representing 3.3% of all deaths in 2021.

When all data sources are considered, the total of number of euthanasia (MAiD) reported assisted deaths in Canada from legalization to December 31, 2021 is 31,664.

The report indicates that euthanasia represented 3.3% of all deaths, which was up from 2.5% in 2021. The data indicates a big difference in the percentage of euthanasia deaths between provinces. According to the data the percentage of all deaths that were euthanasia increased in all provinces notably:

  • British Columbia: 4.8% in 2021 up from 3.8% in 2020,
  • Quebec: 4.7% in 2021 up from 3.0% in 2020.
  • Prince Edward Island 2.9% in 2021 up from 2.8% in 2020.
  • Ontario: 2.7% in 2021 up from 2.1% in 2020.
  • Newfoundland was the lowest with 1.2% in 2021 up from 0.9% in 2020.

The report indicated that due to the passing of Bill C-7 in March 2021, 2.2% of the assisted deaths were people whose natural death was not reasonably foreseeable.

How did Bill C-7 expand eligibility for euthanasia in Canada?

This is the first Health Canada MAiD report since the federal government expanded eligibility for euthanasia (MAiD) in March 2021 by passing Bill C-7.

  1. Bill C-7 removed the requirement that a person’s natural death be reasonably foreseeable to qualify for assisted death. Therefore, people who are not terminally ill could die by euthanasia.
  2. Bill C-7 permitted a doctor or nurse practitioner to lethally inject a person who is incapable of consenting, if that person was previously approved for assisted death. Therefore, incompetent people can die by euthanasia in Canada.
  3. Bill C-7 waived the ten-day waiting period if a person’s natural death is deemed to be reasonably foreseeable. Thus, a person could request euthanasia on a “bad day” and die the same day.
  4. Bill C-7 created a two-track law. A person whose natural death is deemed to be reasonably foreseeable has no waiting period, while a person whose natural death is not deemed to be reasonably foreseeable has a 90-day waiting period before being killed by lethal injection.
  5. Bill C-7 approved euthanasia for mental illness alone, but established a two-year moratorium on euthanasia for mental illness alone to create guidelines.

The data indicates that there were 12,286 written requests for MAID in 2021 representing an increase of 27.7% over the number of written requests in 2020. The majority of the written requests (9,950 or 81.0%) resulted in an assisted death. There must be some missing reports. The data states the 9,950 written requests resulted in euthanasia, but there were 10,064 reported euthanasia deaths.

There were 2,336 requests (19.0%) that resulted in an outcome other than MAID.

  • 231 individuals withdrew their request (1.9% of written requests);
  • 487 individuals were deemed ineligible (4.0% of written requests); and
  • 1,618 individuals died prior to receiving MAID (13.2% of written requests).

It is concerning that only 4% of the written requests were deemed ineligible. The Netherlands and Belgium have higher rates of people being deemed ineligible.

The main reasons for requesting euthanasia were

  • the loss of ability to engage in meaningful activities (86.3%),
  • loss of ability to perform activities of daily living (83.4%), and
  • inadequate control of pain, or concern about controlling pain (57.6%).

It is concerning that approximately 1740 people (17.3%) died by euthanasia based on loneliness and isolation. Many people with significant medical conditions also live with loneliness and isolation. Social isolation and loneliness require a compassionate caring community, not death by lethal injection.

Inadequate control of pain or concern about controlling pain were reasons for 57.6% of the requests for euthanasia, and yet the report states that 80.7% of the people who requested euthanasia were “receiving palliative care.” Being enrolled in palliative care and receiving palliative care are different. A study needs to be done to determine how many people who died by euthanasia were actually receiving palliative care.

The federal euthanasia report essentially provides basic data that is not analysed.

Québec is the only province that provides an analysis of the euthanasia reports, and has a multiple reporting system that may uncover discrepancies in the reports.

Amy Hasbrouck, the past President of the Euthanasia Prevention Coalition, examined the Québec report data (April 1, 2020 to March 31, 2021). Hasbrouck reported that since Québec has a multiple reporting system, the data indicates a discrepancy between the 2426 euthanasia reports submitted by doctors and the 2688 euthanasia reports submitted by hospitals, nursing homes, and other facilities. A discrepancy of 262 deaths.

Since Québec reviews the euthanasia reports, the Québec report indicated that at least 7 of the euthanasia deaths did not fit the criteria of the law. Canada’s federal report does not analyze the reports; it only provides data from the reports. Research needs to be done to ensure compliance with the law.

Sadly, Canada has quickly become the most permissive euthanasia regime in the world. Further to that, a Canadian government committee is examining expanding the law to include euthanasia for children, “mature minors,” and euthanasia for incompetent people.

Recent stories indicate that Canadians are now dying by euthanasia for reasons of povertydisability, and mental illness.

It appears that the horse has already left the barn, but I have hope that Canadians will recognize that the slope we have chosen is very slippery and the direction needs reversing, not accelerating.

We need a caring community, not a killing community. Note: Alex Schadenberg is the executive director of the Euthanasia Prevention Coalition and you can read his blog here.