Packed with statistical data points, a new research report from the non-partisan Cardus think tank starkly suggests the reality of the Canadian medical assistance in dying (MAiD) regime for vulnerable populations has been significantly more outsized than predicted in the 2015 Supreme Court ruling that decriminalized euthanasia.

“In Contrast to Carter: Assisted Dying’s Impact on Canadians with Disabilities,” released on Sept. 16, concluded “that Canada’s legalization of assisted suicide has led to an intensified risk of premature death for vulnerable groups, and that the expected safeguards have failed to materialize.”  

This commissioned study was authored by Alexander Raikin, a visiting fellow at the Ethics and Public Policy Center in Washington, D.C., under the direction of Rebecca Vachon, the program director for Cardus Health.

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Raikin begins this report by summarizing the specific expectations outlined in the Carter v. Canada decision that would make it agreeable for a physician-assisted euthanasia program to be legally adopted in this country.

There was not to be a disproportionate impact on the right to life for vulnerable groups as physicians would vigilantly analyze the intricacies of a request filed by persons living with disabilities or depression. MAiD, after all, was originally promoted for people whose natural death was foreseeable because of their terminal illness. And there was an assurance of a scrupulous review to ensure the right to life and personally autonomy would be safeguarded for individuals who felt like a burden, were suffering from social isolation or living with neurological illnesses and disabilities.

In reality, Raikin, by reviewing Health Canada reports 2019 to 2023, said “at least 42 per cent of all MAiD deaths were of persons who required disability services, including over 1,017 persons who required but did not receive these services.” Under closer examination, in 2019 there were 87 MAiD clients who required disability supports but did not receive them, and in 2023 that annual figure grew to 432 such individuals.

The 2019-2023 period also saw 19,720 Canadians who required disability services and received them dying of euthanasia. The annual figure grew 233 per cent from 2,223 in 2019 to 5,181 in 2023.

Vachon, the official spokesperson for the report, told The Catholic Register that “it really is quite sad” to read that a growing number of Canadians who request disability services are proceeding with assisted suicide because they are not receiving that help. She said there are also concerns that thousands of Canadians with disabilities receiving help are still ultimately being euthanized.

“The data we have doesn’t tell us anything about the adequacy of the services,” said Vachon. “The fact that so many people then are receiving MAiD, I think continues to raise questions about the adequacy of the services provided.”

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Raikin also noted that the original trial judge for Carter v. Canada, British Columbia Supreme Court Justice Lynn Smith, considered publicly available evidence from the assisted suicide programs of Oregon, Washington, Belgium, Luxembourg, the Netherlands and Switzerland. She also endorsed findings in studies from Margaret Battin for The Netherlands and Linda Ganzini from Oregon.

Justice Smith wrote in her decision that Battin and Ganzini’s findings “were based on evidence and that they had analyzed that evidence carefully.” She wrote “the evidence does not support the conclusion that, since the legalization of physician-assisted death, there has been a disproportionate impact, in either Oregon or the Netherlands, on socially vulnerable groups such as the elderly or persons with disabilities.”

“In Contrast to Carter: Assisted Dying’s Impact on Canadians with Disabilities,” suggests that the Canadian MAiD regime no longer was comparable to other jurisdictions as of 2021 when Bill C-7 (Track 2 MAiD) became law and “liberalized existing safeguards and expanded assisted dying to include those with non-terminal illnesses.” This new legislation was inspired by the 2019 Superior Court of Quebec decision that declared the reasonable foreseeability of natural death criterion unconstitutional.

Now, Raikin wrote, “Canada today permits disability as a sole qualifying condition for MAiD, including for those who are not dying,” and “this expansion occurred despite significant opposition from national disability groups.”

In September 2024, the disability rights organizations Inclusion Canada, the Council of Canadians with Disabilities, Indigenous Disability Canada and DAWN Canada, teamed up as a coalition to file a legal challenge against Track 2 MAiD.

The dramatic increase in MAiD ushered in by the 2021 expansion is a far cry from what was promised to Canadians, said Vachon.

“When you see what the expectations were, and you contrast that with the data, it's a very stark difference,” said Vachon. “The expectations that Canadians have, I think, are rooted in some of those expectations that were set up by the court. If you look at some studies that have been done of what Canadians actually believe about MAiD, when you test their knowledge and when you ask them what they actually support, Canadian support is MAiD (can be) a last resort in exceptional circumstances. The way MAiD has ballooned is beyond that.

“Hopefully this report will start to enable Canadians to see there’s a big gap here and we have a lot of work to do in addressing these care needs and enhancing the accountability structures in place to ensure that (MAiD) is not being driven by unmet needs.”

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As of March 17, 2027, more guardrails are poised to be removed: Individuals solely living with a mental illness will also be granted access to the procedure. Bill C-218 has been tabled in the House of Commons in a bid to stop this expansion. A vote at second reading is anticipated before the end of 2025.

Read “In Contrast to Carter: Assisted Dying’s Impact on Canadians with Disabilities,” online.