Bridging the Gaps – Legislative and practice problems in Canada’s MAiD regime: Ramona Coelho and David Shannon – MLI
August 6, 2025
An emphasis on “choice” and “access” ignores the reality that desperation driven by systemic neglect can lead some to pursue assisted suicide under coercive conditions.
I. Background and Current State
Since its legalization in 2016, Canada’s Medical Assistance in Dying (MAiD) regime has expanded rapidly. Framed as the exceptional use of euthanasia or assisted suicide at the end of life for those experiencing intolerable suffering, MAiD, of which 99.9 per cent consists of euthanasia, has since deteriorated in both law and practice. In 2021, Canada legislatively extended eligibility to individuals who have physical disabilities but are not near death (Track 2) and, in the near future, to individuals whose sole underlying medical condition is mental illness. As legislators and MAiD lobbyists campaign for “access” and “choice,” evidence suggests that the safeguards intended to ensure free and informed consent while protecting vulnerable populations from wrongful death often fail or are bypassed.
Ontario’s MAiD Death Review Committee (MDRC) reports, government data, and investigative journalism illustrate how MAiD can be rushed forward without a thorough exploration of the reversible sources of suffering, robust capacity assessments, or alternative options such as palliative, social, and disability supports. Under some circumstances, MAiD is more accessible than basic care, particularly for those experiencing poverty, isolation, or inadequate medical and social support. This Commentary reviews the failures of current MAiD safeguards and proposes policy changes to address them. These include improving oversight, strengthening consent and capacity assessments, and ensuring access to meaningful alternatives, especially for disabled and marginalized people at risk of wrongful death under the current regime.
