“I’m Sorry My Colleague Killed Your Sister”

A few weeks ago, while walking through the halls of the hospital where I work, I ran into the brother of a former patient. I asked him how his sister was doing, having positive memories of journeying alongside her as she recovered from a stroke. He proceeded to inform me that she was “gone.” Saddened, I offered my condolences and asked what had happened. “She went for MAiD,” he said, his gaze drifting into a thousand-yard stare just to my right. “We didn’t agree with her choice, but she said that if she was not able to walk on her own after a year, she was going to go for it.” Sure enough, a year went by and she still was not able to walk on her own. I replied: “I’m sorry my colleague killed your sister.” 

As I said it, a wave of sadness hit me, not just for the despair this woman must have felt, but also that a doctor—one who had sworn an oath to “do no harm”—had affirmed her darkest thoughts. 

The brother seemed surprised at what I’d said. I told him it had been a pleasure taking care of his sister and assured him that this was not the “medicine” that I had signed up for. He thanked me, almost as if my view of care was a unique approach to “the healing art.” In Canada, it increasingly is.

The curious thing about my “unique” way of practicing medicine—where I refuse to kill my patients—is that it’s actually not unique at all. Historically, medical ethics has always maintained that doctors have no business killing their patients, as evidenced by texts from ancient China, India, and Greece, all the way up to modern times. It was not until 2016 that it became legal in Canada for doctors to kill their patients, and then only for cases that were “grievous,” “irremediable,” and “terminal.” Physicians were assured that “their independent, professional judgment makes them uniquely capable of detecting a patient’s vulnerability.” 

Yet in the following years, the safeguards for the vulnerable were repealed further. Courts allowed MAiD for individuals with non-terminal diagnoses that are nonetheless deemed “grievous and irremediable” in what are called “Track 2” MAiD cases. Track 2 cases are tricky because “grievous and irremediable” are qualitative assessments that the patients themselves make of their own conditions. It does not take a doctorate in medicine to know that a person’s opinion of what might be considered “grievous and irremediable” can vary greatly from one week to another due to a myriad of influences like mental health, finances, relationships, and so forth. While a new disability can be a shocking and painful adjustment, it need not spell the end of one’s life. I have known many people who flourish using wheelchairs and assistive mobility devices. I believe my former patient could have been one of them if she had the proper support and resources in place.

MAiD is conducted under the banner of “choice” and “autonomy,” but this is rarely how Canadians experience their healthcare system. After nearly a decade of seeing the underbelly of medicine in Canada, I’ve witnessed a steady decline in access to care, longer wait times, overflowing hospitals, and rising physician burnout. Canadian healthcare has become a bloated and broken bureaucracy that prompts vulnerable patients toward the most economically expedient option: death. It is no secret that MAiD saves the state a lot of money, and the savings are even included in the official fiscal reports.

The MAiD program has more than doubled between 2019 and 2022, and increased by 16 percent from 2022 to 2023. The most recent report reveals that roughly sixty thousand Canadians have ended their lives through the MAiD program since 2016. In contrast, California legalized what they call physician-assisted suicide (PAS) in 2016, yet only 4,287 patients have received PAS in the same period of time—even though it has a similar population size to Canada.

The independent investigative panel probing the reason for Canada’s rapid uptick in MAiD deaths found that 428 cases did not meet the criteria for euthanasia, making the deaths legally homicides (and these are only the cases that we know about). But there has been no referral to criminal authorities.

There have been a few instances where provincial police have launched criminal investigations. One woman with an untreated post-concussion syndrome was euthanized without her daughters’ knowledge. Another investigation and subsequent lawsuit found that a bipolar man received MAiD while on a day pass from a hospital stay without anyone’s knowledge. 

Despite already being one of the most lenient jurisdictions in the world when it comes to MAiD, Canada is continuing to expand euthanasia eligibility. In 2021, Bill C-7 received Royal Assent, which included the expansion of MAiD eligibility to those with mental health as the sole underlying medical condition. In response to a large backlash from healthcare professionals and the public, the government has delayed its implementation to 2027.

The protocol for administering MAiD reveals a sinister view of anyone who is not completely sound in body and mind. If I, in good health, wanted to die and attempted to kill myself, physicians would have the ability, by law, to restrain me against my will and ensure that I receive treatment for this desire to die. But if I was handicapped or ill, then the same physicians could help me end my life. The MAiD system says that the healthy are worthy of suicide prevention, and the disabled and ill are not. This is not just my opinion, but also that of the U.N. special rapporteur on human rights. Furthermore, the U.N.’s Convention on the Rights of Persons with Disabilities has formally recommended that Canada repeal its Track 2 MAiD program due to such injustices. The bias doesn’t stop with the sick and disabled: Many Canadian MAiD providers are quietly struggling with euthanasia requests from vulnerable populations, including the poor, homeless, and those living in long-term care homes.

It is often said that the true measure of a society lies in how it treats its most vulnerable members. By that standard, Canada is a society that is headed down a very dark path.

Note: The details of the case have been changed for the privacy of the patient and family.