Toronto doctors slam Canada's MAID program, warn patients are being rushed toward death
· Toronto Sun
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OTTAWA — It’s less of an approval process and more of a rubber stamp.
That’s how two Toronto physicians are describing Canada’s medical assistance in dying (MAID) program in a scathing op-ed published Monday in the New York Times .
Drs. Gary Rodin and Madeline Li — both psychiatrists at Princess Margaret Cancer Centre — warn their peers are increasingly being used as “conduits” to therapeutic suicide rather than seasoned medical professionals. They say doctors are rushing patients toward death without regard for what, in many cases, amounts to treatable social distress and psychological pain.
Medical suicide no longer a last resort
Canada’s MAID framework, they said, is no longer an option of last resort.
“Too many people are receiving the procedure without the opportunity for careful reflection about it with a health provider,” they wrote, adding that patients are often approved for MAID when they shouldn’t be.
“Reports have emerged of people seeking assisted death in the context of poverty or loneliness, raising concerns that they may feel they have no other options. In other cases, including for many of our cancer patients, medical assistance in dying may be the right choice eventually, but there’s a risk of rushing into it and shortening what can be a meaningful period in patients’ lives.”
The authors spoke of instances where MAID can be a dignified and “profoundly meaningful” experience for all involved, recalling a man in his 30s who chose to die before his condition progressed to an unbearable state.
“He said a final goodbye to everyone he loved, including his 5-year-old son, and died with his wife beside him and a music therapist singing Leonard Cohen’s ‘Hallelujah,’ ” they wrote in their column.
Canada at a MAID crossroads
In 2021, Canada removed the requirement that death had to be “reasonably foreseeable” to qualify for MAID.
Legislation was passed in February 2024 to expand MAID to those whose sole underlying medical condition is mental illness — scheduled to begin in March 2027.
Patients seeking medical assistance in dying in Canada are assigned to one of two tracks — Track 1 for those with terminal illnesses or whose natural death is near; and Track 2 for those whose death is not a reasonable outcome in the foreseeable future.
Canada’s inclusion of Track 2 MAID prompted condemnation from around the world, including a 2021 admonishment from a UN special rapporteur, who claimed it violated the UN’s Universal Declaration of Human Rights.
In June, a report from the Special Joint Committee on Medical Assistance in Dying — consisting of both Senators and House of Commons members — called for amendments to the Criminal Code to “indefinitely exclude persons whose sole underlying medical condition is a mental illness from eligibility for medical assistance in dying.”
The committee based its work on testimony from 44 witnesses across six meetings.
A total of 16,499 Canadians died through medically assisted suicide in 2024, making MAID Canada’s fourth most common cause of death that year — between accidents and strokes.
Doctors need to consider what’s best for patients
Rodin and Li highlighted the importance of maintaining sober, second thoughts when it comes to MAID, including one case of a woman in her 70s who, after decades as the family matriarch, was approved for medical suicide because she was unable to cook meals for her family.
“Through counseling, she came to understand that her family valued who she was, not what she did for them,” they wrote.
“She decided not to go through with ending her life, at least for now. That Christmas, her family gathered and she sat proudly at the table, while others did the cooking and serving.”
Such cases aren’t grounds for ending MAID in Canada, they said — but they are grounds for approaching the topic more thoughtfully.
“ We are arguing instead that medical providers pause, that they help their patients (in both Track 1 and Track 2) consider and truly understand alternatives that might relieve their suffering and allow them the possibility of more time to live meaningfully,” they said.