After Parliament legalized assisted suicide in 2016, 2,838 Canadians killed themselves with the help of doctors the following year. By 2024, that number had risen almost six-fold to 16,499.
Assisted suicide (euphemistically mischaracterized as medical assistance in dying, or MAID) is now the fourth-largest cause of death in Canada, accounting for 5.1 percent of Canadian deaths in 2024, and a shocking 7.9 percent of deaths in Quebec. After the Netherlands, Canada comes in second place as the global leader in assisted suicide, even dwarfing ever-progressive Belgium, where assisted suicide was responsible for 3.6 percent of deaths in 2024.
Across Canada, patients are routinely and repeatedly offered assisted suicide as a “treatment” option—including veterans. In March 2027, Canadian law will change again to allow doctors to help mentally ill Canadians kill themselves. Mental illness alone, even without physical suffering or a terminal illness, will be reason enough for Canadian doctors to legally help their patients to commit suicide.
Canadians rightfully fear dying alone and lonely, in a sterile and bleak hospital environment, separated from loved ones and from the comfort of home. Many Canadians would choose palliative care and spend their final days at home, or in home-like and agreeable surroundings in a hospice. Yet government policies fail to respect terminally ill patients who wish to spend their final days in care environments that affirm life.
In B.C., the government withdrew funding from the Delta Hospice Society over its refusal to offer assisted suicide as part of the palliative care it provided to patients. The same society is now intervening in a B.C. Supreme Court action in which Dying With Dignity Canada seeks to force a Catholic hospital in Vancouver to provide suicide-as-treatment to patients.
St. Paul’s Hospital is operated by Providence Health Care Society, which describes itself as “a Catholic health care community dedicated to meeting the physical, emotional, social, and spiritual needs of those served through compassionate care, teaching, and research.” The court action maintains that St. Paul’s willingness to provide information about assisted suicide, and to transfer suicide-seeking patients to other facilities, is not an acceptable compromise. Dying With Dignity seeks to compel this Catholic hospital to assist patients in committing suicide. The goal here is coercion, not autonomy and choice.
Pro-suicide groups like Dying With Dignity also advocate for people being able to make “advance requests” for assisted suicide, whereby a person could pre-authorize their future euthanasia. While presented as “prudent planning,” advance requests actually sever the link between consent and the act that follows. As Jonas-Sébastien Beaudry wrote in a Policy Options article, to sign an advance request “imposes a past self’s instructions on a future self who can no longer give or withhold consent, and whose best interests may not always align with past wishes.” Expert witness Dr. Catherine Ferrier said in a brief submitted to the Special Joint Committee on Medical Assistance in Dying (AMAD) in May 2022: “I have noticed in this debate the assumption that written advance directives are a proven tool that enables autonomy and provides adequate free and informed consent to medical interventions. This is false. … Advance consent can never be fully informed.”
Discussions about non-consensual assisted suicide, or “involuntary euthanasia”—where third parties decide whose lives no longer warrant continuation—have now entered Canada’s political lexicon. In a chilling testimony to AMAD, Dr. Louis Roy of the Collège des médecins du Québec suggested that deformed infants up to one year old, living in pain and with no hope of survival, might be euthanized. He then recommended that the committee “reflect” on elderly individuals “failing to thrive,” whose lives may seem devoid of meaning.
Canada’s failing health-care system provides another incentive for expanding assisted suicide. The majority of health-care money spent on each individual is spent in the last years of that person’s life. A recent study in the OMEGA Journal of Death and Dying concluded that if assisted suicide were expanded to include “the mentally ill, the homeless, and retired elderly,” Canada’s health system would save $1.273 trillion by 2047.
Current realities and future possibilities are a far cry from the sober promises made by the Supreme Court of Canada in its Carter ruling in 2015, when it struck down the Criminal Code prohibition on helping another person to commit suicide. Reversing its 1993 life-affirming Rodriguez ruling, the court praised the Criminal Code objective of protecting “vulnerable persons from being induced to commit suicide at a time of weakness.” But the nine judges believed they could safely carve out a “stringently limited, carefully monitored system of exceptions” for “grievously ill and irremediably suffering people” who are “competent, fully informed, non-ambivalent, and free from coercion or duress.”
The road to hell is often paved with good intentions.
The recent assisted suicide of 26-year-old Kiano Vafaeian should give Canadians pause to think. His mother, Margaret Marsilla, mourns her son’s death and blames Canada’s assisted suicide regime and the physician who administered it for her loss. Marsilla says the physician approved her son’s death when no other doctor would.
The case will likely be recorded as “medically assisted dying,” but Kiano was not dying. He suffered from diabetes, depression, and blindness in one eye. “No protection. No effort to save a life, only to end it. This is not healthcare. This is a failure of ethics, accountability, and humanity. … No parent should ever have to bury their child because a system—and a doctor—chose death over care, help, or love,” Ms. Marsilla said.
Canada urgently needs to provide life-affirming responses to end-of-life suffering. Many Canadians nearing death do not want assisted suicide. Rather, they seek relief from pain, loneliness, and isolation, and they desire environments affirming the value of their lives until natural death. There is no credible reason for Canada’s health-care systems to refuse to provide patients with choice about the kind of environment in which to pass their final days.
If Canadians wish to remain a free people, governed by law rather than expedience, they must insist on robust safeguards: end-of-life spaces free of assisted suicide, and universal access to high-quality palliative care. The choice before us is stark: defend informed consent as the non-negotiable foundation of end-of-life decision-making, or allow freedom and the right to life itself to erode quietly at the bedside.
John Carpay, B.A., LL.B., is president of the Justice Centre for Constitutional Freedoms (jccf.ca).
