Daryl Pullman announces an international symposium examining Medical Assistance in Dying (MAiD) in Canada to be hosted by the Memorial University Centre for Bioethics.

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At a recent international bioethics conference in Montreal, sponsored jointly by the Canadian Bioethics Society and the International Conference for Clinical Ethics Consultation, one of the plenary and several of the concurrent sessions were devoted to the topic of Medical Assistance in Dying (MAiD). The general tone of each session was that MAiD should be incorporated as a routine part of clinical care. Most remaining ethical challenges involve identifying and removing barriers and otherwise expanding access to what is now seen by many as an essential healthcare service.

Although it has been only eight years since MAiD became legal in Canada with the passage of Bill C-14, in eight short years Canada has become one of the most liberal MAiD regimes in the world. The Netherlands formally legalized medical euthanasia in 2002 but has practiced it informally for much longer. Yet while the number of assisted deaths in that country increased slowly but more or less steadily over the years until plateauing at around 5% of all deaths annually, Canada is fast approaching that number nationally and some jurisdictions have already exceeded it. Over 7% of deaths in Quebec are now MAiD deaths intentionally facilitated by medical professionals. A recent study predicts that the number of deaths by MAiD will continue to grow in Canada for the foreseeable future until 10% of all deaths in that country will be MAiD deaths.

Photo Credit: Wikimedia Commons. Image Description: Signal Hill, overlooking the harbour and city of St. John’s, Newfoundland and Labrador, Canada.

Far from seeing the rapid expansion of MAiD in Canada as a cause for concern, however, many view it as something to be celebrated. The plenary session at the aforementioned international conference is a case in point. That session featured representatives from four countries that currently allow MAiD (The Netherlands, Australia, Columbia, and Canada). The Canadian representative reported that Canada’s rapidly expanding MAiD regime, which has seen a year over year 30% increase in the number of assisted deaths, is a clear indication that there is an unmet need for medically assisted dying in Canada that is finally now on the way to being met. The implicit message was that we are doing things right here in Canada and our practice is something to be emulated.

While not in principle opposed to MAiD in all circumstances, I am nevertheless concerned about the rapid expansion of Canada’s MAiD regime and the persistent pressure to extend it further. There is much to question about the manner in which MAiD is practiced and regulated in Canada: many of the perceived “positive” aspects of MAiD in Canada should be scrutinized. For example, might the “unmet need” that MAiD is supposedly meeting as evidenced by the rapid and continuing expansion, be an unmet need for better access to healthcare services in general and palliative care in particular? Is the very liberal interpretation of what constitutes a “reasonably foreseeable natural death” as promulgated by the Canadian Association for MAiD Assessors and Providers (the federally recognized body responsible for supporting the practical implementation of MAiD in Canada), resulting in more individuals being considered eligible and offered MAiD rather than offering  alternative interventions to manage their health conditions?

To the end of taking a sober second look at the current MAiD regime in Canada, the Centre for Bioethics at Memorial University is organizing an international symposium in St. John’s, Newfoundland and Labrador that will examine such emerging and pressing concerns. The symposium will take place September 27-28 at the Signal Hill Campus of Memorial University. We invite anyone interested in the issue of MAiD in general and MAiD in Canada in particular to consider submitting an abstract or to attend the event.

More information about the symposium, including how to submit an abstract, is available here. The deadline for abstract submission has been extended to June 14.

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Daryl Pullman is a Professor of Bioethics in the Centre for Bioethics at Memorial University.