Nearly Half of MAID Recipients Whose Deaths Not ‘Reasonably Foreseeable’ Cited Loneliness in 2023: Annual Report

Almost half of Canadians who sought medical assistance in dying (MAID) in 2023 whose death was not reasonably foreseeable cited “isolation or loneliness” as part of their eligibility criteria, according to Canada’s annual report on euthanasia.

The Fifth Annual Report on Medical Assistance in Dying in Canada found that 21.1 percent of Canadians in the Track 1 category, where their natural deaths were “reasonably foreseeable,” cited loneliness and isolation as a reason for seeking MAID. For Track 2, that number was 47.1 percent.

“Social isolation and loneliness are shown to have a serious impact on physical and mental health, quality of life, and longevity,” the report said, citing information from the World Health Organization.

The report noted that 95.9 percent of MAID provisions were for those in Track 1, while the remaining 4.1 percent were for Track 2—specifically, of the 15,343 individuals who received MAID in 2023, 14,721 were part of Track 1 versus 622 for Track 2.

The majority of the Canadians surveyed in Track 1 and Track 2 said they were seeking the procedure due to a “loss of ability to engage in meaningful activities,” a “loss of ability to perform activities of daily living,” and a “loss of dignity.”

Other reasons included “inadequate pain control, or concern about it,” which was cited by 54 percent of those in Track 1 and 59 percent of those in Track 2; “loss of independence,” cited by 53 percent in Track 1 and 39 percent in Track 2; “perceived burden on family, friends, or caregivers,” cited by 45 percent in Track 1 and 49 percent in Track 2; and “emotional distress, anxiety, fear or existential suffering” cited by 39 percent in Track 1 and 35 percent in Track 2.

The report said the 15,343 people who received MAID in 2023 represented a 15.8 percent increase over 2022 but a “slowing” of growth from 2019 to 2022, during which the average growth rate was about 31 percent. “It is not yet possible to make reliable conclusions about whether or not these findings represent a stabilization of growth rates over the longer term,” the report said.

Those who received MAID under Track 1 were older and more likely to have cancer as an underlying condition, while those receiving the procedure under Track 2 were predominantly women, slightly younger, and had lived with their illnesses for a much longer period of time.

The vast majority of those who received MAID and responded to the survey were Caucasian, at 96 percent, while the second most common identity was East Asian, at 2 percent.

MAID in Canada

Canada’s medically assisted dying regime came under scrutiny in late 2022, when a military veteran revealed having been offered MAID by a Veterans Affairs Canada (VAC) agent during a call with that agent. The unnamed veteran said they had been seeking treatment for a traumatic brain injury and post-traumatic stress disorder.

In October 2022, the House of Commons Veterans Affairs Committee heard from a witness that a VAC agent had told a veteran that he could receive MAID. CAF veteran and former paralympian Christine Gauthier also revealed to the committee in December 2022 that she was offered the procedure when trying to get a new wheelchair platform lift installed at her home, becoming the sixth known veteran to have been offered MAID unsolicited.

In March 2023, VAC released a report that said an internal investigation found four incidents in which MAID was “inappropriately raised.” The report said all of the incidents stemmed from one employee “who is no longer employed with the Department,” and concluded that “this is not a widespread, systemic issue.”

While Canada’s MAID regime was set to be expanded on March 17, 2023, to include people whose mental illness was their sole medical condition, a month before that date, Ottawa introduced Bill C-39 to extend the date to March 17, 2024. Then, in January 2024, Ottawa announced it would again extend the deadline to give more preparation time for medical providers and provinces, but it has not said what the new timeline would be.