Anaya Nolan
Canada's Medical Assistance in Dying (MAID) law, passed in 2016, recognises the right to die with dignity. Unlike other jurisdictions, a terminal condition is not a prerequisite for MAID eligibility in Canada. Instead, MAID eligibility criteria include being 18 or older, having decision-making capacity, being eligible for publicly funded healthcare services, and giving informed consent. As of 2021, MAID eligibility no longer requires a person's natural death to be reasonably foreseeable. Canada's MAID law is one of the most liberal in the world, and the country publishes regular reports on its implementation.
| Characteristics | Values |
|---|---|
| Name of the law | Medical Assistance in Dying (MAID) |
| Year of introduction | 2016 |
| Year of revision | 2021 |
| Eligibility criteria | Be 18 years of age or older and have decision-making capacity; be eligible for publicly funded health care services; make a voluntary request that is not the result of external pressure; give informed consent; have a serious and incurable illness, disease or disability (excluding a mental illness until March 17, 2027); be in an advanced state of irreversible decline in capability; have enduring and intolerable physical or psychological suffering that cannot be alleviated under conditions the person considers acceptable |
| Number of deaths as a percentage of total deaths in Canada in 2022 | 4.1% |
| Number of MAID patients in Canada whose deaths were reasonably foreseeable | 96.5% |
| Number of people opting for MAID in Canada who were receiving palliative care | 8 in 10 |
| Number of independent healthcare professionals required to evaluate an individual to determine whether they qualify for MAID | 2 |
| Number of days the eligibility assessment must take | 90 |
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What You'll Learn
Canada's euthanasia law is one of the most liberal in the world
Canada's euthanasia law, also known as the Medical Assistance in Dying (MAID) law, is considered one of the most liberal in the world. The law allows eligible adults in Canada to request medical assistance in ending their lives, under specific circumstances and rules.
The MAID law was passed in June 2016, following a ruling by the Supreme Court of Canada in February 2015. The Court found that the Criminal Code provisions prohibiting medical assistance in dying violated the Canadian Charter of Rights and Freedoms. As a result, the government was given until June 2016 to create a new law, and the Parliament of Canada subsequently passed federal legislation legalizing and regulating euthanasia.
The MAID law has undergone several revisions since its implementation. In 2020, the Minister of Justice and Attorney General of Canada introduced Bill C-7, which proposed changes in response to the 2019 Truchon decision by the Superior Court of Québec. This decision found the “reasonable foreseeability of natural death” criterion in the Criminal Code to be unconstitutional. The 2021 revisions to the MAID law created a two-track approach to procedural safeguards, ensuring sufficient time and expertise are spent assessing requests from persons whose natural death is not reasonably foreseeable.
To be eligible for MAID, individuals must meet specific criteria, including being 18 years or older, having decision-making capacity, being eligible for publicly funded healthcare services, and providing informed consent. Additionally, they must have a serious and incurable illness, disease, or disability (excluding mental illness until March 17, 2027), be in an advanced state of irreversible decline, and experience enduring and intolerable suffering that cannot be alleviated under acceptable conditions.
Canada's MAID law provides two methods for medical assistance in dying. The first method involves a physician or nurse practitioner directly administering a substance that causes death, such as an injection of a drug. The second method allows eligible individuals to self-administer a substance prescribed by a physician or nurse practitioner to end their life. The law also includes legal safeguards to prevent abuse and ensure informed consent.
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The law changed after a Supreme Court ruling
Canada's euthanasia law is one of the most liberal in the world. Assisted dying became legal in Canada in 2016 with the Medical Aid in Dying (MAID) law, following a Supreme Court ruling. The law changed after a Supreme Court ruling in 2015 that found that banning assisted death infringed upon the Canadian Charter of Rights and Freedoms. This was a result of the legal case Carter v. Canada. The Supreme Court of Canada enjoined the government to comply with the Charter, recognizing every individual's freedom to die with dignity.
In 2020, the Minister of Justice and Attorney General of Canada introduced former Bill C-7, which proposed changes to the country's MAID law. These changes were in response to the Superior Court of Québec's 2019 Truchon decision, which found the "reasonable foreseeability of natural death" eligibility criterion in the Criminal Code to be unconstitutional. The changes also took into account feedback from over 300,000 members of the Canadian public, experts, practitioners, and other stakeholders.
The 2021 revisions to Canada's MAID law created a two-track approach to procedural safeguards for medical practitioners. The new approach ensures that sufficient time and expertise are spent assessing MAID requests from persons whose natural death is not reasonably foreseeable, while easing procedural safeguards in cases where natural death is foreseeable. This differs from the previous law, under which only persons whose natural death was reasonably foreseeable were eligible for MAID.
As of March 17, 2021, persons who wish to receive MAID must meet several eligibility criteria. These include being 18 years or older, having decision-making capacity, being eligible for publicly funded health care services, and giving informed consent. Additionally, the person must have a serious and incurable illness, disease, or disability (excluding mental illness until March 17, 2027), be in an advanced state of irreversible decline, and have enduring and intolerable physical or psychological suffering that cannot be alleviated under conditions they consider acceptable.
Quebec became the first province in Canada to allow advance requests for medical assistance in dying in 2024. The waiver of final consent is available to individuals whose death is reasonably foreseeable and allows those who have been approved for MAID to receive it even if they do not have the capacity to consent at the time of the procedure. This amendment is named after Audrey Parker, a woman from Nova Scotia who had to access MAID earlier than she wanted due to fear of losing capacity and not being able to provide consent.
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MAID requests must be assessed by two independent practitioners
Canada's euthanasia law, passed in 2016, is considered one of the most liberal in the world. The country's Medical Assistance in Dying (MAID) law allows eligible individuals to receive assistance from a medical practitioner in ending their lives. As of 2021, MAID requests in Canada must be assessed by two independent practitioners. These practitioners can be physicians or nurse practitioners, and they must be independent of each other and the patient. To be considered independent, the assessors must not hold a position of authority over one another, cannot knowingly benefit from the patient's death, and must not be connected to each other or the patient in any way that could affect their objectivity.
The eligibility criteria for MAID include being 18 years or older, having decision-making capacity, being eligible for publicly funded healthcare services, making a voluntary request, and giving informed consent. Additionally, the patient must have a serious and incurable illness, disease, or disability (excluding mental illness until March 17, 2027), be in an advanced state of irreversible decline, and experience enduring and intolerable physical or psychological suffering that cannot be alleviated under conditions they consider acceptable.
The eligibility assessment process must take at least 90 days to ensure a thorough evaluation. However, this period can be shortened if the individual is at immediate risk of losing their decision-making capacity, as long as both independent assessments have been completed. The role of the independent practitioners is crucial in ensuring that all eligibility requirements are rigorously evaluated and confirmed in writing.
One of the two practitioners assessing eligibility must have expertise in the medical condition causing unbearable suffering. If neither practitioner has this expertise, they must consult with another practitioner who specializes in the specific medical condition during the assessment process. This additional consultation ensures that the unique circumstances and complexities of each case are adequately addressed.
The MAID law in Canada provides a two-track approach to procedural safeguards for medical practitioners. This approach ensures that sufficient time and expertise are dedicated to assessing MAID requests, particularly for those whose natural death is not reasonably foreseeable. The law has evolved to address diverse sources of suffering and vulnerability that could lead individuals who are not nearing death to request MAID.
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MAID eligibility criteria include intolerable suffering
Canada's euthanasia law is considered one of the most liberal in the world. The country's Medical Assistance in Dying (MAID) law allows eligible individuals to access medical assistance in dying or euthanasia.
To be eligible for MAID, a person must meet specific criteria, including experiencing intolerable suffering. This means enduring physical or psychological suffering that the person finds intolerable and that cannot be relieved under conditions they deem acceptable.
The MAID eligibility criteria require a person to have a "grievous and irremediable medical condition," which can be defined as having a serious and incurable illness, disease, or disability. This definition involves two criteria: the condition is permanent and irreversible, and it causes unbearable suffering that cannot be alleviated in ways the person finds acceptable.
Two independent healthcare practitioners must conduct assessments and confirm eligibility for MAID. One assessor must be a specialist in the condition causing the person's unbearable suffering. These assessors must inform the person of all options for relieving their suffering, including counselling, mental health support, and palliative care. The person must seriously consider these options, and immediately before receiving MAID, they have the opportunity to withdraw their request.
It is important to note that persons suffering solely from a mental illness are currently excluded from MAID eligibility. The government has postponed the inclusion of mental illness as an eligible condition until March 17, 2027. This postponement aims to allow for further discussion, public debate, and parliamentary review of the unique considerations surrounding MAID for those with mental illnesses.
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MAID accounts for 4.1% of deaths in Canada
Canada's euthanasia law, also known as the Medical Assistance in Dying (MAID) law, is one of the most liberal in the world. It was passed in June 2016 and allows capable, consenting adults suffering from "grievous and irremediable" conditions to end their lives with dignity. MAID accounts for a small but growing proportion of deaths in Canada, with 4.1% of all deaths in the country in 2022 occurring under this law. This percentage has been increasing annually, up from 3.3% in 2021, 2.5% in 2020, and 2.0% in 2019.
The MAID law has undergone revisions, with the 2021 changes being particularly significant. Previously, only persons whose natural death was reasonably foreseeable were eligible for MAID. However, the 2021 revisions removed this criterion, allowing individuals with serious and incurable illnesses, diseases, or disabilities (excluding mental illness until March 17, 2027) to access MAID. This two-track approach ensures that procedural safeguards are in place to address the diverse sources of suffering and vulnerability that could lead someone to request MAID.
The number of written requests for MAID has been steadily increasing, with an average annual growth rate of 28.2% between 2020 and 2022. In 2022, there were 16,104 written requests, of which 81.4% resulted in the administration of MAID. The median age of MAID recipients in 2023 was 77.6 years, which is slightly higher than the average age of recipients since the service became legal in 2016, which is 76 years.
While MAID has been a controversial topic, with concerns about safeguards and clinical standards, the data shows that it is being implemented in a controlled and monitored manner in Canada. The government has also been proactive in addressing concerns, as seen by the postponement of the inclusion of mental illness as an eligibility criterion to 2027, to allow for the development of appropriate standards and practices.
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Frequently asked questions
Yes, Canada has a Medical Assistance in Dying (MAID) law that allows eligible Canadians to seek medical assistance to end their life.
To be eligible for MAID in Canada, a person must:
- Be 18 years or older and have decision-making capacity
- Be eligible for publicly funded health care services
- Make a voluntary request that is not the result of external pressure
- Give informed consent to receive MAID
- Have a serious and incurable illness, disease or disability (excluding a mental illness until March 17, 2027)
- Be in an advanced state of irreversible decline in capability
- Have enduring and intolerable physical or psychological suffering that cannot be alleviated under conditions the person considers acceptable
To request MAID in Canada, a person must be assessed by two independent medical practitioners (physicians or nurse practitioners) who confirm their eligibility in writing. The eligibility assessment must take a minimum of 90 days, unless the person is at immediate risk of losing their capacity to consent. If approved, the person can choose to have a physician or nurse practitioner administer a substance to end their life or be prescribed a substance to self-administer.
