A Canadian woman in her 70s received approval for assisted suicide after becoming unable to cook for her family and feeling that she no longer had value, according to two Toronto psychiatrists who say Canada’s MAiD system has expanded too far.
University of Toronto psychiatry professors Madeline Li and Gary Rodin described the case in a New York Times op-ed published Monday while warning about the direction of Canada’s Medical Assistance in Dying program.
Li and Rodin, who said assisted dying can play a role in end-of-life care, cautioned that “Canada's system for assisted death is no longer an option of last resort,” and that increasing numbers are seeking it to remedy normal unhappiness.
“Too many people are receiving the procedure without the opportunity for careful reflection about it with a health provider. In some cases, patients are being approved who should not 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,” they wrote.
The psychiatrists pointed to the case of a woman who had long been the matriarch of her family but became despondent after she was no longer able to prepare Sunday meals.
“She sought and received approval for assisted dying after she lost the ability to cook. She felt she had lost her value to her family. Through counseling, she came to understand that her family valued who she was, not what she did for them. 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,” they wrote.
Li and Rodin said the case shows how some patients may pursue assisted death before receiving enough support to address despair, diminished purpose or a loss of dignity.
They described Canada’s MAiD framework as “one of the most permissive in the world,” noting that eligibility has broadened beyond patients whose natural deaths are reasonably foreseeable.
“This latitude may contribute to Canada having the fastest growth rate of assisted dying in the world, increasing 16-fold in the eight years since legalization. The procedure now accounts for over 5 percent of all deaths in the country,” they wrote.
The doctors said they are not seeking “to dissuade patients from going forward” with assisted dying, but urged health providers to spend more time helping people find alternatives and maintain a sense of meaning.
“A society that permits assisted dying should also ask whether it has done enough to help people sustain their sense of dignity and meaning in life. Death must not become the only kind of relief people can imagine,” they wrote.
Canada legalized physician-assisted suicide in 2016 for eligible adults with serious and incurable medical conditions involving enduring and intolerable suffering. The law was broadened in 2021 to include some patients whose natural deaths are not considered reasonably foreseeable.
