Request Withdrawn but Ignored: Warning Signs Flash Over Canada’s Assisted Dying System

Trust in Canada’s Assisted Dying System Shaken
Ethical Debate over Assisted Dying Intensifies

In Canada, controversy over the safety and ethics of the Medical Assistance in Dying (MAID) system is intensifying after it was revealed that an elderly woman died just hours after officially withdrawing her request for assisted death.

On January 26, Yonhap News TV, citing foreign media including the Daily Mail, reported that there is growing debate over the safety of the assisted dying system in Canada.

Canada has gradually expanded the scope of assisted dying since legalizing it in 2016. Currently, it includes not only terminal patients but also those with chronic illnesses and severe disabilities. There is ongoing social debate about whether to allow assisted dying solely for mental illness in the future. The photo is unrelated to the specific content of the article. Pixabay

Previously, on January 23, the Ontario Medical Assistance in Dying Review Committee in Canada released an investigative report on the recent case of a woman in her 80s, referred to as Ms. A. According to the report, Ms. A’s health deteriorated rapidly due to post-surgical complications while she was receiving palliative care, and the assisted dying process was initiated at her husband’s request. Although she initially agreed, she later made it clear that she did not wish to proceed with assisted death for personal and religious reasons and expressed her desire to continue with palliative care.

However, her request for palliative care was not accepted. Her husband requested an urgent reassessment, citing “caregiver burnout,” and ultimately, assisted death was carried out that evening. The initial medical team in charge of the assessment objected, stating there was a lack of immediate urgency and raising concerns about possible pressure from the caregiver. Nevertheless, two other assessors who were subsequently assigned determined that she was eligible, and the process moved forward.

The committee pointed out in its report that “the decision-making process was excessively brief, and the patient’s care environment, as well as alternative treatments and support measures, were not sufficiently considered.” The report especially highlighted concerns that the husband led the entire request and evaluation process, and that there was insufficient documentation on whether the patient was able to express her wishes independently and freely. Dr. Ramana Coelho, a committee member, stated, “What should have been prioritized in this case was not assisted dying, but the strengthening of palliative care and support. The burden of caregiving may have influenced the patient’s decision to choose death.”

Expansion of Assisted Dying, Recurring Controversy

Since legalizing assisted dying in 2016, Canada has gradually expanded the scope of eligibility. Currently, it includes not only terminally ill patients but also those with chronic diseases and severe disabilities. There is ongoing social debate about whether to allow assisted dying solely for mental illness in the future. However, as the system expands, concerns about the “voluntariness of choice” are also growing.

Assisted death controversies continue not only in Canada but also in other countries. In the Netherlands and Belgium, the scope has expanded to include patients in the early stages of dementia and those with mental illnesses, leading to criticism that "the right to die is becoming a means to cover up failures in treatment and care." Pixabay

Critics argue that in situations where medical and care resources are insufficient, assisted dying could become a “choice without alternatives.” It is repeatedly pointed out that caregiver burden, financial pressure, and social isolation may influence a patient’s decision.

More Countries Allow Assisted Dying, but “Voluntariness and Alternative Treatments” Remain Unresolved Issues

Currently, countries that allow medical assistance in dying or physician-assisted suicide include Canada, the Netherlands, Belgium, Luxembourg, Spain, Colombia, and New Zealand. In the United States, it is permitted in some states such as Oregon and California under limited circumstances, while Switzerland recognizes “assisted suicide,” in which the physician does not directly administer the medication.

Meanwhile, assisted death controversies continue not only in Canada but also in other countries. In the Netherlands and Belgium, the scope has expanded to include patients in the early stages of dementia and those with mental illnesses, leading to criticism that “the right to die is becoming a means to cover up failures in treatment and care.” Regarding the recent Canadian case, local media and civil society groups are warning that “the moment assisted dying becomes a destination rather than a choice, the system can put the most vulnerable people at risk.”