Discrimination-driven deaths – Analysing Ontario Coroner Reports on Euthanasia and Assisted Suicide
by Dr Ramona Coelho, BMJ:
Introduction:
As a family physician in Ontario, Canada, my practice largely serves marginalised groups: refugees, individuals facing incarceration or facing legal charges, or those living with disabilities or mental illness, including substance use disorders. My patients can experience extensive wait times to access medical care and may be unable to access or afford certain medications, counseling and other necessary services. Many endure discrimination and isolation, and all these structural inequalities significantly harm their health. I now view euthanasia and assisted suicide as introducing a new risk to my patients: the risk of wrongful, premature death.
Background:
In 2016, Canada legalized euthanasia and assisted suicide using the umbrella term medical assistance in dying (MAiD). This was initially presented as an exceptional measure for persons with intolerable suffering at the end of their life. However, our system evolved at an alarming pace, with MAiD expanding far beyond its initial scope. In 2023, there were over 15,000 MAiD deaths, pushing the total to 60,000 by the year’s end. Quebec announced their MAiD annual death rate has surpassed 7%—staggering in comparison to initial provincial estimates of 100 requests per year. Meanwhile, recent reports from Ontario’s MAiD Death Review Committee (MDRC) raise red flags, warranting a closer look at the unintended yet foreseeable risks tied to the legalization of euthanasia and assisted suicide.
Cases:
As a MDRC committee member, I work with the Office of the Chief Coroner of Ontario, reviewing cases flagged by the Coroner’s MAiD Review Team. Members offer expertise to help shape recommendations for future MAiD practice. The 2 released reports, include MAiD for those suffering with inadequately treated mental illness and MAiD for social and housing vulnerability.
Some examples are summarized here:
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