Unravelling MAiD in Canada: Euthanasia and Assisted Suicide as Medical Care
Edited by Ramona Coelho, K. Sonu Gaind, and Trudo Lemmens
Edited by Ramona Coelho, K. Sonu Gaind, and Trudo Lemmens, Unravelling MAiD in Canada: Euthanasia and Assisted Suicide as Medical Care includes fifteen chapters exploring various aspects of Canada’s MAiD (Medical Assistance in Dying) legislation and implementation. The contributors discuss ethical and philosophical concerns, the potential for pressure to be applied to vulnerable populations to consent to MAiD, and concerns about the planned expansion of MAiD to include advance directives. They also discuss persons suffering solely from mental illness.
“Unravelling MAiD in Canada challenges readers with the ethical, medical, legal, societal, and disability justice rights concerns that have arisen in regard to this hotly debated irreversible practice.”
Canada’s medically assisted death legislation has proceeded in stages. Bill C-14, passed in 2016, made it legal to provide medical assistance in dying for those whose natural death was approaching in the reasonably foreseeable future. Bill C-7, passed in 2021, expanded access to MAiD outside the end-of-life context. Some provisions, such as MAiD for persons suffering solely from a mental illness, were also contemplated but have been delayed until at least March 17, 2027.
In Unravelling MAiD in Canada, the authors of the various chapters offer information about Canadian MAiD legislation and how it came about, comparisons to other countries with similar legislation, and facts about MAiD uptake in Canada. They also explore philosophical and ethical issues surrounding the expansion of MAiD beyond the end-of-life context.
Contributors to the book include physicians, some of whom have specializations in caring for the elderly or people living with disabilities. Sections were written by psychiatrists, law professors, and palliative medicine specialists, among others.
One of the chapters I found the most powerful was written by Gabrielle Peters. Peters, a disabled writer, researcher, consultant, and policy analyst, explores the potential negative impacts to individuals living with disabilities, including concerns about the possibility people might feel pressured into opting for MAiD.
A chapter titled “Indigenous Peoples and MAiD” was contributed by the Honourable Graydon Nicholson, an attorney, judge, and politician who was the first Indigenous person to hold the office of the lieutenant governor of New Brunswick, as well as the first Indigenous person to obtain a law degree in Atlantic Canada. Nicholson articulates the concerns of communities already struggling with high suicide rates, if and when MAiD regulations are expanded to include for persons suffering solely from a mental illness.
Some chapters deal with the conflict between MAiD and palliative care, whose aim is to help people live as well as possible as their life approaches its end. Authors note that in some cases, palliative care resources such as personnel and time are being redirected to MAiD, potentially impacting the ability to carry out the core functions of palliative care.
Other authors point out the irony that there is a shorter waiting period for MAiD, in some cases, than for specialized care and treatment that might alleviate a patient’s suffering to the point where MAiD wouldn’t be an option they would pursue.
Many of the authors are critical of the process by which the legislation was enacted, suggesting that the views of vulnerable groups potentially affected by the legislation were not sufficiently considered. They also question whether the government made the right call in assuming that certain decisions made about charter rights in provincial courts would necessarily be upheld if challenged.
There is a depth of detail within the chapters. Many of the authors draw on references such as Senate debates, journal and news articles, calls to action, submissions made to panels, and other sources. Some chapters have more than 100 end-notes citing sources.
Unravelling MAiD in Canada raises difficult questions. Some of the questions, and the examples and issues cited, are not comfortable ones, but they are necessary questions to contemplate. Our answers to them ultimately say a lot about the kind of society we are choosing to create.
Reading Unravelling MAiD in Canada enhanced my understanding of the current state of MAiD legislation in Canada, as well as making me think more deeply about the impact of the legislation on marginalized and vulnerable populations. There were compelling arguments made about the potential for people to be pressured toward MAiD when it really isn’t what they want.
Beyond the discussion about MAiD, Unravelling MAiD in Canada also prompted broader thinking about society’s views about disability, the weight we should place on privilege versus the need to protect the vulnerable, and how our society does (or does not) value its older members.
Those seeking a broad understanding of the risks inherent in Canada’s current approach to MAiD, and in particular its potential adverse impact on vulnerable populations, will find Unravelling MAiD in Canada a useful resource.
About the Author
Ramona Coehlo is a family physician in London, Ontario, and is a founding member of Physicians Together with Vulnerable Canadians. She is a senior fellow with the Macdonald-Laurier Institute.
K. Sonu Giand is professor and governor at the University of Toronto and chief of psychiatry at Sunnybrook Health Sciences Centre.
Trudo Lemmens is professor and Scholl Chair in Health Law and Policy at the Faculty of Law and the Dalla Lana School of Public Health, University of Toronto.
About the Reviewer
Lisa Timpf lives in Simcoe, Ontario, where she writes poetry, book reviews, short stories, and creative nonfiction. Lisa’s speculative poetry collections Cats and Dogs in Space (2025) and In Days to Come (2022) are available from Hiraeth Publishing. Lisa is a member of SF Canada and the Science Fiction and Fantasy Poetry Association. You can find out more about Lisa’s writing projects at http://lisatimpf.blogspot.com/.
Lisa is also on Bluesky, @lisatimpf.bsky.social
Book Details
Publisher: McGill-Queen's University Press
Publication date: April 22 2025
Language: English
Print length: 552 pages
ISBN-10: 0228023696
ISBN-13: 978-0228023692