“Charlie is told that he has Alzheimer’s disease. His doctor sits down with him to discuss his health care options and what his future could look like with the disease. Charlie learns that he will likely lose his ability to make decisions about his health care in the future. Later, after thinking about it further, Charlie decides that should his health decline rapidly and he starts experiencing intolerable suffering after he has lost capacity to make health care decisions, he would like to have MAID provided.”

That is the hypothetical included in Health Canada’s What We Heard report, which follows the government’s national consultation regarding advance requests for euthanasia.

Charlie’s advance requests, the report goes on to explain, could specify certain conditions under which to euthanize him, such as not being able to feed himself, not being able to get out of bed, or not being able to recognize his children for over a month.

An advance request is a formal declaration made by a person who retains decision-making capacity, stating that they wish to receive euthanasia if specific conditions are met after they lose the ability to make decisions for themselves. In Quebec, the only Canadian jurisdiction that allows advance requests, the person must have a diagnosis of a capacity-limiting illness (such as dementia) before making an advance request.

 The Criminal Code prohibits euthanasia by advance request. A key element in Canada’s euthanasia law is that a person must consent immediately before being euthanized. The only exception is through a waiver of final consent, where a person consents at the time the euthanasia death is scheduled, even if they are no longer capable of giving consent when that date arrives. But despite Quebec’s flagrant violation of the Criminal Code, euthanizing someone based on an advance request remains illegal.

Yet advance requests appear to be the next big push for euthanasia expansion in Canada.

National Consultation on Advance Requests

In December 2024, the federal government announced that it would launch a national conversation on advance requests for euthanasia. At the time, they also released a questionnaire asking Canadians to share their perspectives. As ARPA explained at the time, that questionnaire did not provide many opportunities to explain answers or to share a full perspective. Some of the questions seemed to assume advance requests would be allowed and simply asked about safeguards that would be necessary to protect people who give advance requests. There was little opportunity to oppose advance requests. In fact, some anti-euthanasia groups encouraged their supporters not to fill out the questionnaire due to its pro-euthanasia framing. Health Canada’s “What We Heard” report does not offer recommendations or outline next steps. Instead, it summarizes the main themes and takeaways from the online questionnaire, public opinion research, and virtual roundtables. Like the questionnaire, parts of the report seem to present foregone conclusions.

The report begins by explaining that euthanasia is a ‘health service.’ Although this is increasingly how doctor-assisted death is portrayed, we cannot forget that it is an exception to homicide in the Criminal Code. The report goes on to say that Canada’s euthanasia law “has been carefully designed with stringent criteria and safeguards to affirm and protect the inherent and equal value of every person’s life.” Notably, these are the very criteria and safeguards that the government keeps removing to make more people eligible to die at the hands of their doctors.

Results

The government received 46,000 responses to the questionnaire. These respondents were 90% English-speaking Canadians, 75% women, and 66% from urban areas. Fifty-six percent of respondents support Canada’s current euthanasia law, while 38% oppose it. The public opinion research component of the consultation included a randomly selected sample of 1,000 participants. And the roundtables included 200 participants from a variety of organizations.

The report compiles the information into four main themes. First, people generally support advance requests, in principle. In the case of a condition that will lead to a loss of capacity, 69% of questionnaire respondents were supportive. That number increased to 76% in the case of a condition that could lead to loss of capacity, such as high blood pressure that could lead to a severe stroke.

The most common value guiding one’s thinking about advance requests was individual choice about end-of-life care, at 76%. Dignified death followed closely at 73%, with protection of vulnerable people at 51%, and sanctity of life at 39%.

The second theme highlighted concerns about implementing advance requests safely. Of course, while many additional safeguards would be important if Parliament legalizes advance requests, the reality is that advance requests cannot be implemented safely. There is no way for a person to know what their life will be like in the future, and it is impossible to give valid consent to death in future circumstances, especially when they will lose the capacity to consent and be unable to change their mind.

In response to a question about the importance of a person making an advance request voluntarily, only 71% of respondents said it is “very important or important.” That means nearly 30% support involuntary euthanasia in certain circumstances. Meanwhile, 41% expressed fears that a person might feel pressured by family or others to sign an advance request. This is important because, once an advance request is signed and a person has lost the capacity to consent, the doctor and family members decide when it is time for the person to die.

The third theme was the need for supports for patients, families, caregivers and health care providers, including education, counselling, and mental health services. This would also include support for understanding and making advance requests.  

The final theme was the need for greater health system capacity, highlighting a supposed need for more access to euthanasia and more euthanasia providers. Some rightly noted the need for palliative care and other supports that help people not choose advance requests, even if they are legal.

Concerns

While the consultation results support advance requests, they may not accurately reflect Canadians’ wishes. First, the results of a questionnaire and roundtables do not necessarily reflect Canadians’ views broadly. It only represents the “keeners” who took the time to participate.

The randomly selected sample of 1,000 people for public opinion research would be the most representative. The problem with this research, however, is that the polling questions do not define advance requests clearly. Advance requests are complicated, even for those of us who pay close attention to the issue of euthanasia in Canada.

Second, Health Canada gets to choose what is presented because they are writing the report. For example, the report includes 13 direct quotes from roundtable participants. One selected quote reads “End of life. My body, my choice. No dignity in dying a natural death. Die in a manner of one’s choosing. My decision for me only!”

The report does share opposition to advance requests, briefly. The bulk of it is focused on what would need to be done to implement advance requests.

Moving Forward

Euthanasia is always the wrong answer for suffering. And euthanasia by advance request adds more problems as it devalues the lives of Canadians with dementia and similar illnesses.

To go back to the hypothetical example at the beginning of this article, if Charlie’s doctor sits down with him to discuss his care options and what his future looks like with his illness, the doctor’s words can have a massive impact. If the doctor indicates that life will be full of suffering and MAID is a viable option, that may influence Charlie’s wish to die. But if the doctor talks about how people with Alzheimer’s can live happy, fulfilling lives, and discusses the care and supports available, Charlie may desire to live despite his condition.

As euthanasia spirals to include disability, mental illness, and potentially capacity-limiting illnesses, more Canadians may realize the inherent problems with offering death to the vulnerable. Recent research found that Canadians generally remain satisfied with the scope of Canada’s MAID law, although they do not necessarily understand what it entails. Notably, though, the number of Canadians who oppose euthanasia in every circumstance increased from 12% to 18% between 2023 and 2025. Additionally, 42% are opposed to euthanasia for mental illness, and 46% are opposed to euthanasia for disability (which is already legal).

To date, the only bill in Parliament to legalize advance requests is a Senate bill, not a government bill. The government has not said whether it wishes to legalize advance requests. But the conversation continues, and we need to be prepared for the next battle as we advocate for care for vulnerable Canadians, rather than ending their lives.

September 10 is World Suicide Prevention Day, with the theme for 2025 to “Change the Narrative.” That theme is focused on the importance of helping people to discuss suicidality and thereby create a culture of support and compassion to prevent suicide and care for those in need. For years, Canada has promoted suicide prevention, and ought to continue to do so.  

The International Association for Suicide Prevention, which organizes World Suicide Prevention Day, notes that “together, we can make a difference and work towards a future where suicide prevention is prioritized, and everyone feels supported to get the help that works for them.”  

On September 10, Canadians affirm that message of hope, recognizing that suicide prevention must be a priority and that those with mental illness need support and care.  

But this fall, Canadian Parliamentarians will again be considering assisting rather than preventing suicide: should Canada be expanding medical assistance in dying (MAiD) to those with mental illness as their only underlying condition?  

In 2021, the Canadian Senate added a clause to new euthanasia legislation stating that those with mental illness would become eligible as of March 17, 2023. The federal government has twice delayed that expansion until March 17, 2027.  

Notably, the federal government stated that Canada was not ‘ready’ to expand MAiD to those with mental illness. But the concerns raised about the expansion remain very real fears today. Canada is no more ready today than it was in 2023 or in 2024. In fact, Canada will never be ready for such an expansion.  

Member of Parliament Tamara Jansen has introduced a bill to repeal the expansion of MAiD to those with mental illness, recognizing that delaying the expansion is not good enough. Bill C-218 would affirm suicide prevention and the need for better care for those who are struggling with poor mental health. This bill is an opportunity to ‘change the narrative’ on euthanasia, stopping the slippery slope that has resulted in continued expansion.  

As MP Jansen stated when introducing the bill, “imagine that someone’s son or daughter has been battling depression for some time after losing their job or maybe due to a broken relationship. Imagine they feel a loss so deep they are convinced the world would be better off without them … Our society could end a person’s life for solely a mental health challenge.” Surely, that is not the kind of society we want.  

MP Andrew Lawton endorsed Bill C-218, emphasizing the importance of hope in the midst of mental illness. Lawton notes that “If the law on the books were there 15 years ago, I’d probably be dead right now.” Offering MAiD for mental illness ignores the possibility that a person with mental illness may recover. Even without full recovery, many people with mental illness can live well with adequate care and support.  

Canadians recognize the need to prevent suicide rather than endorsing it by offering euthanasia for those with mental illness. A 2023 poll found that a full 82% of Canadians said medical assistance in dying (MAiD) should not be expanded without first improving mental health care access. Fifty percent opposed such an expansion entirely, with only 28% supporting it. Many also noted that mental health care is not readily available, with 40% of Canadians who needed mental health treatment noting that they faced barriers to receiving that treatment.  

People who want to end their own lives and those asking a physician to end their lives are both suicidal. Evidence from the few international jurisdictions that allow assisted suicide for mental illness shows that it overlaps with traditionally suicidal individuals. For example, in the Netherlands, at least 65% of those granted euthanasia for psychiatric conditions are women, a rate that mirrors the ratio of female-male suicide attempts. Sadly, euthanasia simply becomes a foolproof method of suicide.  

Offering MAiD for mental illness flies in the face of suicide prevention efforts and ignores the possibility that recovery may be possible. Canada must promote suicide prevention for all Canadians, not least for those struggling with mental illness. Rather than approving, or even further delaying, euthanasia for mental illness, our government needs to stop the expansion entirely and promote life for those who are struggling.  

Our Members of Parliament need to hear from us as they decide how they will vote on this important legislation. Bill C-218 will likely be debated in November, with a vote soon after. This year on World Suicide Prevention Day, Canadians should encourage Parliamentarians of all political stripes to not just talk about the importance of suicide prevention, but to vote for a bill that will protect those with mental illness and encourage life rather than death; hope rather than despair.  

MP Tamara Jansen introduced a new bill that would repeal the expansion of euthanasia to those with mental illness. Four years into the conversation about euthanasia for mental illness, we’re incredibly happy that there is another proposal to eliminate one of the most egregious parts of Canada’s euthanasia regime. 

History of the Planned Expansion of Euthanasia for Those with a Mental Illness 

Euthanasia for those with a mental illness was first raised in Bill C-7 in 2021, which originally set a date of March 17, 2023 when euthanasia for those with mental illness would be legalized. After a report by a committee of the Quebec legislature recommended against euthanasia for mental illness and an expert panel report on euthanasia for mental illness noted significant risks, the government passed Bill C-39, which delayed the expansion of euthanasia for mental illness until 2024. 

As that date approached, former Member of Parliament Ed Fast introduced Bill C-314, An Act to amend the Criminal Code (medical assistance in dying). If passed, that bill would have repealed the expansion of euthanasia to those with mental illness as the only condition causing their request. Although that bill received unanimous support from the Conservative, NDP, and Green Party, along with 8 Liberals, it failed to pass by a vote of 150-167.  

As ARPA noted at the time, such a close vote, especially on a social issue dealing with a matter of life and death for those with mental illness, sends a message that Canadians have serious reservations about expanding MAiD further. If only nine more MPs had voted in favour instead of against, the bill would have passed 2nd reading and advanced to committee for further study.  

In response to the close defeat of the bill and in light of concerns raised by nearly every provincial government that they weren’t prepared, the government decided shortly after to delay the expansion of euthanasia for mental illness for a second time, this time until 2027. In the wake of the vote, the Conservatives – who had unanimously voted in favour of entirely repealing the expansion – were riding high in the polls, were expected to form government, and promised to repeal the expansion of MAiD to those with a mental illness. But Trudeau’s resignation and Carney’s ascension led to a different outcome in the recent election. 

With no Conservative government in charge of things and no commitment from the Liberals to revisit the issue, MP Tamara Jansen used her opportunity to introduce a private member’s bill on the issue. Her Bill C-218 is identical to the previous one introduced by MP Ed Fast and intends to permanently eliminate – rather than just delay – the tragedy of euthanasia for mental illness. 

The Tragedy of Euthanasia for Mental Illness 

Every case of euthanasia is a tragedy. And every case of euthanasia in our health care system is fundamentally at odds with the central premise of health care of doing no harm. But extending MAiD to those with a mental illness is particularly tragic. 

Simple logic dictates that MAiD  isn’t appropriate for people with mental illness. People who have a mental illness are not able to give fully informed consent to MAiD. By definition, their reasoning isn’t entirely sound, and so they should not be put in a position where they could choose to end their life. We should be providing suicide prevention – not assisted suicide – for those who are suicidal because of a mental illness. 

As a nation, we have poured resources into suicide prevention across the country, particularly for people with mental illness. Canada now has a suicide crisis hotline to help people escape suicidal ideation. We should continue do to this rather than encouraging suicide assistance through MAiD. Indeed, offering suicide assistance undermines suicide prevention efforts. 

As a country, we raise awareness around mental illness and encourage people to seek help or treatment. For example, Bell Let’s Talk Day is all about reducing the stigma around mental illness and getting people the mental health care that they need. MAiD for mental illness entirely undercuts these efforts. Rather than encouraging people to access mental health care, legalizing MAiD for mental illness encourages people to end their lives instead. 

To really drive home the tragedy of euthanasia for mental illness, consider this story that we shared with young people at God & Government youth a few months ago: 

It’s February, and as you’ve experienced it is cold, and snowy. Just behind Parliament Hill the wind howls across the Alexandria bridge.  

It’s just after dinner time, and a man originally on his way home from the corner store is now standing on one of the struts that hold the bridge in place. Emergency vehicles have begun swarming around, the bridge has been cordoned off, and traffic is being redirected to the Portage bridge further up river. A camera crew from Ottawa CTV station, craving a good story, hover just off the bridge, attempting to see what the commotion is all about.    

Paramedics prepare warming blankets and pull out supplies. Police officers and other personnel chat to each other through earpieces. They’re waiting for someone. A moment later, an officer jumps out of a police car that pulls up just a few feet away from where the man clings to the buttress of the bridge.  

“What’s your name, son?” the officer hollers over the whistle of the wind. “Can we talk about this right now?” 

“I just don’t think I can do it anymore,” the man shouts back. “I’m done with everything. My depression is simply too much to bear. I don’t have any desire to live anymore.”  

“I see,” the officer shouts back, “well if that’s the case…”  

The officer jogs up to the side of the bridge, snow crunching under his heavy boots until he stands near the railing where the man is just within reach.    

He hoists himself up onto the railing, reaches over and stretches until he has a hold of the bottom of the man’s heel. With a sudden jerk, he wrenches the man’s right leg high into the air. He disappears into the darkness below. “We’re good,” the cop chirps into his radio, “it’s what he wanted.”    

The following morning’s headline in the Ottawa Citizen read, “Heroic Police Officer supports a young man’s right to Die with Dignity, in the face of overwhelming and debilitating depression.”    

Virtually no Canadian wants to live in such a country. And yet, legalizing euthanasia in any form but especially euthanasia for mental illness, functionally puts our health care system in the exact same position. 

The Road Before Us 

Bill C-218 again offers Canada the opportunity to step back from the euthanasia ledge and onto firmer ground that respects the value and dignity of very human life. We are grateful that another MP has taken up this issue and is pushing the government to repeal further expansion of euthanasia. 

The new Parliament after the spring election has a fairly similar makeup in government as when Bill C-314 – the previous proposal to scrap the planned expansion for euthanasia for mental illness – was voted on. Prime Minister Carney has not expressed where he stands on the issue of MAiD. Perhaps he will whip his caucus to defend the previous government’s law, but perhaps he will allow a free vote among his MPs on the issue. 

The fact that this is still a live issue and that now four separate pieces of legislation have arisen on this topic in just four years is a testament to your continual advocacy! You’ve worked hard to email and meet with your MPs, talk with your neighbours, and deliver nearly 250,000 flyers to spread the message of caring, not killing.  

This has contributed to the ongoing conversation, but with another bill on the table, we need to get back at it. Take a few minutes to email your own Member of Parliament expressing your support of Bill C-218 and ask them to support it as well. Copy Prime Minister Mark Carney, Minister of Justice Sean Fraser, and Health Minister Marjorie Michel on that email, encouraging the government to support the legislation as well. 

As Christians, we can continue to advocate for caring, not killing, in all circumstances. And we can continue to put pressure on our elected officials to do the same.   

Status: Completed first reading in the House of Commons

Description: Would eliminated the expansion of eligibility for euthanasia to those with mental illnesses. Bill C-7, the last piece of euthanasia legislation, had a sunset clause that would allow those with mental illnesses to be eligible for euthanasia. While the government delayed the implementation of this clause by another three years in Bill C-62, this bill proposed to scrap that clause entirely.

Analysis: It is incomprehensible that our society provides suicide prevention to one class of citizens and assisted suicide to another class of citizens. The extension of assisted suicide to those with mental illness effectively means that assisted suicide is a perfectly legitimate solution to suicidal ideation. Instead of offering assisted suicide to those with mental illnesses, we need to provide better mental health care and support to those who are suffering.

Action Items: Visit CareNotKill.ca for more information on all of these action items:

For immediate release from the Association for Reformed Political Action (ARPA) Canada 

March 26, 2025 

OTTAWA, ON –  

The United Nations Committee on the Rights of Persons with Disabilities released its report on Canada on March 21. The Committee recommends that Canada repeal Track 2 Medical Assistance in Dying (MAiD) and refuse to expand MAiD any further. Track 2 MAiD is euthanasia for persons whose natural death is not reasonably foreseeable, who do not have a terminal condition. It was first permitted in 2021, when Parliament passed the Liberal government’s Bill C-7. 

“Over the past four years, the federal government has continued its reckless expansion of Medical Assistance in Dying” said Daniel Zekveld, policy analyst with ARPA Canada.  

In 2023, just two years after Bill C-7 passed, over 600 Canadians were euthanized under Track 2. Nearly 60% of them were women.  

On top of that, although the Trudeau government delayed the expansion of MAiD to those with mental illness as their sole underlying condition, that expansion is scheduled to take place in 2027. The UN Committee has called on the government of Canada to repeal this expansion as well before it goes into effect. 

“At the very least, Canada’s next Prime Minister will need to address the mental illness expansion. Rather than promoting state-sponsored suicide, a new government must reject and repeal any further expansion of euthanasia,” Zekveld said.  

But our next federal government should also go further than that, argues Zekveld. “Allowing MAiD for Canadians who are not dying devalues their lives and implies that they are dispensable. Offering euthanasia as a ‘solution’ for disability or chronic illness reduces incentives to improve treatments and supports.”  

ARPA Canada supports all the Committee’s recommendations on MAiD in its report and calls on federal party leaders to commit to implementing them.  

ARPA Canada actively opposed the Trudeau government’s rapid expansion of euthanasia into one of the most permissive euthanasia regimes in the world. Many others, including disability rights groups, have been calling on the government to reject euthanasia for people with disabilities whose death is not ‘reasonably foreseeable.’  

As election day approaches, will party leaders promise to protect Canadians who are not dying from MAiD?   

– 30 –  

The Association for Reformed Political Action (ARPA) Canada has a long history of involvement with euthanasia laws and policy in Canada. ARPA was granted intervenor standing at the Supreme Court of Canada in the Carter case in 2016. They have also provided a variety of policy reports, research, and analysis on the topic. In 2020, ARPA launched the Care Not Kill campaign, a national grassroots initiative that educates Canadians on the harms of euthanasia as well as equipping people to engage respectfully on this sensitive topic. 

For further comment or interviews, please contact Daniel Zekveld at [email protected] or 1-866-691-2272.

On December 11, Health Canada released its fifth annual report on Medical Assistance in Dying (MAiD). From legalization in 2016 until the end of 2023, at least 60,301 Canadians have been euthanized. The report concludes that “The Government of Canada will continue its work to help ensure that the framework for MAID in Canada is safe, reflects the needs of people in Canada, protects those who may be vulnerable, and supports autonomy and freedom of choice.” But ultimately, the government’s approach reveals an emphasis on autonomy over protecting anyone from euthanasia.  

The Numbers 

In total, 15,343 Canadians died at the hands of doctors or nurses in 2023. Canada permits both euthanasia (where a doctor or nurse practitioner ends a patient’s life) and assisted suicide (where a patient ends his own life using prescribed pills). But assisted suicide is almost non-existent in Canada, with fewer than 5 people using this option last year.  

 The number of euthanasia deaths in 2023 is a 15.8% increase over 2022. While lower than the 30% rate of increase in previous years, this still represents over 2,000 more euthanasia deaths than in 2022. Euthanasia deaths as a percentage of all deaths in Canada jumped from 4.1% in 2022 to 4.7% in 2023. This means that nearly 1 in every 20 deaths in Canada is state-sponsored. The only country with a higher rate of euthanasia deaths is the Netherlands, at 5.4%.  

Nearly 85% of euthanasia deaths took place in British Columbia, Ontario, and Quebec, although these provinces represent roughly 70% of the country’s population. Of the 15,343 Canadians who were euthanized in 2023, 622 died on track 2 (where natural death is not ‘reasonably foreseeable’) compared to 463 in 2022, an increase of 34%.  

Of nearly 20,000 verbal and written requests for euthanasia, only 915 patients were deemed ineligible and 496 withdrew their request. A person might also request euthanasia but then die naturally before they can be killed by their doctor. This happened in nearly 3,000 cases. The report states: “These findings bring into focus how even modest delays can interfere with a person’s ability to receive MAID.” That’s an odd way of saying that some patients (roughly 1/6) seeking MAID die before they can be euthanized, but it signals that the government sees MAID as a valuable service, rather than a tragedy to avoid. 

Illness and Suffering 

Reasons a person might request euthanasia include cancer, organ failure, or neurological, respiratory, or cardiovascular conditions. But there is also a category listed as ‘other.’ The most common conditions in the ‘other’ category include frailty and chronic pain. Frailty, according to the report, “may include loss of muscle mass and strength, cognitive impairment, fatigue or exhaustion, weakness, and reduced tolerance to medical interventions, leading to poor health outcomes.” This condition was reported for nearly 1,400 euthanasia deaths in 2023, significantly higher than those in 2022. While many patients have multiple conditions, frailty was the only condition for 92 patients.  

The cases of frailty raise serious questions about how doctors might be assessing patients’ eligibility for euthanasia. If something like frailty can make a person eligible, doctors can be quite loose in their interpretations. Frailty may also be interpreted as a condition where death is ‘reasonably foreseeable.’  

In addition to frailty, the ‘other’ category includes chronic pain. Nearly 1,000 patients listed chronic pain as a reason for requesting euthanasia. Yet the report notes challenges in assessing chronic pain. Namely, patients may experience fluctuations in severity of pain, they often have difficulty accessing treatment, and they often have a psychiatric condition such as major depressive disorder. This shows that people may be seeking euthanasia due to mental illness even if it is another condition that makes them eligible for euthanasia.  

Health Canada also notes the nature of suffering that is listed by patients who are euthanized. Many patients list multiple sources of suffering. The most cited suffering is the loss of ability to engage in meaningful activities (over 95%), followed by loss of ability to perform activities of daily living (over 83%). Pro-euthanasia advocates often list stories of severe pain in requests for expansion, but fewer than 60% of patients cite inadequate pain control as a source of suffering. Loss of dignity has become the third most cited reason for suffering.  

In 2022, 17.1% of patients listed isolation or loneliness as a source of their suffering. In 2023, that number for those nearing death jumped to 21.1%. But for those requesting euthanasia who were not nearing death, it skyrocketed to 47.1%. Another disturbing increase is in those who felt like they were a burden on family, friends or caregivers. In 2022, that number was 35.3%. In 2023, the number for those who were dying increased to 45.1%. For those who were not dying, it was even higher at 49.2%. Nearly half of all who died by euthanasia saw themselves as a burden.  

These numbers indicate a difficult reality about why people are requesting death. Pain, disease, or disability may be a factor. But so are loneliness, dependence, and a faulty view of human dignity. And these social factors are increasingly contributing to euthanasia deaths in Canada as euthanasia becomes more normalized.  

Suffering is real and can be caused by various factors. But the response should never be to offer to kill those who are suffering. These numbers speak to the ways we must improve care for suffering people. It also shows the need for suicide prevention, rather than suicide assistance, in all cases. 

Euthanasia Providers 

The report notes that 2,200 doctors and nurses euthanized at least one patient in 2023. However, just 89 medical practitioners were responsible for over 5,300 euthanasia deaths. That’s an average of 60 deaths each in one year. Health Canada argues that this is good because it lets providers keep pace with demand and suggests that “MAID is becoming an area of focused expertise for some.” But is it a comfort to know there are doctors who specialize in killing patients? Some doctors are known to interpret the law loosely and will approve patients who other doctors might refuse to euthanize. Recently, a woman who was declined euthanasia in Alberta found a doctor in B.C. who was willing to kill her. Thankfully, a court intervened and stopped that death from happening. The same doctor who approved the woman for euthanasia has admitted to killing over 400 patients.  

But in how many cases do doctors interpret the law loosely and kill patients who are not eligible for euthanasia? We don’t know. The lack of oversight in nearly every province increases concerns about doctors who specialize in euthanasia. Health Canada emphasizes that euthanasia is a health care service. This mindset leads to a lack of caution, and a lack of adequate safeguards and oversight. But euthanasia isn’t health care. It is an exception to the criminal prohibition on homicide and is essentially the “service” to end health care services.  

Conclusion 

Health Canada’s report once again reveals, as expected, the rapid growth rate of euthanasia in Canada. The current federal government has shown no desire to slow this growth. Other party leaders in the House of Commons have also said little about the problems with euthanasia. Check out ARPA’s Care Not Kill website for action items where you can raise awareness and ask your Member of Parliament to commit to protecting Canadians from euthanasia.  

Provincial governments also have a responsibility to reduce the rates of euthanasia in their jurisdiction. If you live in Alberta, participate in the government’s ongoing review of euthanasia. If you live in another province, ask your provincial government to take action on this issue as well. Together, we can continue to speak up for inherent human dignity and meaningful care for those who are suffering. 

When Parliament legalized euthanasia and assisted suicide in 2016, many warned of a slippery slope. First legalized as a last resort for those nearing natural death, euthanasia and assisted suicide have since been expanded to people not nearing natural death (2021) and to those with mental illness (scheduled for 2027). In the meantime, safeguards have been removed. Between 2016 and 2022, nearly 45,000 Canadians were euthanized.

Professor John Keown, comparing euthanasia in the Netherlands and Canada, writes, “In 40 years, the Dutch have slid down the slippery slope. In fewer than 10, Canada appears to be veritably skiing.”

Bill C-7

Bill C-7, An Act to amend the Criminal Code (medical assistance in dying) was introduced in 2020 and received Royal Assent in March 2021. The bill removed the requirement that a person’s natural death be reasonably foreseeable, thus making persons with non-terminal illness eligible for euthanasia. It also created two different sets of safeguards, one for those who were nearing natural death, and another for those who were not. If a person is nearing natural death, they can be fast-tracked for euthanasia with fewer safeguards. If a person is not nearing natural death, there are a few additional safeguards such as a 90-day waiting period.

The Senate added a clause to Bill C-7 to permit euthanasia for mental illness as the sole underlying medical condition, starting in March 2023. That was later delayed until 2024, and then until 2027.

Care Not Kill Campaign

Since the mental illness expansion had not yet come into effect, ARPA Canada’s Care Not Kill campaign focused from 2021 to early 2024 primarily on cancelling that expansion. Many of you, our supporters, got involved in that campaign by delivering flyers, writing emails to your federal representatives, sending submissions to committee, or running bus ads. You sent a clear message that euthanasia should never be a solution for mental illness.

Last fall, MP Ed Fast introduced Bill C-314, which would have cancelled the plan to permit euthanasia for mental illness. Although the bill failed to pass (by only 17 votes), some members of all parties supported it. Earlier this year, nearly every province asked the federal government to delay the scheduled expansion of euthanasia indefinitely. The Conservative Party of Canada has committed to repealing this expansion if they form government following the next election. We can continue to encourage other parties to do the same.

Euthanasia should never be a solution for suffering. Euthanasia and assisted suicide encourage a culture of neglect for suffering, elderly, disabled, and vulnerable people. Canada should promote suicide prevention and life-affirming care for all. Given the successful pushback across Canada on the mental illness expansion, now is the time to call for additional safeguards in the law.

Repeal C-7

The Care Not Kill campaign is asking the government to repeal Bill C-7 entirely. That would not only cancel the mental illness expansion, but would end euthanasia for those who are not dying. It would also restore other safeguards that Bill C-7 removed.

Bill C-7 changed Canada’s law on assisted suicide to offer it as an escape from what is perceived as a difficult life, or even a difficult period of life. Only people with disabilities or chronic illness are offered assisted suicide as a solution for their suffering. The able-bodied who suffer are offered suicide prevention and various other supports. The implicit message is that some lives matter more than others. We need to call on the government to promote life-affirming care for all.

Just as we advocated for the repeal of euthanasia for those with mental illness, we can call for the repeal of euthanasia for those with disabilities or non-terminal illnesses.

Next Steps

With a federal election looming next year, we have an opportunity to ask candidates and MPs how they will protect vulnerable Canadians from euthanasia. We can encourage candidates to talk about the issue during their campaigns, and we can call on the next government to pass legislation to reverse Canada’s slide down the slippery slope when it comes to euthanasia. Stay tuned over the coming months for updated Care Not Kill materials and action items.

Jesus once told a parable that fits perfectly with how we as Reformed Christians ought to participate in politics: the parable of the persistent widow. This parable comes from Luke 18.

The Unrighteous Judge

The parable starts with an interesting setting: “In a certain city there was a judge who neither feared God nor respected man” (18:2).

Now isn’t that pretty similar to our situation in Canada? We look at the culture and the governments around us and we see people who neither fear God nor respect man, at least not in their behaviour or their actions. For example, our government – both our judges and politicians – chose to legalize euthanasia, the murder of people who are suffering. God clearly commands us in the sixth commandment not to murder.

And why shouldn’t we murder? Because every single person is made in the image of God. We read that, in the very beginning of time, “God created man in His image. In the image of God He created Him.”

In his book The Air We Breathe, minister and evangelist Glen Scrivener comments on this passage, “…mankind is formed from the dust. But we are also breathed upon by God. We are dirtbags kissed by heaven. In ourselves we are [not worth much]. But we are touched by the divine too, and in connection with God we are precious beyond all earthly valuation.”

Some people argue that euthanasia should be legal because we euthanize or put down pets if they are suffering, but here’s the key point: human beings aren’t dogs. Human beings are made in God’s image. Dogs – no matter how much you might love them – aren’t. And that’s why it is perfectly alright to own dogs. We buy and sell them. We spay and neuter them. We breed them. We kill them if they get too old, or sick, or dangerous. Some people eat them.

But we don’t do that to human beings made in the image of God.

But our government doesn’t care. They legalized euthanasia for people near the end of life in 2016. Then they legalized euthanasia for those with chronic illness or disability in 2021. And then they set out to legalize euthanasia for those with a mental illness, an expansion that has thankfully been delayed.

Fun fact:every Prime Minister in Canada’s history claimed to fear God and claims to be a Christian: Catholic, Presbyterian, Evangelical, or some other denomination. But the laws and policies they promote really make you wonder if they truly do fear God.

And so, we find ourselves in a similar setting to this parable, living in a certain place where the government leaders do not seem to fear God or respect man.

The Persistent Widow

Jesus continues his parable, “And there was a widow in that city who kept coming to him and saying, ‘Give me justice against my adversary’” (18:3).

She kept coming. And coming and coming.

And that’s what we at ARPA, and you our supporters, have done on euthanasia through direct lobbying and through our Care Not Kill campaign. We’ve continually asked the government to stop expanding euthanasia. You’ve helped send thousands of emails and postcards to members of Parliament. You’ve helped deliver hundreds of thousands of flyers around the country. ARPA staff have had dozens of lobby meetings with MPs on this issue. Together, we have been persistent, just like the widow in Jesus’ parable.

And what was the judge’s response to the persistent widow? Back to the Bible. “For a while he refused, but afterward he said to himself, ‘Though I neither fear God nor respect man, yet because this widow keeps bothering me, I will give her justice, so that she will not beat me down by her continual coming’” (18:4-5).

At long last, thanks to her persistence, the judge finally gave the widow the justice that she was asking for.

And we also have finally gotten some justice. For years, ARPA and Reformed Christians have pleaded with the government to roll back their planned expansion of euthanasia for people with mental illness. For years it seemed like the government was going to ignore us. But eventually, because of all the pushback they received from citizens on this issue, they relented. Last year they passed a bill that would pause the expansion of euthanasia for one more year, to March 17, 2024.

But for us, a pause on expanding euthanasia wasn’t enough. By God’s grace, MP Ed Fast introduced a bill that would entirely delete the planned expansion of euthanasia to those with a mental illness. This would be not just a pause, but a reversal.

The entire Conservative caucus voted in favour of this bill to stop euthanasia’s expansion. The entire NDP caucus voted in favour of it. Several Liberal MPs voted in favour of it. Unfortunately, that bill was defeated in October 2023 by a vote of 167-150. But we didn’t stop. MPs who cared about this didn’t stop. We were persistent. And they were persistent.

And again, because of all this persistence, the government relented again. Just over a month ago, the government introduced a new bill that would delay the expansion of euthanasia for mental illness until 2027, after the next election. Every single MP voted in favour of it, except for one Liberal MP and the Bloc Quebecois caucus. The Senate passed it by such a wide margin that they didn’t even bother to record the vote.

This isn’t fully justice yet. As it stands right now, Canada will still expand access to euthanasia to those with a mental illness at some point. And far too many Canadians are still allowed to choose – and do choose – euthanasia. Almost 45,000 Canadians have died by euthanasia since 2016.

But it is a step in the right direction. A step towards justice. All because of persistent political action. ARPA’s persistent political action. Your persistent political action.

The Practical Message

But that’s not the end of the parable. The purpose of Jesus’ parables is to show a truth about God. While it is good and right and effective to engage in persistent political action, that isn’t the point of the parable.

Jesus says what the point of the parable is: “‘Hear what the unrighteous judge says [Though I neither fear God nor respect man, yet because this widow keeps bothering me, I will give her justice, so that she will not beat me down by her continual coming.] And will not God give justice to his elect, who cry to him day and night? Will he delay long over them? I tell you, he will give justice to them speedily…’ (18:6-8). And he told them this parable “to the effect that they ought always to pray and not lose heart” (18:1).

Jesus told this parable so that we would always pray. How often do you pray for our governments? For people to seek their identity and worth in God, and value life? Even if political action isn’t your favourite thing to do, we can all pray.

And never lose heart. It may seem like you always pray or are persistently politically active, but nothing happens. That doesn’t mean that you lose heart and give up. If the widow lost heart and gave up, she would have never received justice from the judge. And if we lose heart and give up, why would we expect God to work in our country to outlaw euthanasia, or abortion, medical transitioning for minors, or any other evil?

So be persistently politically active. Always pray. And never lose heart.

In Quebec, euthanasia deaths in 2022 increased by 45.5% compared to 2021. Euthanasia accounted for 6.6% of all deaths, compared to the national average of 4.1%. Michel Bureau, head of the Quebec Commission on end-of-life care, worries that euthanasia is no longer seen as a last resort within that province, stating, “We’re now no longer dealing with an exceptional treatment, but a treatment that is very frequent.”

Despite these disturbing statistics, the government of Quebec continues to push euthanasia as the solution to suffering, particularly in palliative care settings. This push is the focus of a recent legal challenge filed in the Quebec Superior Court.

Background

The National Assembly of Quebec passed The Act respecting end-of-life care in 2014 for the purpose of establishing an “integrated vision of palliative and end-of-life care.” The framework includes palliative care as well as euthanasia. Through that framework – and this is true throughout the country – euthanasia is one among many end-of-life care options.

The legalization of euthanasia throughout Canada in 2016 created a host of problems for federal and provincial governments as they craft legislation, regulations, and professional guidelines. One issue for governments is how to handle medical professionals who believe euthanasia is never the appropriate solution for suffering. Some provincial governments have tried to force doctors to facilitate euthanasia deaths, even if doctors do not have to provide the procedure directly.

Beyond individual conscience rights, another issue is whether institutions can refuse to offer euthanasia within their facilities. In June 2023, the government of Quebec amended their euthanasia law through Bill 11, An Act to amend the Act respecting end-of-life care. Among other changes, these amendments addressed questions of religious or conscientious objection when it comes to institutions providing euthanasia.

Religious Objection

Other provinces allow religious palliative care facilities to opt out of providing euthanasia. For example, British Columbia, when pressured to force a Catholic hospital to provide euthanasia, came up with a compromise that gives patients easier access to euthanasia without forcing religious institutions to provide it. You can read more about that here.

Quebec’s law was clear, until recently, that palliative care providers could decide whether euthanasia would be done on their premises. Bill 11 changed that in 2023, mandating that “no palliative care hospice may exclude medical aid in dying from the care it offers.” According to the government of Quebec, palliative care must include the option of euthanasia. This creates a dilemma for religious facilities opposed to euthanasia.

According to the Quebec palliative care association, as of March 2023 there were only four palliative care facilities in Quebec that did not offer euthanasia. One of these facilities is St. Raphael’s, a Catholic palliative care centre in Montreal. Its founders and supporters have clearly stated their opposition to euthanasia and their emphasis on relieving pain to enhance quality of life. Prior to the change in law, if a patient at their centre wanted to be euthanized, staff at the facility would send them to a provincially run facility. But now St. Raphael’s must either provide euthanasia or close its doors. The Catholic Archbishop of Montreal has filed a legal challenge, arguing that the law violates religious freedom.

Legal Precedent

Although we have seen disputes between Christian healthcare institutions and governments, such as those in British Columbia, the Archbishop’s legal challenge is the first of its kind in Canada. Whether the challenge succeeds or fails will set an important precedent for how religious freedom and religiously supported health care institutions are viewed in Quebec.

A win for the Archbishop would be binding precedent only in Quebec, but it would signal to other governments that Christian institutions must be allowed to provide care in a way that aligns with their beliefs and convictions.   This legal challenge is important, not simply because of what it means for St. Raphael’s and other religiously supported institutions in Quebec, but also for institutions across the country. Rather than pushing religious institutions out of providing health care, governments should give them the freedom to continue helping the sick and dying in their communities.

Status: No longer active.

Description: Proposes to delay the expansion of eligibility for euthanasia to those with mental illnesses until 2027. Bill C-7, the last substantial piece of euthanasia legislation, had a sunset clause that would allow those with mental illnesses to be eligible for euthanasia in 2023. While the government delayed the implementation of this clause until 2024 in Bill C-39 and then rejected Bill C-314’s proposal to scrap that clause entirely, this bill would delay that expansion until March 17, 2024. That’s after the next scheduled election

Analysis: It is incomprehensible that our society provides suicide prevention to one class of citizens and assisted suicide to another class of citizens. The extension of assisted suicide to those with mental illness effectively means that assisted suicide is a perfectly legitimate solution to suicidal ideation. Instead of offering assisted suicide to those with mental illnesses, we need to provide better mental health care and support to those who are suffering.

Action Items: Visit CareNotKill.ca for more information on all of these action items: