Medical Assistance in Dying (MAID), Canada’s preferred euphemism for euthanasia, has become so popular practitioners struggle to meet demand.

According to government figures for 2023, the last full year of statistics available, MAID accounted for 4.7 percent of deaths nationwide, making Canada second only to the Netherlands. In Quebec, the figure is over seven percent, giving it the highest euthanasia rate in the world.

MAID deaths have been growing by double digits each year since the practice was legalized in 2016, and especially since it was approved for patients who are not terminally ill in 2021.

The growth of legalized health worker killings slowed to only 16 percent in 2023, a substantial slide from the average of 31 percent growth in previous years, although the Canadian government was uncertain as to why the rate of growth declined so sharply.

Critics say Canadian doctors are not only making assisted suicide available, but actively pushing it as an option – even for people whose only medical or psychological complaint was thinking about suicide.

Canada’s doctors actually kill their patients, rather than providing them with tools for suicide and allowing them to pull the fatal trigger themselves. The Atlantic on Monday published an eerie article entitled “Canada Is Killing Itself” that followed doctors gathering for a euthanasia conference in Vancouver, complete with lunch buffets, a disc jockey, and complimentary tote bags for the attendees.

MAID practitioners assembled for the convention said they are already having trouble keeping up with demand for termination services and yet demand is expected to jump again in two years, when a much-delayed provision allowing euthanasia for patients with only mental illness goes into effect. The next frontier after that will be killing children, an idea already bubbling through the Canadian Parliament.

“Medical professionals who decided early on to reorient their career toward assisted death no longer feel compelled to tiptoe around the full, energetic extent of their devotion to MAID. Some clinicians in Canada have euthanized hundreds of patients,” the Atlantic noted.

Critics of doctor-assisted suicide predicted it would coarsen the medical profession and those predictions have been borne out in Canada. One of the practitioners interviewed by the Atlantic was a maternity doctor turned euthanasia provider who decided to think of both procedures as “deliveries,” no different except that one delivers a new baby into the world, and the other delivers a patient into the hereafter.

“It’s a happy sad, right?” another said of his work. “It’s really sad that you were in so much pain. It is sad that your family is racked with grief. But we’re so happy you got what you wanted.”

No one in Canada really argues about the “slippery slope” anymore – the only argument is over what to call it. MAID proponents see a relentless logic in providing the option of death to ever-larger groups of people. 

Once the door was cracked open, the debate shifted to equity instead of morality – why should this group of people have access to MAID, but not that group? Why not everyone? And if everyone can have it, why should doctors not aggressively promote the option, especially when the Canadian healthcare system is overloaded to the point of collapse? MAID recipients do not require follow-up appointments.

Canadians grew skittish when the conversation shifted to offering death as an option to people who might not be capable of making such momentous decisions with clarity, including the mentally ill and children, but that bout of squeamishness seems to be passing.

Health worker killers now speak of having multiple “procedures” per week, and soon it will be multiples per day. Participants in the euthanasia conference attended seminars for using various termination methods, with an eye toward making the patient as comfortable as possible. Meanwhile, online startups have begun offering Canadians assistance with designing their “MAID experience” – from their final earthly hours through post-death ceremonies and helping children adjust to the loss of their parents. Suggestions for helping children adjust include holding “a pajama party at a funeral home” and “painting a coffin in a schoolyard.” Any resemblance between these services and the catered termination experience in the 1973 movie Soylent Green is purely coincidental.

Another booming industry in Canada is the “MAID House,” essentially a form of hospice care that gives patients a warm and comfortable space to be killed in, preferable to the clinical austerity of a hospital or potentially squalid and chaotic conditions at home. MAID Houses make the process of being killed brisk and calm, like saying farewell at an airport departure lounge. Patients spend their final minutes in a La-Z-Boy recliner.

As with many other disruptive social changes, MAID began as a careful and ethically challenging balance between different factors – but now one factor is smashing through all of the others like a bulldozer, that being the concept of “patient autonomy.”

To put it bluntly, no other standard or restriction can survive patients repeatedly demanding euthanasia, even when their illnesses are treatable. When something is normalized, restrictions soon become abnormal. As one Canadian doctor explained to The Atlantic, the early MAID law required prospects to be suffering from an untreatable disease – but if the patient adamantly refuses treatment, anything can become untreatable.

At this point, the biggest roadblock to MAID expansion could be availability, as many Canadian doctors remain uncomfortable with killing. Given how much social and political momentum MAID has, it is surprising how many doctors began having second thoughts after their demand for euthanasia from a patient who was not terminally ill.

The Canadian public still seems to support MAID, but with growing unease that lofty talk of “patient autonomy” is a smokescreen for people being pushed into euthanasia as a cost-effective alternative to prolonged medical treatment. Even the United Nations, specifically its Committee on the Rights of Persons with Disabilities, has grown uneasy with the prospect of “negative, ableist perceptions of the quality and value of disabled lives” tainting the decision-making process for MAID.

If Canada pushes ahead with authorizing MAID for children and the mentally ill, either a large number of doctors will have to master their unease, or more MAID specialists will have to be trained to meet surging demand.