Is Canada’s MAID System Out of Control?

An Honest Look at the Evidence

Canada’s Medical Assistance in Dying program, widely known as MAID, is currently one of the most closely watched assisted dying programs in the world. It genuinely divides opinion among doctors, ethicists, disability advocates, and lawmakers—not just among traditional pro- and anti-VAD campaigners.

The claim that the system is “getting out of control” is not simply fringe propaganda, but it is also not a settled fact. Canada’s system has some real, well-documented problems, alongside features that are working exactly as intended. Reasonable people disagree on how to weigh that up. Welcome to Taboo Education, where every Friday we talk about death from a variety of angles. Today, we are taking an honest look at Canada’s MAID system.

What the Numbers Actually Show

Since MAID was legalised in 2016, roughly 90,000 Canadians have died via the program, including 16,499 deaths in 2024 alone (the most recent full year of data from Health Canada’s Sixth Annual Report). That accounted for 5.1 per cent of all deaths in Canada that year, giving the country the second-highest rate of assisted death in the world behind only the Netherlands. Quebec is a particular outlier, recording a global high of 7.9 per cent of all deaths in its most recent reporting year.

The growth rate is the detail critics point to most. Deaths grew by roughly 30 per cent a year in the early years. However, it is worth noting that this growth rate has been slowing for two consecutive years, even as the raw number of deaths continues to rise.

The Good: What is Working as Intended

It is important to acknowledge what is going right. The vast majority of cases fit the original, narrow intent of the law. In 2024, more than 95 per cent of recipients had a terminal illness (most commonly cancer), meaning their natural death was reasonably foreseeable. These are known as Track 1 cases.

Public support also remains incredibly high. Around 77 per cent of Canadians still support this original Track 1 criteria. Additionally, almost three-quarters of all recipients reportedly received palliative care beforehand—though that figure does not necessarily reflect whether that care was adequate or robust.

The Criticisms: Social Suffering and Unmet Needs

The sharpest criticism comes from a wide range of voices—including the United Nations, disability rights organisations, and academic ethicists. Their concerns largely revolve around vulnerability and what is termed “social suffering.”

Almost half of the people who died by MAID in 2024 reported requesting it partly because they felt like a burden to family, friends, or caregivers. Reports of emotional distress or existential suffering as a reason jumped sharply between 2023 and 2024. Critics argue this points to people seeking death because of unmet social, housing, or mental health needs, rather than an incurable medical condition per se.

Furthermore, because Canada’s healthcare is single-payer and resources are finite, MAID is relatively cheap and immediate, whereas adequate disability support or psychiatric care can involve agonizingly long waits. This creates a structural tension that is hard to dismiss.

“The argument that a cash-strapped healthcare system creates real structural pressure pushing vulnerable people toward death as the path of least resistance has genuine evidentiary support from credible sources.”

The Truchon Decision: Why Did Track 2 Arrive So Fast?

In 2021, Canada expanded eligibility to include individuals whose natural death is *not* reasonably foreseeable (Track 2). This arrived just five years after the original legalisation. So, why did such a young system expand so quickly?

It wasn’t a proactive policy choice by the government; it was a court order. In 2019, two Quebec residents with long-term, non-terminal disabilities (Jean Truchon and Nicole Gladu) challenged the original law in court. Both experienced incurable suffering, but had been denied MAID simply because they weren’t close to death. The Superior Court of Quebec agreed with them, ruling that limiting MAID to terminal cases violated their Charter rights.

The government chose not to appeal and was handed a binding deadline to rewrite the law, resulting in Bill C-7. Track 2 is the direct result of that legal obligation. This is vastly different from countries like Belgium or the Netherlands, where non-terminal eligibility was debated in parliament for years before being implemented.

Is the Government Targeting Vulnerable People?

Some campaigners go as far as arguing that the government is deliberately using MAID to remove disabled or elderly people it considers a burden—even drawing deeply inappropriate comparisons to historical eugenics programs. The evidence does not support this extreme framing.

Canadian disability rights groups themselves argue a very different point: that Track 2 effectively singles out a Charter-protected group, and that systemic neglect (poverty, lack of housing, poor support services) is coercing people into choosing MAID. They are arguing about systemic neglect and a lack of alternatives, not deliberate state-directed killing. Dressing a legitimate structural critique up in the language of malice only makes genuine, actionable concerns easier for lawmakers to dismiss.

Australia vs. Canada: The VAD Divide

For our Australian audience, it is important to note that our system was deliberately built to avoid the criticisms Canada is currently facing. Australia has no federal VAD law; it is legislated state-by-state. The single biggest structural difference is that every Australian jurisdiction explicitly requires a prognosis of death (typically within 6 to 12 months).

Australia has no equivalent to Track 2, and explicitly excludes disability or mental illness alone from qualifying a person for VAD. Because Australia kept terminal prognosis as a hard eligibility gate, our national prevalence rate sits far below Canada’s, with Victoria recording just 0.85 per cent of all deaths in its most recent reporting period.

Sam’s Take: The Right to Die vs. System Failure

I believe everyone has the right to die. If you have the right to live, you have the right to die, provided that is genuinely what you want. But some of these cases in Canada were not about people wanting to die; they were about people who could not access the resources they needed to help them live. That is unacceptable, and if it is not a wake-up call for the government, I don’t know what is.

Canada also moved far too fast. The court case that produced Track 2 played out during COVID, and the implementation should have been postponed until the healthcare system had the capacity to handle it properly. You do not make major ethical and medical decisions in the middle of a crisis.

Ultimately, both sides of this debate hold truth. The system is functioning beautifully for terminally ill patients who want a dignified end. But for vulnerable populations facing systemic neglect, the lack of alternatives remains a glaring flaw. And with that, go talk death.