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Years ago, I sat on a bench reading as my children were at a nearby playground. I was absorbed in The Hand of God—Bernard Nathanson’s autobiographical account of his transformation from an abortion doctor into a pro-life activist. Nathanson’s description of his contributing role in the American abortion industry was disturbing, but there was one sentence that sent chills down my spine.

He warned, “It is no accident that the next step in the perverse mutation of medical skills is to be … where physicians are endowed by the state to assist, always in the name of compassion, in the act of suicide.”

I remember putting the book down and looking over at my kids. What future would they face if euthanasia became legal here in Canada? I wanted to resist Nathanson’s words, but the pit in my stomach indicated I wasn’t successful. What he said made sense. If we sanction doctors ending life in the womb—beyond rare and extenuating circumstances—is it not easier to also accept doctors ending life in its later stages, when age and infirmity have taken their toll?

Abortion and suicide are not identical. But they do ask a similar question of us. Who can be helped to die, and what does society become when we treat that as medical care?

How Canada Arrived Here

At the time I read Nathanson, Canada had held the distinction for nearly a decade of being the only democratic nation in the world without an abortion law. This distinction still holds true today, decades later.

In 1988, the Supreme Court of Canada struck down the 1969 abortion law as “manifestly unfair” due to inconsistent decisions made by hospital review committees. The intent of the decision wasn’t for Canada to be left without a law, but that has been the result as no other law has replaced it. Marge Berer, an abortion-rights activist describes Canada as “stand(ing) out as the only country to date that…effectively decriminalized abortion altogether.”

So, does Nathanson’s warning about euthanasia make sense within the Canadian context? What is the situation here?

On February 6, 2015, the Supreme Court ruled that the Criminal Code provisions prohibiting assisted suicide were unconstitutional. On June 17 of the following year, the Medical Assistance in Dying (MAID) Act was brought in through the passage of Bill C-14. Individuals, who were eighteen years or older, could now seek out euthanasia if they had a “grievous and irremediable medical condition” that is in an “advanced state of irreversible decline” and in which “natural death has become reasonably foreseeable.”  

More expansive steps soon followed. In March 2021, Bill C-7 passed. The significant requirement of natural death being reasonably foreseeable was dropped and individuals could opt for “Track 2”. And in 2024, Bill C-62 passed which allowed MAID for individuals whose sole underlying condition is a mental disorder. Parliament has pushed back this bill’s implementation, but it is currently planned for March 17, 2027.

What We Mean by MAID

Vague language is often used in the discussion of MAID—including in the acronym itself—so clear definitions are needed to figure out what is happening.

In Canadian law, MAID includes both the administration of a substance by a practitioner and the prescription of a substance for self-administration. The first is euthanasia, when a medical professional takes the action that causes death. The second is assisted suicide, in which a medical practitioner knowingly aids in an effort to end one’s own life. 

Even though the term euthanasia is rarely used in Canadian messaging, 99.9 of assisted deaths in Canada, accomplished through MAID, are in fact euthanasia. The official government website often refers to this as “Method 1.”

Euthanasia Is No Longer Rare

As we recently reached the 10th anniversary of MAID in Canada, we are speeding ahead and hitting numbers that surpass jurisdictions that legalized euthanasia and assisted suicide many years earlier. By the fall of 2025, approximately 90,000 Canadians had been euthanized (other than the 0.1 percent who chose assisted suicide) since MAID was implemented. 

Dr. Sonu Gaind, the chief of psychiatry at Sunnybrook Hospital in Toronto, observed, “We’ve gone in a trajectory that no other country on the planet has gone.” With the current pace of growth, Canada is poised to soon be the world leader in the percentage of its deaths that occur through euthanasia.

In 2024, there were an estimated 16,499 deaths through MAID which represented 5.1 percent of all deaths for the year. This rate placed Canada second only to the Netherlands which legalized both euthanasia and assisted suicide in 2001. The province of Quebec, however, had the highest proportion of assisted deaths anywhere accounting for 7.9 percent of deaths in 2024.

Closer to home, consider how we compare to the United States where euthanasia is against the law, but assisted suicide is legal in thirteen states. For example, California legalized medically assisted suicide the same year that MAID came to Canada. The two jurisdictions have similarly sized populations but there were only 853 medically assisted deaths in California versus 13,241 in Canada in 2022. In Oregon, medically assisted suicide has been available for much longer—since 1997—but accounted for only 0.8 percent of all deaths in 2023, whereas Canada’s rate was 4.7 percent  of deaths through MAID that year.

When looking at these numbers, it’s not surprising that Alex Raikin, from the Ethics and Public Policy Center, describes Canada as becoming a “spectre (that) is haunting the global debate on euthanasia.” He says, “No other Canadian public policy has ever been as influential as MAID. For both supporters and critics of euthanasia, Canada remains both a model and the most dangerous canary in the coal mine…The backlash to the Canada MAID program is so intense that supporters of assisted suicide globally have begun to backtrack.”

Our Shared Story of Life

Margaret Somerville, a philosopher and former law professor at McGill University, has written extensively about euthanasia. She warned against its legalization in Canada in the years leading up to MAID, and many of her articles appeared in Canadian publications. I followed her work during that time, and I will turn to her wisdom now.

In her book, Death Talk, Somerville describes that we are living at a time of “unusually intense activity with respect to the evolution of a new cultural paradigm.”  With this rapid societal change, we are losing our shared story that includes our values, attitudes, beliefs, commitments, and myths. We have moved toward “intense individualism” and have become increasingly focused on individual autonomy rather than the responsibilities of belonging to a community.

Somerville argues that there are times when the community must be prioritized over individual needs so that vulnerable people are protected. Respect for human life must be demonstrated not only at the individual level but also at the societal level. When someone claims a right to euthanasia out of a belief in individual autonomy, this stands in conflict with the respect that must be held for human life in general society. Somerville explains—

Euthanasia…is one of the situations where the needs of the community—society—must take priority over the claims of the individual. We cannot afford to routinize and institutionalize, let alone, legalize killing…In considering the legalization and institutionalization of euthanasia, we are considering an alteration to the fundamental presumption against killing each other on which the morality and law of civilized society are based.

Euthanasia fractures our shared story, and we are left with competing worldviews. For some, human dignity is believed to be maintained through autonomy and control. For others, dignity is inherent in each human life regardless of circumstance. These differences in belief come to a head when facing the “two great marker events of human life”—birth and death. Somerville argues that the stance adopted toward one is likely to be the stance taken toward the other. She echoes Nathanson in linking abortion with euthanasia, and their ability to fundamentally alter society. Abortion leads the way and euthanasia follows.

In Canada, where there have been no legal restrictions on abortion for decades, MAID has become rapidly normalized in the last ten years. It is increasingly common to have known someone personally who used MAID, or who is considering using it in the future. Unlike abortion, which is often kept somewhat private, MAID is talked about more openly. In many cases, individuals plan for a shared event with family and close friends. This signifies a massive cultural shift in how we handle death—perhaps even greater than the shift that abortion caused despite the current numbers not being as large. Dr. Michel Bureau observes that in Quebec, “We’re now no longer dealing with an exceptional treatment, but a treatment that is very frequent.” What was initially viewed as a last resort is now a well-known, accepted option.

As Canadians, we’d be wise to pause and consider where euthanasia could lead us. Will those who are sick or elderly begin to feel they should die rather than be a burden when MAID seems like such a reasonable and accessible option? Could the individual right to euthanasia possibly morph into a duty to die—particularly with our strained health care system—and ironically turn autonomy into a communal obligation? And, specifically in the case of MAID for mental illness, could suicide prevention be viewed as something that stands in the way of a person’s right to choose, rather than as community support?

Where the Church Clarifies

To push back on the Canadian expansion of MAID in 2020, the First Presidency of the Church of Jesus Christ of Latter-day Saints endorsed an ecumenical Declaration Against Euthanasia and Assisted Suicide initiated by the Canadian Council of Catholic Bishops and Evangelical Fellowship of Canada. The church was added as a signatory, and it reissued its statement on Euthanasia and Prolonging Life. It’s worth quoting this in full because clarity is necessary due to the normalization of euthanasia through MAID.

The Church of Jesus Christ of Latter-day Saints believes in the sanctity of human life, and is therefore opposed to euthanasia. Euthanasia is defined as deliberately putting to death a person who is suffering from an incurable condition or disease. Such a deliberate act ends life immediately through, for example, so-called assisted suicide. Ending a life in such a manner is a violation of the commandments of God.

The Church of Jesus Christ of Latter-day Saints does not believe that allowing a person to die from natural causes by removing a patient from artificial means of life support, as in the case of a long-term illness, falls within the definition of euthanasia. When dying from such an illness or an accident becomes inevitable, it should be seen as a blessing and a purposeful part of eternal existence. Members of the Church should not feel obligated to extend mortal life by means that are unreasonable. These judgments are best made by family members after receiving wise and competent medical advice and seeking divine guidance through fasting and prayer.

The Church wisely differentiated euthanasia from prolonging life in this statement because many advocates conflate the two and this adds confusion for the public. Non-specific language is commonly used by those advocating for euthanasia and assisted death. This needs to be pointed out.  

A Needed Pause

MAID in Canada has recently been making international headlines. As Canadians, we benefit from this because it puts a needed spotlight on us. The most recent story to capture attention is about a doctor, Dr. James MacLean, who counseled his 45-year-old patient outside a Tim Hortons restaurant. Later that day, he personally drove the man, who had Crohn’s disease and depression, to the morgue and administered the lethal injection. This could be the punchline to a joke about Canadian-style euthanasia if it wasn’t so morbid. It also highlights an important fact of human nature—there are individuals who cannot be trusted, even among doctors. Dr. Bernard Nathanson would agree, and it is worth reading The Hand of God to warn us of the parallels to the practice of abortion.

Canadians are known for their politeness, and we don’t like to step on each other’s toes, but we must speak out. Individual stories of human suffering swayed people’s opinions toward the legalization of euthanasia. The disturbing stories we’re now hearing may have the power to convince people of the danger MAID presents to vulnerable members of our community. As Canadians, we don’t need to accept being legal outliers on life issues.

Many medical practitioners, groups representing people with disabilities, and faith organizations have been sounding the alarm to our government for years. The province of Alberta recently passed Bill 18—the Safeguards for Last Resort Termination of Life Act. Among other safeguards, it limits MAID to Track 1 individuals, that is,. those whose natural death is foreseeable within a year, and it permanently prohibits mental illness as a sole condition to qualify for MAID. At the federal level, the Special Joint Committee of Medical Assistance in Dying tabled its final report June 17, 2026 and recommended that the government amend the Criminal code to “indefinitely exclude” mental illness as a sole underlying condition for individuals applying for MAID.

Many people are pushing back, and we need to add our voices to theirs.

It’s been almost 30 years since that day at the playground, and my concern now extends to my grandchildren. I wish the chill I’d felt long ago had been unfounded, but Nathanson was correct about where we were headed.

I just wish my beloved Canada wasn’t the country that decided to prove him so right.

The post What MAID Has Made Normal appeared first on Public Square Magazine.

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