The rate of medical assistance in dying — also known as euthanasia — has risen in Canada for the fifth year in a row, albeit at a slower pace.
The state released its fifth annual report since legalizing euthanasia in 2016, which for the first time included data on the race of those seeking euthanasia.
About 15,300 people underwent assisted dying last year, representing 4.7% of deaths in the country. Canadian lawmakers are currently seeking to expand access to euthanasia to include people with mental illnesses by 2027.
Canada is among the few countries to introduce assisted dying laws in the past decade. Other countries include Australia, New Zealand, Spain and Austria.
Figures released by Health Canada on Wednesday show Canada's assisted dying rate rose by about 16 per cent in 2023. That number represents a sharp decline from the average increase of 31 per cent in previous years.
The report cautioned that it is too early to determine the reason for the slowdown in the rate.
Almost all of those who requested assistance in dying — about 96% — experienced a predictable, natural death. The remaining 4% were granted euthanasia because they had a long-standing chronic illness and where natural death was not imminent.
The average age of those seeking assisted dying was about 77, and cancer was the most common underlying medical condition.
For the first time, the report looked at racial and ethnic data for those who died by euthanasia.
About 96% of recipients identified as white, who represents about 70% of Canada's population. It is not clear what causes this disparity.
The second most frequently mentioned ethnic group was East Asians (1.8%), who represent about 5.7% of Canadians.
End-of-life care continues to have the highest utilization rate in Quebec, accounting for approximately 37% of all euthanasia deaths, despite the province having only 22% of Canada's population.
The Quebec government launched a study earlier this year to examine why its euthanasia rate is so high.
Although the number of medically assisted deaths in Canada is increasing, the country still lags behind the Netherlands, where euthanasia was responsible for about 5% of all deaths last year.
UK MPs voted late last month to pass a similar bill giving terminally ill adults in England and Wales the right to have an assisted death, although it will face months of additional scrutiny before it becomes law.
As British MPs debated the legislation, some cited Canada as a cautionary tale for its perceived lack of safeguards.
Like the United Kingdom, Canada initially only legalized assisted dying for those whose deaths were “reasonably foreseeable.”
However, Canada expanded access in 2021 to people who may not have a terminal diagnosis, but want to end their lives due to a chronic, debilitating condition.
It was set to expand access again for people with mental illness earlier this year.
But that was delayed for a second time after Canadian provinces, which oversee health care delivery, raised concerns about whether the system could handle such an expansion.
Health Canada on Wednesday defended the measure, saying the Criminal Code sets “strict eligibility” criteria.
But the Christian think tank Cardus said the latest numbers were “alarming” and showed Canada has one of the fastest-growing euthanasia programs in the world.
A report released in October by Ontario – Canada's most populous province – shed some light on controversial cases where people were given assisted dying when they were nowhere near their natural death.
An example is a woman in her 50s with a history of depression and suicidal thoughts who had severe allergies to chemicals.
Her request for euthanasia was granted after she failed to secure housing that would have met her medical needs.
Another case that made headlines in recent months involved a Nova Scotia cancer patient who said she was asked if she was aware of assisted death as an option twice while undergoing mastectomies.
She told the National Post that the question was “asked in very inappropriate places.”
Canadian media have also reported on cases in which people with disabilities have considered assisted death due to a lack of housing or disability benefits.
