Name: How Euthanasia Became an Epidemic in Canada | Amanda Achtman
Uploaded: 2025-11-26T07:52:06.000Z
Description: In less than a decade, euthanasia has become tied for the fifth leading cause of death in Canada, accounting for one in every 20 deaths since it was first legalized in 2016. Over 60,000 Canadians have died via euthanasia.

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[RUSH TRANSCRIPT BELOW] In less than a decade, euthanasia has become tied for the fifth leading cause of death in Canada, accounting for one in every 20 deaths since it was first legalized in 2016. Over 60,000 Canadians have died via euthanasia.

“This marks a massive cultural shift in how we live and die in Canada,” says Amanda Achtman, a leading critic of the practice and the founder of the Dying to Meet You Project.

Patients no longer need to be terminally ill to request euthanasia, and there are ongoing debates about whether minors or people with mental illnesses should be able to apply. Disability advocate groups have been some of the leading critics of the program, arguing it sends a disturbing message: that the lives of those who are disabled are worth less.

What are the ethical implications of Canada’s euthanasia program? How is it changing family dynamics, societal norms, the meaning of a life well lived, and the fundamental role of a physician?

Views expressed in this video are opinions of the host and the guest, and do not necessarily reflect the views of NTD.
RUSH TRANSCRIPT
Jan Jekielek:

Amanda Achtman, such a pleasure to have you on American Thought Leaders.

Thanks for having me.

So euthanasia now in Canada has become tied for the number five cause of death, as I’ve been reading, or also known as, Medical assistance in dying [MAID]. Chart me what happened here.

In 2016, Canada legalized euthanasia nationwide, and this was in response to a court decision. And that’s largely how the changes have happened, not so much through public conversation, but through the courts. And so what happened was the government had a deadline to create a law that essentially legalized euthanasia across the board.

And of course, as it always begins, euthanasia, or as it has become known, medical aid in dying, was officially and initially for persons whose deaths were deemed reasonably foreseeable. Of course, all of our deaths are reasonably foreseeable, but sort of…

More in an immediate sense.

In an imminent sense, maybe, and not with a specific time horizon. So reasonably foreseeable with a grievous and irremediable condition. That’s how it was ushered in. And since then, euthanasia has become a leading cause of death in Canada. Euthanasia in Canada now accounts for one in 20 deaths.

As a Canadian, there’s almost not a day that goes by that I don’t hear a personal story of how this is touching people. Many people know someone who has been euthanized or who is thinking about it. And so this marks a massive cultural shift in how we live and die in Canada.

So, I mean, let’s just talk about the actual numbers. I mean, from what I read since 2016 to 2023, that’s as far as the data is available, that’s just over 60,000 people who have died this way or committed suicide this way. Actually, how would you describe that?

Many people are sensing a loss of meaning as they approach the end of their life. And that’s what the government’s own data bears out. Each year, the government asks people about the kind of suffering leading to the request, and while people may be living with a terminal illness or a disability or perhaps with ALS [Amyotrophic Lateral Sclerosis] or dementia, when asked what kind of suffering leads them to request MAID, the number one kind of suffering by people’s own admission is a loss of ability to engage in meaningful life activities. And so this, though it is in the public health care and medical context, really marks an existential crisis, a crisis of meaning.

So that, I mean, that’s fascinating. But what do we even call this? Is this committing suicide? Is there another name for it? Like, how is it described? How do you, what do you call it? Or what is it generally, how is it viewed in Canada?

Even the former Liberal Minister of Justice referred to euthanasia, to medical aid in dying, as a species of suicide. He said that on a program. And so it is a form of suicide. And psychiatrists have made this point that it puts them in an impossible position as psychiatrists, where on the one hand, their responsibility is to provide suicide prevention. And yet when there’s a whole segment of the population for whom medical assistance in dying is available, then why do we now have this world where some people get suicide assistance and others get suicide prevention?

And we know that there are certain demographics who are being met with this offer of state-facilitated assisted suicide. And I have heard from persons with disabilities who say, this is the first thing the government has told me I’m eligible for. To be told that you qualify for a premature death is already killing the person. It already deflates and defeats your sense of worth. That’s the impact that euthanasia is having on Canadians.

I want to explore that a little more in a moment, but presumably the difference, right, between a time when you would get help, well, it’s consent, isn’t it? Like, isn’t that, that’s when you would get help in doing it, right, if you said, yes, this is what I would like?

Many people will say, isn’t this the defining characteristic of modern medical aid in dying, that at least the person is asking for it? I would say to that, if what a person is requesting is to be killed, is that not itself a red flag? Let’s consider the nature of what is being requested. And why do we look at that as reasonable and in the service of the person when it is never in the person’s interest not to exist? This is a cry for help. And we have to receive it as such.

Well, so many things to unpack here and what we just discussed. Why don’t we just start off with you telling me a little bit how you actually got into, you know, this very, very fraught issue.

Sure. So when I was in high school and my early university years, my grandfather lived with my family, which is not that common to necessarily have grandparents in the home, but he was very present in my life and we had a very warm relationship. He was also my kind of intellectual sparring partner. And it was around the time that the government started talking about legalizing euthanasia for people whose deaths are deemed reasonably foreseeable. And I thought, okay, this concerns people like him, and this affects families like mine.

And so from that early stage, I started to pay attention to this and to see this as an affront to the dignity of older adults, of seniors, of the elderly, and of people who might be susceptible to the pressure, whether from their family or from a doctor, to have a premature ending to their life. My grandfather thankfully died a natural death just before the euthanasia law was ushered in, but I had seen him in moments of suffering and agony where he could have been susceptible, and it struck me that it doesn’t actually surprise me that sometimes people have a temptation to consider death.

But what we must not tolerate is everyone else concurring with that. When we go through a difficult time or face even suicidal ideation, that’s not so surprising. What’s surprising is when people gather around and say, sure, I affirm you, go for it. That is what we cannot abide. That is what I could not tolerate seeing happening in my country.

And so some years later, I started working with a member of parliament, and it so happened that the issue became that the liberal government was intent on expanding euthanasia beyond the preliminary parameters. And this always happens because once legalized, euthanasia cannot remain limited. Here’s why.

If euthanasia is seen as a reasonable and compassionate means to alleviate suffering, why would you limit it? Why would you withhold it from anyone? It doesn’t make any sense. Why would you withhold it from children or from people who cannot necessarily…

Well, children, you would say because they’re unable to give consent. But what about people? Let’s first talk about people that are of age.

I do think it’s important to mention children though because in Canada a turning point in our euthanasia debate nationally happened when a father named Robert Latimer killed his disabled daughter in Saskatchewan. He had a 12-year-old daughter who had cerebral palsy, and he gassed her in the back of his truck and this was an international story. It was covered in the New York Times; it was a key turning point. Why?

Because many people sympathized with the father, that he had done something merciful, that he had put his daughter out of her suffering. And that was when many people with disabilities thought, oh no, something is amiss, because people are sympathizing with the father who ended his daughter’s life. She couldn’t consent, she was not able to speak, and the way that she was described with such dehumanizing language compared to the father who was described in these glowing terms is part of the story.

Now you’re talking about the media coverage around this?

The media coverage and the response of ordinary Canadians. And now this man is living outside of jail and he’s back on his farm in Saskatchewan. And so we are also seeing an explicit push for euthanasia for—they’re not referred to as children, they’re referred to as mature minors in the debate around euthanasia. And the head of the Quebec College of Physicians and Surgeons testified before Parliament that he thinks it’s important that MAID be considered for children with severe deformities and abnormalities, as he put it. And the leading euthanasia lobby in Canada has suggested MAID be expanded to those mature minors who they think have the capacity to consent, maybe along with a parent or guardian agreeing, but are able.

So this is an actual conversation in the policy space across Canada. And we already see the elimination of the requirement for consent with the euthanasia of persons with dementia who might make an advance request, but then are unable to really change their mind. Their former self can bind their future self so irrevocably that they are not required to give consent, final consent, which was a former safeguard that we had before the moment of their death. And so these crises of consent also get eroded.

But yes, by and large, most Canadians are ostensibly consenting to have their life ended. And maybe interestingly to note, many people want to die in their own home. That’s a common hope. And now euthanasia doctors are coming—well, they’re doctors who come and provide MAID. That’s the language that’s used—in a person’s own home. And I think this is partly because of our culture where we order our food, we curate our playlists, we have so much in the way of preferences that why shouldn’t we be able to curate the way that we die and create a kind of social media-like death that is palatable to others? But I think that that denigrates the experience of dying that every person deserves to have.

Why don’t we look very quickly at what qualifies you for being able to do this? Because it’s not that anybody off the street can say, doctor, I’d like help with this.

The criteria for choosing medical aid in dying is rather subjective because it largely rests on the person’s account that their suffering is intolerable to them. The majority of persons seeking euthanasia have a terminal illness like cancer or maybe live with illnesses like ALS or MS [Multiple Sclerosis]. And these conditions are challenging. Obviously, there’s a kind of concurrent mental health challenge in facing these conditions.

But what message does it send when the response to getting a diagnosis or entering into this phase of life is to prematurely cut it short and end it? It makes everyone else who has that diagnosis more precarious. It makes all of us more precarious because as soon as there’s a social criteria by which life becomes less bearable, and it becomes less reasonable to live, then everyone with that condition, whether they would want it or not, is regarded as living a life that might be less worth living.

Well, so there was, as we started a little bit earlier, talking about, you mentioned that at the beginning, the criteria were much stricter. And you were actually involved in some legislation working with a Canadian Parliament member on, well, trying to stop legislation that would widen it. But kind of, can you chart that course for me about where it started and where we are today?

Right. So when Canada first legalized euthanasia, it was for this grievous and irremediable condition and for those who were at end of life. And there were more stringent so-called safeguards where there needed to be independent witnesses, there needed to be a 10-day reflection period. These were the safeguards that were removed for those who were deemed imminently dying. So what Canada did in 2021 was usher in a two-track system.

Track one is for those terminally ill persons and for those whose deaths are deemed imminent, and track two is for those whose deaths are not reasonably foreseeable. And that is the track that brought in euthanasia for people with disabilities. Once euthanasia is seen as a reasonable response to suffering, then why would you limit it to those only at the end of life?

And so this was the rationale by which euthanasia was expanded to those with disabilities, that many people suffer even more throughout their lives than some do when they approach the end of their lives and are dying naturally. And so wouldn’t they be entitled to the same option to relieve their suffering through death?

What is the status of euthanasia for mental health conditions? Because I know this has been the subject of debate and in some cases, you know, has been mischaracterized.

When I was working in politics, the Liberal government was seeking to expand euthanasia first on the basis of disability, which was called Bill C-7. With the Member of Parliament with whom I was working, we put up a website called No Same Day Death, because part of what this ushered in is the ability to request euthanasia and be killed on the same day, no more 10-day reflection period.

Opposing the eradication of those safeguards that had been deemed essential just some years prior, we put out this petition. And many, many thousands of people signed it. Then we put out a call for stories and said, we need your stories about how the expansion of euthanasia can affect you and your loved ones. And because the Senate had added a proposal to also expand it to those for whom mental illness was a sole underlying condition, we received stories about both mental illness and disability. Well, those hundreds of stories poured in of people begging and imploring us not to allow this expansion of euthanasia on these conditions and how it would affect people themselves and their loved ones.

And I was poring over these letters at the height of the pandemic in this parliamentary office that had felt like it became a suicide prevention office, and feeling the responsibility to respond to each one and to address them in their candid vulnerability. And people were writing to us saying that they had struggled with suicidal ideation, that if this law had been in place when they were struggling, they would not be here. And so the weight that we felt working on this issue, knowing that if this law passed, many people would be lost, was quite overwhelming.

And so this is what happened though, the legislation was brought in, euthanasia was expanded to include this so-called track two to persons with disabilities, and it was also including euthanasia for persons for whom a mental illness is the sole underlying condition. However, that piece of the legislation, mental illness as a sole condition, was postponed and it has since been postponed year after year so that it’s set to take effect in March 2027 unless there’s a change.

So basically we do already have euthanasia for persons who are struggling with their mental health, if not with a diagnosable mental illness, but as a compounding factor. So that if you use a wheelchair and you’re depressed, you qualify for euthanasia. But if you’re only depressed, you don’t. And that is what has led people in the disability community to say that this has made persons with disabilities into a killable class.

You know, I’m thinking back. I just recently interviewed Laura Delano, who spent 14 years on psychiatric medications. And at times, she tried to commit suicide, almost succeeded. It was almost a miracle that she didn’t succeed. But she deeply wanted it and was actually, when she survived, she was really unhappy about the fact that she made it. But, you know, and multiple steps ensued.

But in the end, when she started weaning herself off of certain types of medications, she kept rediscovering that will to live. It’s a very fraught area. What I’m trying to say is this is such a fraught area because you could be convinced for a while, right, that death is the only solution. It’s the only reprieve from the suffering you’re experiencing. But you know very quickly with some kind of inspiration or you know you might change your mind.

Right, your worst day should not be your last day. I’m sure we all know people who have experienced something that they thought they would never come out of. I’m sure we can all ask ourselves if we were shown a preview of all that we would suffer in this life ahead of time, who would think that they could bear and withstand and go through the whole ordeal of a life? And yet, I think it’s interesting how inspiring most people find Holocaust survivors.

Man’s Search for Meaning by Viktor Frankl is one of the best-selling books, and we look at these stories of resilience with appropriate admiration. And I think part of what suffering entails is it can narrow that horizon of transcendence that reminds you that you are not unique. There is a uniqueness and a deeply personal dimension to suffering, but you’re not the only person who’s ever suffered.

In fact, your suffering is the basis of your deeply human solidarity with everyone else. And we need to be reminded and reawakened to our humanity when we recognize that suffering is the basis for our communion and fellowship with other human beings. It does not throw us and cast us out of the human community. It actually constitutes it. But only when we rise to the occasion, are there for one another, and we help make some meaning out of what we’ve suffered.

I often think of a quotation of a writer, Isak Dinesen, who said, any sorrow can be borne if you can put it into a story or tell a story about it. And a leading Canadian psychiatrist, Dr. Harvey Chochinov, has this brilliant dignity therapy, Final Words for Final Days, which is about drawing out that meaning at the end of life. I think that people can bear things when someone comes alongside them and has a posture of saying, what do you have to teach me?

But when everyone falls away and that person is abandoned in their loneliness, of course we have a crisis. But that is the more demanding cause that we must address and the occasion to which we must rise. Euthanasia is not a declaration of freedom, it’s a declaration of defeat and no point of pride for a society.

And so I have such nobler aspirations that in the face of suffering and death, we would have exemplary deaths that would be educative for the rising generation about how to contend with the whole ordeal of the lives we lead. Is there any scenario where euthanasia is appropriate in your mind?

No, because in every case, the person’s existence implies that they have a task in the world. Maybe that task is to receive the loving attention of others. Maybe to exist is to know that you have a place in the world, that you are needed for something. And that also we short circuit our opportunities to love when we evict people from the human community based on their suffering. It’s very lazy on our part to decide that once people become inconvenient, complicated, and demanding that they have no place in our lives.

Instead, we have to address this risk to the kind of kindness quotient in our society that euthanasia poses. It actually, of course, first and foremost matters to the person, him or herself. The suffering dying person deserves not to have their death reduced to a 15-minute coffee appointment or legal appointment, not to have their death scheduled neatly into the lives and schedules of others. But part of dying naturally is its unexpectedness, its unpredictability. The way in which it is inconvenient is part of what is in it for us to discover.

I was just listening to a friend of mine who was accompanying her father in his last days, and she said it’s good when death takes time and is slow, and yes, you need palliative care; you absolutely need to manage the pain. This is not about being masochistic. We don’t need to seek out suffering, and yet with proper palliative care, the dying process can be the gradual surrender with the accompaniment of others that will be instructive in how to live and that will leave a legacy.

You know, I mean, this is what I’m thinking about, right? It’s, you know, you’re young, you look healthy, you know, you probably have a long life ahead of you. And there are just people who are old and in a ton of pain and who don’t see the point in sticking around. And maybe, as you were alluding to earlier, they’re thinking to themselves, you know, I’d just like to make it easier on my offspring or whatever. I’m under a lot of pain. Like, really, this really does seem like a better solution, quite frankly, objectively. I mean, I’ve heard this argument made, right? And I don’t even know how to respond to that if someone is making that choice. Sorry, sorry, you can’t. You have to suffer, and you have to, you know, be a burden and all those things. Sorry, you can’t make that decision. This is kind of the core question in a way, but to me, what do you think?

The only response to the cry of the heart that you describe is love. No argument, but presence. And so it is incumbent upon me and my friends and my generation to tell a different story, which is that we need you in our lives. Don’t go through with this. And I speak very often to older adults, and I make the point that as long as this is a legal reality in Canada, the rising generations’ growth and development will be stunted because we lose those opportunities to go out of ourselves and to be confronted even with our own mortality in the ways that coming alongside someone gives us.

I think back to when I was age 18, I went on a Holocaust study trip to Germany and Poland for the first time, and I traveled with two survivors, walking hand in hand with them to the sites of their trauma, and it awakened me. Those were the moments that helped me to take life seriously. And I’ve had other events throughout my life, facing the drama of mortality that have awakened my sense of life’s value. And I think this is something that we don’t want to miss. We don’t want to miss the moral urgency that comes from the preciousness of life in its limits. And so I really like to say to older people, I’m watching how you die, so do it well. Your death sends a message to me.

I was recently speaking with a 28-year-old woman in Canada whose grandmother she described as the paragon of strength in the entire family, the ultimate matriarch, and no one messed with grandma. But then her grandma, in her 90s, as she was imminently dying, opted for MAID. And this 28-year-old woman said to me that she struggles with mental health challenges. She’s gone through a lot. And she says, if my grandmother, who was such a figure of strength in my life, could choose that in a moment of weakness, I don’t stand a chance. What can I do?

So these things affect each other. And what message can an older person give a younger person with respect to resilience or to even not harming themselves with behaviors that are self-destructive if they go and prematurely have their life ended? It might seem neat. It might seem coordinated, all of this with a euthanasia doctor ending the life in 15 minutes in this kind of curated way, but it’s not real. It’s not real. And that unreality is shattering.

You know, you’re making me think of this. You made a series of these short videos of kind of very interesting case studies, the things that I hadn’t contemplated. One case in particular, Christopher Lyon, where he gets a call from a provider, I guess is the term, saying, you know, you’ve got two days to see your dad. Your dad is scheduled for dying in two days. Come or you won’t see him again. I mean, I’m paraphrasing here, but basically that was the message he got. And so he’s talking to you. Let’s actually roll that clip and then we can discuss it.

(video)

My opposition to euthanasia is not speculative. It’s not abstract. It’s not theoretical. It is experiential because I watched doctors kill my father in front of my family on a family member’s birthday.

Tell me about your father’s life.

Growing up, my dad was a complex man. He was, in many ways, a very loving father. He was very, very proud of having his kids. You know, he would hug you very quickly. He was an affectionate guy. But he also had a dark side. And I noticed this as a teen. He would talk about drifting off into Georgian Bay on a canoe, never to return again. And he would talk about deaths he witnessed in the police. And it wasn’t until years later that I saw that as indicative of somebody who is deeply traumatized or deeply depressed. But, you know, that was the dark side of him. The light side was this loving, jovial man who would laugh heartily.

Were you concerned that he would commit suicide long before euthanasia was ever legal?

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