A severely anorexic woman has expressed her interest in applying for Canada’s Medical Assistance In Dying (MAID) program, which is slated to expand eligibility to those without a terminal or incurable ailment.
Lisa Pauli, a 47-year-old woman living in Toronto, Ontario, has struggled with an eating disorder since she was a child. Now weighing just 92lbs, Pauli says that her anorexia has resulted in difficulty performing simple daily tasks such as carrying groceries and doing her laundry.
In a recent interview with Reuters, Pauli said: “Every day is hell … I’m so tired. I’m done. I’ve tried everything. I feel like I’ve lived my life.” She went on to explain that many people have pleaded with her to seek treatment, but that she would rather die than recover and gain weight.
During an appointment with her psychiatrist in 2021, Pauli says she was encouraged to seek information about assisted suicide, an option she is now asserting she wants to pursue.
Since 2016, Canadian law has allowed for euthanasia in cases where a patient has a terminal disease. This law was expanded in 2021 to include incurable conditions that did not have an imminent risk of death. But people like Pauli were still unable to access options for MAID because it was not yet open to those with a mental illness.
But the eligibility for MAID set to be expanded once again in March of 2024 due to court rulings that struck down almost all remaining restrictions.
According to an expert panel report to Canada’s parliament, the new guidance will make Canada one of the most liberal countries in the world for assisted suicide.
Those in support of euthanasia have made the argument that a person’s choice to die is a matter of personal autonomy. But six disability and religious rights advocates told Reuters that the pace of the planned changes to the euthanasia framework in Canada sets a dangerous precedent.
Some are expressing concerns that opening the eligibility to almost all Canadians will result in the most vulnerable, especially those unable to access social services, opting to die.
Canada’s Justice Minister, David Lametti, has dismissed those concerns, instead expressing that he was “proud” of the direction the MAID program was heading.
“We have gotten where we are through a number of very prudent steps,” Lamette said in an interview with Reuters in June. “It’s been a slow and careful evolution. And I’m proud of that.”
As of the most recent statistics available, just over 10,000 people died through assisted suicide in Canada in 2021, accounting for approximately 3.3% of all deaths in the nation that year. That compares to 4.5% in the Netherlands and 2.4% in Belgium, where assisted dying has been legal since 2002.
But concerns over the potential abuse of the program are not entirely unfounded, as some of Canada’s provincial health authorities have reported that a number of assisted suicides did not comply with regulations.
In 2021-22, Quebec found 15 MAID deaths did not follow existing guidelines. The province referred the cases to Quebec’s self-governing medical body and medical facilities, provincial spokesperson Marie-Claude Lacasse said. In six of those cases, the patient did not have a serious and incurable condition.
None of the investigations resulted in any disciplinary action for the participating doctors.
Since 2016, more than 30,000 people have died through MAID in Canada. Over a third of the deaths are from 2021, when the law expanded to allow people whose illnesses were not considered fatal. Even after the change in the legislation, about 98% of the assisted deaths in 2021 were people deemed near their natural death, according to Health Canada data.
“So far nothing I see would suggest that we need to worry about having gone too far,” Justice Minister Lametti has said of the program.
To be approved for medically assisted suicide, the applicant must be covered by a Canadian Healthcare Program, fill out a written application and must have two assessments from two separate medical practitioners. Only one must be a specialist in the individual’s current condition as long as the patient is not close to their natural death. The process usually involves an injection to be administered at home.
In February of 2023, the Special Joint Committee on Medical Assistance in Dying presented its latest report to the Canadian Parliament. Included in its list of recommendations was a further expansion of the program to include “mature minors,” which they define as children under the age of 18 who are “deemed capable of making [the] decision” to access MAID.
According to The Post Millennial, the committee stated that in order to give minors the “final say” in whether they choose to go through with assisted suicide, provisions would need to be put into place to ensure that the child had “requisite decision making capabilities.”
The committee also argued that the ability to weigh options was enough and MAID should not be denied based on age alone. The Trudeau committee came to the conclusion that before amendments could be placed on existing policies to allow for “mature minors,” they would give parliament five years to carry out supporting research.