Medical Assistance in Dying (MAiD) has been one of Canada’s most debated policies, but as Dr. Ramona Coelho and I discussed in our recent podcast, the conversation is far from over. In fact, it’s only getting more urgent.

Since our last discussion, MAiD cases in Canada have skyrocketed, surpassing 80,000 deaths—far outpacing comparable jurisdictions like California. But here’s the real issue: many of these deaths aren’t the result of terminal illness.

Dr. Coelho, a family physician who works closely with marginalized communities, shared troubling findings from Ontario’s MAiD Death Review Committee, exposing cases where individuals chose euthanasia due to financial hardship, housing insecurity, or loneliness. These are people who, in a functioning society, should be receiving care—not a lethal injection.

Even more concerning? Canada’s laws make MAiD easier to access than palliative care. In some cases, individuals can be approved and euthanized within 24 hours. Compare this to places like California, where strict safeguards—including mandatory hospice or palliative care—exist before MAiD is even an option.

But perhaps the most striking part of our conversation was the racial and cultural divide in who is opting for MAiD. Government data shows that 95% of Canadians accessing MAiD are white, even though they make up only 72% of the population. In California, it’s even more stark—85% of MAiD cases are white patients, despite white Americans being just 35% of the population. Why? Many responses point to a lack of family support, weaker community ties, and declining spirituality.

This isn’t just about politics. It’s about the ethics of choice vs. coercion—and whether people are being subtly pushed toward death due to systemic failures in our healthcare and social support systems.

Dr. Coelho’s research shows how MAiD has drifted far from its original intent. What was once framed as an option for terminal illness has expanded into a system where individuals with disabilities and mental illness are given the “choice” to die—not because they want to, but because they feel they have no better options.

So where does Canada go from here? The government has already delayed the expansion of MAiD for mental illness, signaling that even policymakers know they’ve gone too far. But is that enough?