New report shows who is getting medical help with dying despite not being close to natural death

The relative ease with which people who aren't close to death can get medical assistance in dying is troubling, especially given new data that shows poor people are more likely to seek help ending their life, a London, Ont., family doctor who works with marginalized patients says.

"The trends that have emerged are not insignificant," said Dr. Ramona Coelho, who sits on the chief coroner's medical assistance in dying (MAiD) death review committee. 

"A lot of suffering could be alleviated through better health care, community support, finding community help, figuring out where you can access resources and that is the kind of help that is not offered to these marginalized patients."

The death review committee just released a report about the vulnerability of people who seek MAiD but whose natural deaths are not reasonably foreseeable, known as Track 2, which has been allowed since March 2021. (Track 1 offers medical assistance in death for people whose natural deaths are reasonably foreseeable). 

"While the circumstances of the deaths reviewed are not representative of most MAiD deaths, the themes identified during the review are not uncommon within the MAiD review process and likely have implications for emerging MAiD practice," the committee wrote in its report.

Since 2021, only 2.6 per cent of all MAiD deaths fall under the Track 2 category. In 2022, that meant 121 deaths and in 2023 116 deaths.  

The trends found in the report included: 

The trends show what Coelho says she's suspected: that people who are in lower socioeconomic situations and have a lack of support may choose to end their lives if they're not given alternatives. 

"Patients are getting offered drugs for their pain relief and their suffering but we're not actually addressing many of the things that have actually caused the suffering," she said. "These cases are devastating and they're exactly the kinds of desperation I see. I'm alarmed at what I'm seeing." 

It's often quicker to get approved for a medically assisted death than to get access to complex care, Coelho said.

"The same government that is failing to offer social systems is the same government that is offering quick and easy MAiD. There's a perverse disincentive to improve care.

"It's quite dispiriting to know that it's easier for these folks to get MAiD than to get the help that would actually help them lead more fulfilling lives."