This text is apparently no longer applicable to Canada (and has not been for some time now). It was written before Medical Assistance in Dying was legal. In the early pages of the book, the author states that Canada, among other Western countries, will be performing assisted suicides. (With assisted suicide, the doctor prescribes the patient medication or a cocktail and the patient takes it himself, rather than the doctor literally administering drugs that cause death—as veterinarians do.)

Patients giving themselves physician-prescribed cocktails is not what’s going on here. A 2022 article that appeared in CMAJ (the Canadian Medical Association Journal) “Medications and dosages used in medical assistance in dying: a cross-sectional study” cites statistics from the Second annual report on medical assistance in dying in Canada 2020 and the CFPC Task Force on End-of-Life Care. A guide for reflection on ethical issues concerning assisted suicide and voluntary euthanasia:

Although nearly 7000 Canadians have died with medical assistance, there is little information on the technical aspects of providing MAiD. The current literature predominantly explores the ethical issues, eligibility, and the impact on patients, families and health care providers.However, it is clear that, across Canada, self-administered MAiD is rare, with fewer than 7 cases reported.

What we have here in Canada is undeniably “voluntary euthanasia”.

Contrary to the author’s dismissal of “exaggerated” concerns about allegedly vulnerable people being pressured into early departures, I’d argue that there is growing evidence that this has occurred, is occurring, and (we have no reason to doubt) will continue to occur in Canada. We’re on a slippery slope.

A little while back, a young woman presented to a British Columbia hospital. She was in distress and seeking help for her suicidal feelings. She was interviewed by a mental health professional who asked her if she’d considered MAiD. The young woman was informed of the inadequacy of mental health services and told a story of someone who’d long suffered with suicidal ideation who had finally succeeded in killing him or herself and was now at peace.

When the media learned about the young woman’s experience and contacted the health authority for an explanation, the latter blew off questions about why a suicidal person requesting help would be asked about MAiD. Officials responded that it was a “screening” question to see how intent the sufferer was on killing him- or herself. In this case, a young woman wanted help and was shocked by the interviewer’s comments.. MAiD has not yet been approved for mental illness. Why was this discussion even occurring?

Many of us understand why assistance in dying might be needed by patients whose deaths are imminent, but a whole host of problems is developing around those whose deaths are not imminent, many of which Yuill appears not to have foreseen.

My comments are based on a sample of the text, and the author may make other pertinent arguments about assistance in dying. My sense, however, is that this book could do with some serious revision. The model in Canada is much more like the Netherlands. In the Netherlands, however, at least the patients’ family doctors perform the euthanasia. In Canada, the last doctors are essentially strangers. How invested can a stranger be on the right course of action for patients and their families? ( )