Connect with us
[bsa_pro_ad_space id=12]

National

Medical Assistance in Dying now accounts for over 4% of deaths in Canada

Published

11 minute read

The following are interesting statistics pulled directly from the:

Fourth annual report on Medical Assistance in Dying in Canada 2022

Growth in the number of medically assisted deaths in Canada continues in 2022.

  • In 2022, there were 13,241 MAID provisions reported in Canada, accounting for 4.1% of all deaths in Canada.
  • The number of cases of MAID in 2022 represents a growth rate of 31.2% over 2021. All provinces except Manitoba and the Yukon continue to experience a steady year-over-year growth in 2022.
  • When all data sources are considered, the total number of medically assisted deaths reported in Canada since the introduction of federal MAID legislation in 2016 is 44,958.

Profile of MAID recipients

  • In 2022, a slightly larger proportion of males (51.4%) than females (48.6%) received MAID. This result is consistent with 2021 (52.3% males and 47.7% females), 2020 (51.9% males and 48.1%  females) and 2019 (50.9% males and 49.1% females).
  • The average age of individuals at the time MAID was provided in 2022 was 77.0 years. This average age is slightly higher than the averages of 2019 (75.2), 2020 (75.3) and 2021 (76.3). The average age of females during 2022 was 77.9, compared to males at 76.1.
  • Cancer (63.0%) is the most cited underlying medical condition among MAID provisions in 2022, down from 65.6% in 2021 and from a high of 69.1% in 2020. This is followed by cardiovascular conditions (18.8%), other conditions (14.9%), respiratory conditions (13.2%) and neurological conditions (12.6%).
  • In 2022, 3.5% of the total number of MAID provisions (463 individuals), were individuals whose natural deaths were not reasonably foreseeable. This is an increase from 2.2% in 2021 (223 individuals). The most cited underlying medical condition for this population was neurological (50.0%), followed by other conditions (37.1%), and multiple comorbidities (23.5%), which is similar to 2021 results. The average age of individuals receiving MAID whose natural death was not reasonably foreseeable was 73.1 years, slightly higher than 70.1 in 2021 but lower than the average age of 77.0 for all MAID recipients in 2022.

Nature of suffering among MAID recipients

  • In 2022, the most commonly cited sources of suffering by individuals requesting MAID were the loss of ability to engage in meaningful activities (86.3%), followed by loss of ability to perform activities of daily living (81.9%) and inadequate control of pain, or concern about controlling pain (59.2%).
  • These results continue to mirror very similar trends seen in the previous three years (2019 to 2021), indicating that the nature of suffering that leads a person to request MAID has remained consistent over the past four years.
Eligibility Criteria
  • Request MAID voluntarily
  • 18 years of age or older
  • Capacity to make health care decisions
  • Must provide informed consent
  • Eligible for publicly funded health care services in Canada
  • Diagnosed with a “grievous and irremediable medical condition,” where a person must meet all of the following criteria:
    • serious and incurable illness, disease or disability
    • advanced state of irreversible decline in capability,
    • experiencing enduring physical or psychological suffering that is caused by their illness, disease or disability or by the advanced state of decline in capability, that is intolerable to them and that cannot be relieved under conditions that they consider acceptable
  • Mental Illness as sole underlying medical condition is excluded until March 17, 2024

3.1 Number of Reported MAID Deaths in Canada (2016 to 2022)

2022 marks six and a half years of access to MAID in Canada. In 2022, there were 13,241 MAID provisions in Canada, bringing the total number of medically assisted deaths in Canada since 2016 to 44,958. In 2022, the total number of MAID provisions increased by 31.2% (2022 over 2021) compared to 32.6% (2021 over 2020). The annual growth rate in MAID provisions has been steady over the past six years, with an average growth rate of 31.1% from 2019 to 2022.

Chart 3.1: Total MAID Deaths in Canada, 2016 to 2022
Chart 3.1

Access to MAID for individuals whose deaths were not reasonably foreseeable marked its second year of eligibility in 2022. In Canada, eligibility for individuals whose death is not reasonably foreseeable began on March 17, 2021, after the passage of the new legislation.Footnote8 There were 463 MAID provisions for persons whose natural death was not reasonably foreseeable, representing 3.5% of all MAID deaths in 2022. This is just over twice the total number of provisions for individuals where natural death was not reasonably foreseeable in 2021 (223 provisions representing 2.2% of all MAID provisions in 2021). Table 3.1 represents total MAID provisions in Canada from 2016 to 2022, including provisions for individuals where natural death was not reasonably foreseeable.

All jurisdictions, except Manitoba and Yukon, experienced growth in MAID provisions in 2022. The highest percentage year over year increases occurred in Québec (45.5%), Alberta (40.7%), Newfoundland and Labrador (38.5%), Ontario (26.8%) and British Columbia (23.9%). Nova Scotia (11.8%), Prince Edward Island (7.3%) and Saskatchewan (4.0%) had lower growth rates. The Yukon remained at the same level as 2021, while Manitoba was the only jurisdiction to experience a decline in MAID provisions for 2022 (-9.0%).

Table 3.1: Total MAID Deaths in Canada by Jurisdiction, 2016 – 2022
MAID NL PE NS NB QC ON MB SK AB BC YT NT NU Canada
2016 24 9 494 191 24 11 63 194 1,018
2017 62 49 853 839 63 57 205 677 2,838
2018 23 8 126 92 1,249 1,500 138 85 307 951 12 4,493
2019 20 20 147 141 1,604 1,788 177 97 377 1,280 13 5,665
2020 49 37 190 160 2,278 2,378 214 160 555 1,572 13 7,611
2021 65 41 245 205 3,299 3,102 245 247 594 2,030 16 10,092
2022 90 44 274 247 4,801 3,934 223 257 836 2,515 16 13,241
TOTAL
2016-2022
267 156 1,068 903 14,578 13,732 1,084 914 2,937 9,219 84 44,958

3.2 MAID Deaths as a Proportion of Total Deaths in Canada

MAID deaths accounted for 4.1% of all deaths in Canada in 2022, an increase from 3.3% in 2021, 2.5% in 2020 and 2.0% in 2019. In 2022, six jurisdictions continue to experience increases in the number of MAID provisions as a percentage of total deaths, ranging from a low of 1.5% (Newfoundland & Labrador) to a high of 6.6% (Québec). MAID deaths as a percentage of total deaths remained at the same levels as 2021 for Prince Edward Island, Nova Scotia, and Saskatchewan, while Manitoba experienced a decline in MAID deaths as a percentage of all deaths (from 2.1% in 2021 to 1.8% in 2022). As with each of the three previous years (2019 to 2021), Québec and British Columbia experienced the highest percentage of MAID deaths as a proportion of all deaths within their jurisdiction in 2022 (6.6% and 5.5% respectively), continuing to reflect the socio-political dynamics of these two jurisdictions in the context of MAID.

4.5 Profile of Persons Receiving MAID Whose Natural Death is not Reasonably Foreseeable

2022 marks the second year that MAID for persons whose natural death is not reasonably foreseeable is permitted under the law if all other eligibility criteria are met (Table 1.1). New federal MAID legislation passed on March 17, 2021, created a two-track approach to procedural safeguards for MAID practitioners to follow, based on whether or not a person’s natural death is reasonably foreseeable. This approach to safeguards ensures that sufficient time and expertise are spent assessing MAID requests from persons whose natural death is not reasonably foreseeable. New and enhanced safeguards (Table 1.2), including a minimum 90-day assessment period, seek to address the diverse source of suffering and vulnerability that could potentially lead a person who is not nearing death to ask for MAID and to identify alternatives to MAID that could reduce suffering.

In 2022, 3.5% of MAID recipients (463 individuals) were assessed as not having a reasonably foreseeable natural death, up slightly from 2.2% (223 individuals) in 2021. As a percentage of all MAID deaths in Canada, MAID for individuals whose natural death is not reasonably foreseeable represents just 0.14% of all deaths in Canada in 2022 (compared to all MAID provisions, which represent 4.1% of all 2022 deaths in Canada). The proportion of MAID recipients whose natural death was not reasonably foreseeable continues to remain very small compared to the total number of MAID recipients.

This population of individuals whose natural death was not reasonably foreseeable have a different medical profile than individuals whose death was reasonably foreseeable. As shown in Chart 4.5A, the main underlying medical condition reported in the population whose natural death was not reasonably foreseeable was neurological (50.0%), followed by ‘other condition’ (37.1%), and multiple comorbidities (23.5%). This differs from the main condition (as reported in Chart 4.1A) for all MAID recipients in 2022, where the majority of persons receiving MAID had cancer as a main underlying medical condition (63.0%), followed by cardiovascular conditions (18.8%) and other conditions (14.9%) (such as chronic pain, osteoarthritis, frailty, fibromyalgia, autoimmune conditions). These results are similar to 2021.

Chart 4.5A: Main Condition, MAID, Natural Death Not Reasonably Foreseeable, 2022
Chart 4.5a

Of the MAID provisions for individuals where death was reasonably foreseeable, the majority were individuals ages 71 and older (71.1%) while only 28.9% were between ages 18-70. A similar trend was observed for individuals where natural death was not reasonably foreseeable which also showed a greater percentage of individuals who received MAID being 71 and older (58.5%) and a lower number of MAID provisions for individuals between 18-70 years (41.5%). Overall, however, MAID provisions for individuals whose death is not reasonably foreseeable tended to be in the younger age categories than those where natural death is foreseeable.

Chart 4.5B: MAID by Age: Natural Death Reasonably Foreseeable Vs Not Reasonably Foreseeable, 2022
Chart 4.5b

 

After 15 years as a TV reporter with Global and CBC and as news director of RDTV in Red Deer, Duane set out on his own 2008 as a visual storyteller. During this period, he became fascinated with a burgeoning online world and how it could better serve local communities. This fascination led to Todayville, launched in 2016.

Follow Author

Business

Federal government’s accounting change reduces transparency and accountability

Published on

From the Fraser Institute

By Jake Fuss and Grady Munro

Carney’s deficit-spending plan over the next four years dwarfs the plan from Justin Trudeau, the biggest spender (per-person, inflation-adjusted) in Canadian history, and will add many more billions to Canada’s mountain of federal debt. Yet Prime Minister Carney has tried to sell his plan as more responsible than his predecessor’s.

All Canadians should care about government transparency. In Ottawa, the federal government must provide timely and comprehensible reporting on federal finances so Canadians know whether the government is staying true to its promises. And yet, the Carney government’s new spending framework—which increases complexity and ambiguity in the federal budget—will actually reduce transparency and make it harder for Canadians to hold the government accountable.

The government plans to separate federal spending into two budgets: the operating budget and the capital budget. Spending on government salaries, cash transfers to the provinces (for health care, for example) and to people (e.g. Old Age Security) will fall within the operating budget, while spending on “anything that builds an asset” will fall within the capital budget. Prime Minister Carney plans to balance the operating budget by 2028/29 while increasing spending within the capital budget (which will be funded by more borrowing).

According to the Liberal Party platform, this accounting change will “create a more transparent categorization of the expenditure that contributes to capital formation in Canada.” But in reality, it will muddy the waters and make it harder to evaluate the state of federal finances.

First off, the change will make it more difficult to recognize the actual size of the deficit. While the Carney government plans to balance the operating budget by 2028/29, this does not mean it plans to stop borrowing money. In fact, it will continue to borrow to finance increased capital spending, and as a result, after accounting for both operating and capital spending, will increase planned deficits over the next four years by a projected $93.4 billion compared to the Trudeau government’s last spending plan. You read that right—Carney’s deficit-spending plan over the next four years dwarfs the plan from Justin Trudeau, the biggest spender (per-person, inflation-adjusted) in Canadian history, and will add many more billions to Canada’s mountain of federal debt. Yet Prime Minister Carney has tried to sell his plan as more responsible than his predecessor’s.

In addition to obscuring the amount of borrowing, splitting the budget allows the government to get creative with its accounting. Certain types of spending clearly fall into one category or another. For example, salaries for bureaucrats clearly represent day-to-day operations while funding for long-term infrastructure projects are clearly capital investments. But Carney’s definition of “capital spending” remains vague. Instead of limiting this spending category to direct investments in long-term assets such as roads, ports or military equipment, the government will also include in the capital budget new “incentives” that “support the formation of private sector capital (e.g. patents, plants, and technology) or which meaningfully raise private sector productivity.” In other words, corporate welfare.

Indeed, based on the government’s definition of capital spending, government subsidies to corporations—as long as they somehow relate to creating an asset—could potentially land in the same spending category as new infrastructure spending. Not only would this be inaccurate, but this broad definition means the government could potentially balance the operating budget simply by shifting spending over to the capital budget, as opposed to reducing spending. This would add to the debt but allow the government to maneuver under the guise of “responsible” budgeting.

Finally, rather than split federal spending into two budgets, to increase transparency the Carney government could give Canadians a better idea of how their tax dollars are spent by providing additional breakdowns of line items about operating and capital spending within the existing budget framework.

Clearly, Carney’s new spending framework, as laid out in the Liberal election platform, will only further complicate government finances and make it harder for Canadians to hold their government accountable.

Jake Fuss

Director, Fiscal Studies, Fraser Institute

Grady Munro

Policy Analyst, Fraser Institute
Continue Reading

Business

Carney poised to dethrone Trudeau as biggest spender in Canadian history

Published on

From the Fraser Institute

By Jake Fuss

The Liberals won the federal election partly due to the perception that Prime Minister Mark Carney will move his government back to the political centre and be more responsible with taxpayer dollars. But in fact, according to Carney’s fiscal plan, he doesn’t think Justin Trudeau was spending and borrowing enough.

To recap, the Trudeau government recorded 10 consecutive budget deficits, racked up $1.1 trillion in debt, recorded the six highest spending years (per person, adjusted for inflation) in Canadian history from 2018 to 2023, and last fall projected large deficits (and $400 billion in additional debt) over the next four years including a $42.2 billion deficit this fiscal year.

By contrast, under Carney’s plan, this year’s deficit will increase to a projected $62.4 billion while the combined deficits over the subsequent three years will be $67.7 billion higher than under Trudeau’s plan.

Consequently, the federal debt, and debt interest costs, will rise sharply. Under Trudeau’s plan, federal debt interest would have reached a projected $66.3 billion in 2028/29 compared to $68.7 billion under the new Carney plan. That’s roughly equivalent to what the government will spend on employment insurance (EI), the Canada Child Benefit and $10-a-day daycare combined. More taxpayer dollars will be diverted away from programs and services and towards servicing the debt.

Clearly, Carney plans to be a bigger spender than Justin Trudeau—who was the biggest spender in Canadian history.

On the campaign trail, Carney was creative in attempting to sell this as a responsible fiscal plan. For example, he split operating and capital spending into two separate budgets. According to his plan’s projections, the Carney government will balance the operating budget—which includes bureaucrat salaries, cash transfers (e.g. health-care funding) and benefits (e.g. Old Age Security)—by 2028/29, while borrowing huge sums to substantially increase capital spending, defined by Carney as anything that builds an asset. This is sleight-of-hand budgeting. Tell the audience to look somewhere—in this case, the operating budget—so it ignores what’s happening in the capital budget.

It’s also far from certain Carney will actually balance the operating budget. He’s banking on finding a mysterious $28.0 billion in savings from “increased government productivity.” His plan to use artificial intelligence and amalgamate service delivery will not magically deliver these savings. He’s already said no to cutting the bureaucracy or reducing any cash transfers to the provinces or individuals. With such a large chunk of spending exempt from review, it’s very difficult to see how meaningful cost savings will materialize.

And there’s no plan to pay for Carney’s spending explosion. Due to rising deficits and debt, the bill will come due later and younger generations of Canadians will bear this burden through higher taxes and/or fewer services.

Finally, there’s an obvious parallel between Carney and Trudeau on the inventive language used to justify more spending. According to Carney, his plan is not increasing spending but rather “investing” in the economy. Thus his campaign slogan “Spend less, invest more.” This wording is eerily similar to the 2015 and 2019 Trudeau election platforms, which claimed all new spending measures were merely “investments” that would increase economic growth. Regardless of the phrasing, Carney’s spending increases will produce the same results as under Trudeau—federal finances will continue to deteriorate without any improvement in economic growth. Canadian living standards (measured by per-person GDP) are lower today than they were seven years ago despite a massive increase in federal “investment” during the Trudeau years. Yet Carney, not content to double down on this failed approach, plans to accelerate it.

The numbers don’t lie; Carney’s fiscal plan includes more spending and borrowing than Trudeau’s plan. This will be a fiscal and economic disaster with Canadians paying the price.

Jake Fuss

Director, Fiscal Studies, Fraser Institute
Continue Reading

Trending

X