Connect with us
[the_ad id="89560"]

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

 

Before Post

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

Loblaws Owes Canadians Up to $500 Million in “Secret” Bread Cash

Published on

Continue Reading

Banks

To increase competition in Canadian banking, mandate and mindset of bank regulators must change

Published on

From the Fraser Institute

By Lawrence L. Schembri and Andrew Spence

Canada’s weak productivity performance is directly related to the lack of competition across many concentrated industries. The high cost of financial services is a key contributor to our lagging living standards because services, such as payments, are essential input to the rest of our economy.

It’s well known that Canada’s banks are expensive and the services that they provide are outdated, especially compared to the banking systems of the United Kingdom and Australia that have better balanced the objectives of stability, competition and efficiency.

Canada’s banks are increasingly being called out by senior federal officials for not embracing new technology that would lower costs and improve productivity and living standards. Peter Rutledge, the Superintendent of Financial Institutions and senior officials at the Bank of Canada, notably Senior Deputy Governor Carolyn Rogers and Deputy Governor Nicolas Vincent, have called for measures to increase competition in the banking system to promote innovation, efficiency and lower prices for financial services.

The recent federal budget proposed several new measures to increase competition in the Canadian banking sector, which are long overdue. As a marker of how uncompetitive the market for financial services has become, the budget proposed direct interventions to reduce and even eliminate some bank service fees. In addition, the budget outlined a requirement to improve price and fee transparency for many transactions so consumers can make informed choices.

In an effort to reduce barriers to new entrants and to growth by smaller banks, the budget also proposed to ease the requirement that small banks include more public ownership in their capital structure.

At long last, the federal government signalled a commitment to (finally) introduce open banking by enacting the long-delayed Consumer Driven Banking Act. Open banking gives consumers full control over who they want to provide them with their financial services needs efficiently and safely. Consumers can then move beyond banks, utilizing technology to access cheaper and more efficient alternative financial service providers.

Open banking has been up and running in many countries around the world to great success. Canada lags far behind the U.K., Australia and Brazil where the presence of open banking has introduced lower prices, better service quality and faster transactions. It has also brought financing to small and medium-sized business who are often shut out of bank lending.

Realizing open banking and its gains requires a new payment mechanism called real time rail. This payment system delivers low-cost and immediate access to nonbank as well as bank financial service providers. Real time rail has been in the works in Canada for over a decade, but progress has been glacial and lags far behind the world’s leaders.

Despite the budget’s welcome backing for open banking, Canada should address the legislative mandates of its most important regulators, requiring them to weigh equally the twin objectives of financial system stability as well as competition and efficiency.

To better balance these objectives, Canada needs to reform its institutional framework to enhance the resilience of the overall banking system so it can absorb an individual bank failure at acceptable cost. This would encourage bank regulators to move away from a rigid “fear of failure” cultural mindset that suppresses competition and efficiency and has held back innovation and progress.

Canada should also reduce the compliance burden imposed on banks by the many and varied regulators to reduce barriers to entry and expansion by domestic and foreign banks. These agencies, including the Office of the Superintendent of Financial Institutions, Financial Consumer Agency of Canada, Financial Transactions and Reports Analysis Centre of Canada, the Canada Deposit Insurance Corporation plus several others, act in largely uncoordinated manner and their duplicative effort greatly increases compliance and reporting costs. While Canada’s large banks are able, because of their market power, to pass those costs through to their customers via higher prices and fees, they also benefit because the heavy compliance burden represents a significant barrier to entry that shelters them from competition.

More fundamental reforms are needed, beyond the measures included in the federal budget, to strengthen the institutional framework and change the regulatory mindset. Such reforms would meaningfully increase competition, efficiency and innovation in the Canadian banking system, simultaneously improving the quality and lowering the cost of financial services, and thus raising productivity and the living standards of Canadians.

Lawrence L. Schembri

Senior Fellow, Fraser Institute

Andrew Spence

Continue Reading

Trending

X