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National

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

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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.

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Economy

Federal government’s GHG reduction plan will impose massive costs on Canadians

Published on

From the Fraser Institute

By Ross McKitrick

Many Canadians are unhappy about the carbon tax. Proponents argue it’s the cheapest way to reduce greenhouse gas (GHG) emissions, which is true, but the problem for the government is that even as the tax hits the upper limit of what people are willing to pay, emissions haven’t fallen nearly enough to meet the federal target of at least 40 per cent below 2005 levels by 2030. Indeed, since the temporary 2020 COVID-era drop, national GHG emissions have been rising, in part due to rapid population growth.

The carbon tax, however, is only part of the federal GHG plan. In a new study published by the Fraser Institute, I present a detailed discussion of the Trudeau government’s proposed Emission Reduction Plan (ERP), including its economic impacts and the likely GHG reduction effects. The bottom line is that the package as a whole is so harmful to the economy it’s unlikely to be implemented, and it still wouldn’t reach the GHG goal even if it were.

Simply put, the government has failed to provide a detailed economic assessment of its ERP, offering instead only a superficial and flawed rationale that overstates the benefits and waives away the costs. My study presents a comprehensive analysis of the proposed policy package and uses a peer-reviewed macroeconomic model to estimate its economic and environmental effects.

The Emissions Reduction Plan can be broken down into three components: the carbon tax, the Clean Fuels Regulation (CFR) and the regulatory measures. The latter category includes a long list including the electric vehicle mandate, carbon capture system tax credits, restrictions on fertilizer use in agriculture, methane reduction targets and an overall emissions cap in the oil and gas industry, new emission limits for the electricity sector, new building and motor vehicle energy efficiency mandates and many other such instruments. The regulatory measures tend to have high upfront costs and limited short-term effects so they carry relatively high marginal costs of emission reductions.

The cheapest part of the package is the carbon tax. I estimate it will get 2030 emissions down by about 18 per cent compared to where they otherwise would be, returning them approximately to 2020 levels. The CFR brings them down a further 6 per cent relative to their base case levels and the regulatory measures bring them down another 2.5 per cent, for a cumulative reduction of 26.5 per cent below the base case 2030 level, which is just under 60 per cent of the way to the government’s target.

However, the costs of the various components are not the same.

The carbon tax reduces emissions at an initial average cost of about $290 per tonne, falling to just under $230 per tonne by 2030. This is on par with the federal government’s estimate of the social costs of GHG emissions, which rise from about $250 to $290 per tonne over the present decade. While I argue that these social cost estimates are exaggerated, even if we take them at face value, they imply that while the carbon tax policy passes a cost-benefit test the rest of the ERP does not because the per-tonne abatement costs are much higher. The CFR roughly doubles the cost per tonne of GHG reductions; adding in the regulatory measures approximately triples them.

The economic impacts are easiest to understand by translating these costs into per-worker terms. I estimate that the annual cost per worker of the carbon-pricing system net of rebates, accounting for indirect effects such as higher consumer costs and lower real wages, works out to $1,302 as of 2030. Adding in the government’s Clean Fuels Regulations more than doubles that to $3,550 and adding in the other regulatory measures increases it further to $6,700.

The policy package also reduces total employment. The carbon tax results in an estimated 57,000 fewer jobs as of 2030, the Clean Fuels Regulation increases job losses to 94,000 and the regulatory measures increases losses to 164,000 jobs. Claims by the federal government that the ERP presents new opportunities for jobs and employment in Canada are unsupported by proper analysis.

The regional impacts vary. While the energy-producing provinces (especially Alberta, Saskatchewan and New Brunswick) fare poorly, Ontario ends up bearing the largest relative costs. Ontario is a large energy user, and the CFR and other regulatory measures have strongly negative impacts on Ontario’s manufacturing base and consumer wellbeing.

Canada’s stagnant income and output levels are matters of serious policy concern. The Trudeau government has signalled it wants to fix this, but its climate plan will make the situation worse. Unfortunately, rather than seeking a proper mandate for the ERP by giving the public an honest account of the costs, the government has instead offered vague and unsupported claims that the decarbonization agenda will benefit the economy. This is untrue. And as the real costs become more and more apparent, I think it unlikely Canadians will tolerate the plan’s continued implementation.

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Alberta

Alberta awash in corporate welfare

Published on

From the Fraser Institute

By Matthew Lau

To understand Ottawa’s negative impact on Alberta’s economy and living standards, juxtapose two recent pieces of data.

First, in July the Trudeau government made three separate “economic development” spending announcements in  Alberta, totalling more than $80 million and affecting 37 different projects related to the “green economy,” clean technology and agriculture. And second, as noted in a new essay by Fraser Institute senior fellow Kenneth Green, inflation-adjusted business investment (excluding residential structures) in Canada’s extraction sector (mining, quarrying, oil and gas) fell 51.2 per cent from 2014 to 2022.

The productivity gains that raise living standards and improve economic conditions rely on business investment. But business investment in Canada has declined over the past decade and total economic growth per person (inflation-adjusted) from Q3-2015 through to Q1-2024 has been less than 1 per cent versus robust growth of nearly 16 per cent in the United States over the same period.

For Canada’s extraction sector, as Green documents, federal policies—new fuel regulations, extended review processes on major infrastructure projects, an effective ban on oil shipments on British Columbia’s northern coast, a hard greenhouse gas emissions cap targeting oil and gas, and other regulatory initiatives—are largely to blame for the massive decline in investment.

Meanwhile, as Ottawa impedes private investment, its latest bundle of economic development announcements underscores its strategy to have government take the lead in allocating economic resources, whether for infrastructure and public institutions or for corporate welfare to private companies.

Consider these federally-subsidized projects.

A gas cloud imaging company received $4.1 million from taxpayers to expand marketing, operations and product development. The Battery Metals Association of Canada received $850,000 to “support growth of the battery metals sector in Western Canada by enhancing collaboration and education stakeholders.” A food manufacturer in Lethbridge received $5.2 million to increase production of plant-based protein products. Ermineskin Cree Nation received nearly $400,000 for a feasibility study for a new solar farm. The Town of Coronation received almost $900,000 to renovate and retrofit two buildings into a business incubator. The Petroleum Technology Alliance Canada received $400,000 for marketing and other support to help boost clean technology product exports. And so on.

When the Trudeau government announced all this corporate welfare and spending, it naturally claimed it create economic growth and good jobs. But corporate welfare doesn’t create growth and good jobs, it only directs resources (including labour) to subsidized sectors and businesses and away from sectors and businesses that must be more heavily taxed to support the subsidies. The effect of government initiatives that reduce private investment and replace it with government spending is a net economic loss.

As 20th-century business and economics journalist Henry Hazlitt put it, the case for government directing investment (instead of the private sector) relies on politicians and bureaucrats—who did not earn the money and to whom the money does not belong—investing that money wisely and with almost perfect foresight. Of course, that’s preposterous.

Alas, this replacement of private-sector investment with public spending is happening not only in Alberta but across Canada today due to the Trudeau government’s fiscal policies. Lower productivity and lower living standards, the data show, are the unhappy results.

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