In 2024, a Nova Scotia grandmother was in a hospital gown being prepared for breast cancer surgery when, out of the blue, a doctor suggested she could instead consider death.
Miriam Lancaster, 84, had just arrived at Vancouver General Hospital with severe back pain when she was offered MAID in the ER.
uncertain
she → prepare → ER
“(The doctor) came in and said, ‘Miriam, I understand you’re in a lot of pain.
asserted
you → come → pain
We can offer you MAID,’” Lancaster’s daughter told National Post.
asserted
daughter → offer → Post
Larry Holland, a Catholic priest having a hip fracture treated at Vancouver General Hospital in early 2026 said he was offered MAID twice.
asserted
he → have → MAID
As Holland described it to Canadian Catholic News, he was told the hip fracture could potentially deteriorate to the point where it became a terminal condition, and that MAID was something they were required to “discuss with someone who’s been given a terminal diagnosis.”
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who → describe → diagnosis
In the world’s 20 or so other jurisdictions with some form of legal euthanasia, the above scenarios would likely represent a breach of medical ethics – if not criminal law.
asserted
scenarios → represent → ethics
In August, Australia’s Northern Territory legalized what they call “voluntary assisted dying,” but specifically included a “gag clause” prohibiting doctors from making unsolicited offers of assisted suicide.
asserted
they → legalize → suicide
The California law legalizing “aid-in-dying” prohibits “coercion or undue influence” and even takes pains to assure doctors that they don’t have to answer a patient’s questions about euthanasia if they don’t want to.
asserted
they → legalize → euthanasia
But no such guardrail exists in most of Canada.
asserted
guardrail → exist → Canada
In fact, it’s the precise opposite: one of the aspects of the Canadian MAID regime that most sets it apart from the rest of the world is the view that doctors have a duty to inform patients when they become eligible to die.
asserted
they → ’ → patients
Health Canada’s official MAID guidelines, known as the Model Practice Standards for Medical Assistance in Dying, require doctors and nurse practitioners to “take reasonable steps to ensure persons are informed of the full range of treatment options available to relieve suffering.”
asserted
persons → know → suffering
Rather than MAID discussions being patient-initiated, the guidelines specifically urge that they be doctor-initiated.
asserted
they → initiate → ?
Under a section titled “duties to persons potentially eligible for MAID,” doctors and nurse practitioners are told not to “assume all persons potentially eligible for MAID are aware that MAID is legal and available in Canada.”
asserted
MAID → title → Canada
The only time to hold back on such information, the guidelines state, is if there’s some sign that MAID may conflict with a “person’s values and goals of care.”
uncertain
MAID → hold → care
Only Alberta in 2026 introduced the first legislation in Canada to bar unsolicited offers of MAID.
asserted
Alberta → introduce → MAID
And CAMAP’s own materials are even more overt in citing a duty to inform patients of their eligibility for death.
asserted
materials → cite → death
The paper assures readers that while “counselling or aiding suicide” remains illegal, the legal definition of “counsel” is distinct from the medical definition.
asserted
definition → assure → definition
“’Counsel’ as commonly used for instance by a nurse, means communication, information sharing, active listening, patient education and the provision of psychological support,” it reads.
asserted
it → use → support
“There is no legal restriction on who can raise the subject, i.e., the healthcare professional or patient.”
asserted
who → be → subject
The Netherlands legalized euthanasia in 2002 – 14 years before Canada – and has eligibility criteria that are even more liberal than Canada’s.
asserted
that → legalize → Canada
The Netherlands, unlike Canada, will occasionally approve assisted suicide for children and patients whose only underlying condition is mental illness.
asserted
condition → approve → children
But the official Dutch “end of life” care guidelines do not present assisted suicide as one of a range of treatment options.
asserted
guidelines → present → options
Rather, it’s listed as “an extreme remedy in situations in which there are no reasonable treatment options to relieve the patient’s suffering.”
asserted
it → list → suffering
Dutch doctors are told that “it is essential that, when talking about end-of-life care, the physician and the patient consider the entire range of end-of-life care options.”
asserted
physician → tell → options
There are other world jurisdictions in which doctors are encouraged to bring up assisted suicide as an unsolicited care option.
asserted
doctors → be → option
In 2017, the Australian state of Victoria became the first in that country to legalize assisted suicide, but did so with a “gag clause” preventing physician-initiated discussions of the topic.
asserted
state → become → topic
This was repealed in 2025 with the support of the Royal Australian College of General Practitioners, which complained that the clause prohibited “open, honest conversations with patients about all their end-of-life options.”
asserted
clause → repeal → options
But the difference is that Australia’s voluntary assisted death is still strictly limited to patients with a terminal illness.
asserted
death → assist → illness
In Canada, ever since 2021, MAID has been available for anyone with a “grievous and irremediable” illness, regardless of whether it’s life-threatening.
asserted
it → ’ → illness
As such, virtually any chronic condition that imposes undue pain or discomfort is, under Health Canada guidelines, something for which doctors are duty-bound to inform their patients that they can obtain MAID.
asserted
they → impose → MAID
In one recent case highlighted by the New York Times, a woman in her 70s obtained approval for MAID due to a condition that rendered her unable to cook – only to forego the procedure after learning through counselling that her family “valued who she was, not what she did for them.”
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she → highlight → them
IN OTHER NEWS
For at least the last few months, there’s been a pretty steady train of Indigenous leaders calling for Canadians to be jailed for speech.
asserted
Canadians → call → speech
In June, Nancy Karetak-Lindell, an Inuk Senator, introduced a surprise amendment to a House of Commons bill prescribing two-year jail terms for “condoning, denying or downplaying the Indian residential school system” (it was ultimately defeated).
asserted
it → introduce → system
NDP MP Leah Gazan, a member of the Wood Mountain Lakota Nation, tabled a private member’s bill pledging jail for all those “condoning, denying, downplaying or justifying the Indian residential school system.”
asserted
Gazan → table → system
But then, on Friday, Manitoba Premier Wab Kinew, who is Anishinaabe, said “no.”
asserted
who → say → Friday
The Aporia
