House of Commons Standing Committee on Justice and Human Rights – Bill C-7, An Act to amend the Criminal Code (medical assistance in dying)
Highlights of the First Annual Report on Medical Assistance in Dying in Canada
First Annual Report on Medical Assistance in Dying in Canada, 2019
Highlights
This report contains information collected from practitioners and pharmacists for the 2019 calendar year on written requests for and cases of MAID across Canada. The data presented has primarily been drawn from the federal monitoring system for MAID, which was launched on November 1, 2018. Prior to that date, data was provided voluntarily by provinces and territories (June 17, 2016 to October 31, 2018) which has supplemented some of the analyses presented here.
The report is the outcome of significant collaboration between federal, provincial and territorial levels of government, and provides the most comprehensive portrait of MAID in Canada to date. Future reports using data through the federal monitoring system will build on these analyses to provide an understanding of trends related to requests for, and the delivery of, MAID over time.
The number of medically assisted deaths is steadily increasing
- In 2019, there were 5,631 cases of MAID reported in Canada, accounting for 2.0% of all deaths in Canada.
- The number of cases of MAID in 2019 represents an increase of 26.1% over 2018 numbers, with all provinces experiencing a steady year over year growth in the number of cases of MAID since its introduction into law in 2016.
- When all data sources are considered, the total of number of medically assisted deaths reported in Canada since the enactment of federal legislation is 13,946.
Profile of MAID recipientsFootnote 1
- In 2019, the proportion of men and women receiving MAID across Canada was nearly equal with only slightly more cases among men (50.9%) than women (49.1%).
- The average age of persons who received MAID in Canada was 75.2 years; this average age varied across jurisdictions ranging from a low of 70.4 in Newfoundland and Labrador to a high of 76.9 in British Columbia.
- Over 80% of MAID deaths occur at age 65 or older.
- Cancer (67.2%) was the most commonly cited underlying medical condition of persons who received MAID, followed by respiratory (10.8%) and neurological (10.4%) conditions.
The majority of MAID recipients also received supportive services
- The majority of persons receiving MAID (82.1%) were reported to have received palliative care services.
- Of those MAID recipients who did not access palliative care services prior to receiving MAID, the majority (89.6%) had access to these services but chose not to do so, according to the reporting practitioner.
- Among the 41.3% of patients requiring disability support services, 89.8% had received them.
MAID is most often provided in a home or hospital setting by primary care physicians
- The primary settings for the administration of MAID are hospitals (36.3%) (excluding palliative care beds/units) and patients’ private residences (35.2%). The remaining cases of MAID occurred in palliative care units (20.6%) and residential care (6.9%) or other settings (1.0%).
- There were 1,271 unique practitioners who provided MAID in 2019. MAID was provided most frequently by family medicine physicians (65.0%), followed by palliative medicine specialists (9.1%) and anesthesiologists (5.0%).
Nature of suffering among MAID recipients
- Practitioners reported that suffering among MAID recipients was closely tied to a loss of autonomy.
- Loss of ability to engage in meaningful life activities (82.1%) followed closely by loss of ability to perform activities of daily living (78.1%), and inadequate control of symptoms other than pain, or concern about it (56.4%) were the most frequently reported descriptions of the patient’s intolerable suffering.
One-quarter of written requests for MAID did not result in an assisted death
- There were 7,336 written requests for MAID reported through the MAID monitoring system in 2019. Of these requests, 26.5% (or 1,947) did not result in a MAID death, because the patients died before receiving MAID (57.2% or 1,113 cases), were deemed ineligible (29.3% or 571 cases), or they withdrew their request (13.5% or 263).
- The most frequently reported reasons why a person was deemed ineligible for MAID (7.8% of written requests) were: lack of capacity to make health care decisions (32.2%); the individual’s natural death was not reasonably foreseeable (27.8%); and the individual was not in an advanced state of irreversible decline in capability (23.5%).
- Of those persons who were assessed as eligible for MAID, but did not receive it, the majority died of another cause prior to administration (15.2%), while a small number (3.6%) of persons withdrew their request after having been deemed eligible.
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