Dr. van Veen.
Evidence of meeting #7 for Medical Assistance in Dying in the 45th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was euthanasia.
A recording is available from Parliament.
Evidence of meeting #7 for Medical Assistance in Dying in the 45th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was euthanasia.
A recording is available from Parliament.
Bloc
Liberal
Psychiatrist, As an Individual
Yes, it was quite a long statement.
I largely agree. We're focusing a lot on young women, but if we look at the numbers, the most common people are people of middle age with depression. Maybe that's a good statement to make.
Liberal
Senator, Quebec (De Lorimier), PSG
Thank you, Mr. Chair.
Dr van Os, you said there was an increase of 60% over the last year. You're referring to what you wrote in an article a few weeks ago. It was from 138 in 2023 to 219 in 2024. That's the number of 60%.
Senator, Quebec (De Lorimier), PSG
Yes, thank you.
When you refer to the 500% increase, you go many years back to 2002, when there were about two or three people receiving it every year.
Professor of Psychiatry, As an Individual
That's the rise from five to 30, over 2020 to 2024.
Senator, Quebec (De Lorimier), PSG
You also refer to suicide. I understand that, in 2023, the last number we have is 138 cases of euthanasia for psychiatric grounds and 1,900 suicides. It still represents a small portion, less than 7% of those who are dying because, I understand, in your country suicide and euthanasia are part of the same subclass for statistical purposes.
Professor of Psychiatry, As an Individual
In medicine, we consider premature death as a class because they are related, very strongly correlated. Euthanasia is one form of premature death. Accidents and suicides are in the same class, and they are correlated. We see, in the under thirties, that euthanasia as a form of premature death is taking an increasingly large proportion of all premature deaths in youth under 30 years.
Professor of Psychiatry, As an Individual
It's less than 10%, but it's a lot for euthanasia to have that kind of proportion.
Senator, Quebec (De Lorimier), PSG
The number of suicides is not increasing or decreasing. It's stable.
Professor of Psychiatry, As an Individual
It's increasing a little bit in young people in the Netherlands.
Liberal
Senator, British Columbia, C
Thank you.
Earlier, Dr. van Veen was asked whether it's possible to distinguish suicidality from a rational request for MAID.
Dr. van Rooij, it is also then possible for a psychiatrist to erroneously conclude that it's a rational request for MAID, is it not?
Psychiatrist, As an Individual
It's definitely possible. From a lot of evidence coming up in the Netherlands in public debate, a lot of pro-euthanasia and pro-MAID activists have shared a lot of information about patients who received euthanasia. Concluding from that, a lot of debate arose among Dutch psychiatrists as to whether the due diligence criteria were observed. In some cases, there is serious doubt among psychiatrists. There's no consensus at all.
Senator, British Columbia, C
If there's an error, there's no recourse. The person is already dead.
Dr. van Os, suicide contagion is a concern, which we've heard from witnesses, particularly in the indigenous communities in Canada. Is this a concern being discussed in the Netherlands?
Professor of Psychiatry, As an Individual
Yes, it is discussed, but belatedly. We are now imploring the media to not report on euthanasia in a romanticized fashion like they used to with pictures and using terms like, “It was very courageous” and “It's beautiful” and “We let them go in love” because we know those have a very strong contagious effect on young women who feel trapped or emotionally unstable to adopt a similar death wish in the form of euthanasia requests.
Liberal
The Joint Chair Liberal Marcus Powlowski
Thank you, Senator Martin.
With that, we conclude this panel.
I would very much like to thank all of you from Holland for participating. We realize that you've had to stay up late into the night, but we do appreciate hearing your evidence and your experience from Holland.
I'll take my prerogative as chair to also mention that I very much like your soccer team, given their history and their style of play. I wish you good luck in that, too.
Thank you. Good night.
Liberal
The Joint Chair Liberal Marcus Powlowski
I call the meeting back to order.
I'd like to welcome our second group of witnesses.
As an individual, we have Alicia Duncan, by video conference.
From Dying With Dignity Canada Inc., we have with us Helen Long.
From Euthanasia Prevention Coalition, we have executive director Alexander Schadenberg.
Maybe we can start with Ms. Duncan.
You have the floor for five minutes. I will hold up a prompt when you have 30 seconds left and another when your time is up.
Go ahead.
Alicia Duncan As an Individual
Hello. My name is Alicia Duncan, and I am here today in memory of my mother, Donna Duncan.
I first appeared before this committee in 2022. As someone who is not philosophically opposed to assisted dying, I believed that if Parliament understood what happened to my mother, there would be change. There hasn't been. AMAD has recognized that this issue turns on readiness, oversight, standards and review. The circumstances surrounding my mother's death demonstrate that Canada is not ready to expand MAID for mental illness as a sole underlying condition.
My mother's death demonstrated these three things: One, families cannot reliably intervene to stop a MAID death in real time, even in a clear crisis. Two, after death, there is no effective pathway to determine whether the law was followed. Three, oversight in this system, therefore, is not verifiable in practice.
My mother died through Canada's MAID regime on October 29, 2021, only hours after being released from a psychiatric unit following a suicide attempt. She had experienced a significant decline following a concussion. She was psychiatrically unstable, deeply hopeless and physically deteriorating. Our family did not deny that she was suffering. We questioned whether death should have been accepted as the answer in the midst of that crisis.
When she told us she had scheduled her death in less than two days, we brought an emergency application before a provincial judge, who granted a warrant for her apprehension under the Mental Health Act temporarily stopping the provision. With her consent, we then spoke directly with the head of the MAID coordination centre, who was also one of her assessors, and raised concerns that she was in an active mental health crisis. That concern was confirmed when she attempted suicide, yet hours after being released from psychiatric care, she was euthanized.
Proponents of psychiatric euthanasia frame my mother's case as an outlier. It is not. Since her death, I have connected with many families across this country who have experienced similar circumstances and are now living with the devastating effects of PTSD, conditions that, under an expanded regime, could themselves become grounds for MAID.
In my mother's case, disordered eating and severe caloric restriction contributed to her physical decline and were treated as evidence that her death was near. In effect, the current system allows eligibility for MAID to be shaped not only by illness, but also by behaviour rooted in distress, including self-imposed physical conditions.
After my mother's death, the second failure became clear. We pursued regulators, police and the Privacy Commissioner to determine whether the law had been followed. A police investigation was opened but could not proceed because officers could not access her MAID assessment records. Requests for disclosure, including under public interest provisions, were refused. Most recently, I requested her records under public interest override of B.C.'s Freedom of Information and Protection of Privacy Act. That request was again denied.
I would ask this: What greater public interest exists than determining whether a state-authorized death was carried out in compliance with the law? The only person legally entitled to access the records that would answer that question is my mother, and she is dead.
There is no governing body in this country, criminal, civil or regulatory, that seems willing to reliably determine whether a MAID death complied with the law after it has occurred. Accountability is effectively shifted onto families and executors, who cannot access the information required to pursue it. Public bodies defer to one another. Health authorities resist disclosure, and civil action carries significant financial risk for families. The absence of a negligent finding is often cited as evidence that the system is working. It is not. It reflects a system that cannot be meaningfully examined.
It is within that system that Parliament is now being asked to expand eligibility. When I hear that Canada is ready for expansion, I do not understand how that conclusion is reached. My mother's case has been examined in courts, media and public policy discussions. If a case like hers does not raise fundamental concerns about how the system operates, it is unclear what would.
Nothing fundamental has changed since 2022. Canadians still lack timely access to psychiatric care, trauma care and meaningful recovery supports. We are preparing to authorize psychiatric euthanasia within a system that lacks transparency, meaningful oversight and any reliable way to verify whether the law is being followed.
When MAID is provided in error, the consequence is irreversible. If Canada cannot account for the deaths it has already approved, it is not ready to expand eligibility to mental illness as a sole condition. We are not ready.
Thank you.
Liberal
The Joint Chair Liberal Marcus Powlowski
Thank you, Ms. Duncan.
Ms. Long, go ahead for five minutes.