Life expectancy, cause of death and MAiD

06 December 2023

One way that the quality of life in a country is measured is by looking at how long its citizens live. A longer life is understood as an indicator of the overall health of the population.

It’s concerning, but not necessarily surprising, that life expectancy in Canada has dropped for the third year in a row. A Statistics Canada report tells us that a child born in 2022 is expected to live 81.3 years. This is a full year less than life expectancy in 2019, which was 82.3.

Life expectancy in Canada had steadily increased for decades, from 71 in 1960 to 82.3 in 2019. Statistics Canada’s report explains, “Life expectancy declines when there are more deaths, when deaths occur at younger ages, or a combination of both.”

There are many possible contributing factors to decreased life expectancy. Statistics Canada reports an increase of COVID-19 deaths in 2022. It also points to a significant increase in deaths under investigation (including substance-related toxicity deaths, or overdose deaths) which will be separated into other categories once the final cause of death is determined. There are difficult and tragic situations across the country that could be contributing to a shorter life span.

But what may be surprising is that there is one cause of death not addressed in this report. While the report lists quite a number of causes of death, including intentional self-harm, the StatsCan report on death doesn’t include data on medical assistance in dying (MAID) as a cause of death.

In a separate publication, Health Canada reports that there were 13,241 deaths by MAiD in 2022. However, MAiD deaths are not reported as a distinctive category in the StatsCan cause of death data. Rather, it seems that MAiD deaths are listed under the underlying illness, disease or disability that led to the request for MAiD. It is troubling that we don’t know the breakdown of where those deaths are captured in the StatsCan report.

The number of people who apply for MAiD, the reasons they give for applying and the number of people who die by MAiD are tracked in a separate reporting process.

For example, the College of Physicians and Surgeons of Ontario specifies that doctors “must not make any reference to MAiD or the drugs administered on the death certificate.” They must list the illness, disease or disability leading to the request for MAiD as the cause of death.

This would mean that a person who is diabetic and whose life is ended by MAiD would have diabetes recorded as the cause of death on the death certificate. It seems unbelievable that there could be records that indicate a person’s cause of death was hearing loss, and yet vision/hearing loss were listed as disabilities which made Canadians eligible for MAID in 2022.

The provinces have different processes for submitting information about MAiD applications and MAiD deaths to the federal government. For example, in Ontario, records on MAiD deaths are sent to the Office of the Chief Coroner. In B.C., records go to the provincial Deputy Minister of Health. Several provinces, including Manitoba and the Maritime provinces, send records to Health Canada.

It's important to know where MAiD fits into the broader picture of causes of death in Canada. It is disingenuous to suggest that MAiD itself is not a cause of death when it is a practice that intentionally causes a person’s death – and ends the lives of many much sooner than they would have otherwise. A person who has their life ended by MAiD because of hearing loss has not died of hearing loss. It is inaccurate and misleading to adopt such a reporting practice. It disguises what is actually taking place.

We cannot have a truly accurate picture of the causes of death of Canadians when a major cause of death, particularly one which, year over year, is ending the lives of more and more Canadians, is excluded from the report. People’s attitudes are shaped by what they see and what gets reported.

Life expectancy is a measure of overall population health. There are numerous stories in the media of Canadians dying by MAiD because they don’t have access to the care and supports needed to live. As Canadians, and as Christians, we need to be putting more focus on helping our neighbours to to be able to access the care and supports they need to live. We need to ask for record-keeping that provides a straight-forward, comprehensive record of what is happening in Canada.