Some advocates fear Canada and the U.S. will use assisted dying to curb elder and health care costs

Critics warn Canada’s Medical Assistance in Dying (MAID) program may be expanding beyond its original intent, disproportionately affecting elderly and disabled individuals as a cost-saving measure for strained healthcare systems. In 2024, 16,499 Canadians chose MAID, representing 5.1% of all deaths—a 0.4% increase from 2023—while the U.S. saw 1,242 cases in states where it is legal. The program, legalized in Canada in 2016 after a Supreme Court ruling, now accounts for roughly one in 20 deaths. Experts like Alexander Raikin of the Ethics and Public Policy Center argue that vulnerable groups—elderly, disabled, and those with chronic conditions—are overrepresented among MAID recipients. Lyman Stone of the Pronatalism Initiative at the Institute for Family Studies called it ‘Canada today,’ suggesting cost pressures may be driving its expansion. In the U.S., 14 states permit medical aid in dying, but data is fragmented, with 2024 reports showing 1,242 cases. Both countries face aging populations and rising healthcare costs, fueling fears that MAID could become a default option for elder care. Canada’s fastest-growing demographic is those over 85, increasing pressure on systems already stretched by long wait times for specialists. Ethical debates persist over whether MAID provides a dignified end or risks systemic abuse. Critics argue the program’s expansion may reflect broader societal shifts, where financial constraints influence end-of-life decisions. Meanwhile, Canada’s planned 2025 rollout of MAID for mental health illnesses could further complicate these concerns.