Since legalizing euthanasia and assisted suicide as medical assistance in dying (MAiD) in 2016, Canada has witnessed an internationally unprecedented expansion of the practice, making it the country with the highest number of MAiD deaths.

Initially introduced to relieve suffering in a broad end-of-life context, the law expanded quickly to make MAiD available to disabled Canadians not approaching their natural deaths. MAID will also become legal for sole reasons of mental illness sometime after 2027, and there are plans to expand it further to include minors and advance requests. From a cross-disciplinary perspective, including contributions from authors with lived experience, Indigenous perspectives, and expertise in medicine, mental health, disability, law, and ethics, Unravelling MAiD in Canada challenges readers with the ethical, medical, legal, societal, and disability justice rights concerns that have arisen in regard to this hotly debated irreversible practice.

Canada now provides more state-facilitated euthanasia and assisted suicide than any other country. This volume puts forth critical reflections and valuable insights as more jurisdictions consider their own assisted dying laws and policies.

Ramona Coelho is a family physician in London, Ontario, and a founding member of Physicians Together with Vulnerable Canadians.

Ramona Coelho's profile page

K. Sonu Gaind is professor and governor at the University of Toronto and chief of psychiatry at Sunnybrook Health Sciences Centre.

K. Sonu Gaind's profile page

Trudo Lemmens is Professor and Scholl Chair in Health Law and Policy in the Faculty of Law, the Dalla Lana School of Public Health, and the Joint Centre for Bioethics at the University of Toronto.

Trudo Lemmens' profile page

“This collection of essays educates the reader about the ethics, law, and acceptability of assisted dying as it touches on vulnerable groups. It will interest anyone concerned about the gradual extension of MAiD, especially to those groups whose architecture of choice continues to be effectively restricted. It broadens and deepens the terms of conversation about assisted dying. In setting polemics to one side, it is an indispensable reference tool for anyone who takes an interest in one of the defining issues of the early twenty-first century.” Gerard Quinn, former UN special rapporteur on the rights of persons with disabilities

“The subject of MAiD is more than a political or academic debate, more than a question of bodily autonomy and dignity – it is an existential threat to disabled people. Unravelling MAiD in Canada is a necessary book that analyzes this issue through race, gender, disability, and class. As MAiD expands to more countries, it becomes even more critical to document the history of these policies and their implications for the future.” Alice Wong, author of *Year of the Tiger: An Activist’s Life *

“Unravelling MAiD in Canada is an interesting and insightful examination of one of the most profound issues in Canadian healthcare and law. At a time when the UK debate surrounding assisted suicide is heating up, the broadening of MAiD criteria in Canada and the disproportionate influence this has had on a number of disabled people in choosing an assisted death is something that I find particularly concerning. UN rapporteurs recently suggested that the UK ‘devalues Disabled people’s lives.’ I fear that if assisted suicide is introduced in the UK, there is the potential that we will be led down the same dark path as Canada.” Tanni, Baroness Grey-Thompson, DBE, member of the House of Lords and paralympic champion

“Thorough analysis of data and a review of individual cases approved for ‘assisted dying’ with a critical and reflective eye are crucial. This book’s balanced approach sheds light on aspects often overlooked or avoided by campaigners. The authors clarify the profound challenges faced by those who are socially disadvantaged in societies that are increasingly ableist. Disabled individuals, and those whose autonomy is deeply constrained by poverty or illness, face the risk of being further devalued. The societal mechanisms and approaches revealed in Unravelling MAiD in Canada are thought-provoking – every caring physician, legal expert, and policymaker should read it carefully.” Ilora Finlay, Baroness of Llandaff, Cardiff University School of Medicine

“This extraordinary book provides desperately needed, penetrating insight into many serious failings and dangers in Canada’s accelerated liberalization of doctor-assisted suicide. Its revealing analysis is enriched by evidence and principle, by front-line realities wedded to insightful policy analysis. It should be required reading for anyone making policy or undertaking medical practice in the area of MAiD.” David Lepofsky, University of Western Ontario and University of Ottawa

“Canada’s dysfunctional policy-making process around its MAID law has made it an international case study in how not to debate and implement an assisted dying law. But how and why did it happen? Historians will surely rely on this collection of well-researched, evidence-based, and scholarly contributions that trenchantly yet carefully explain the disturbing truths behind this Canadian tragedy.” Scott Kim, *National Institutes of Health and Council of Canadian Academies Expert Panel on Medical Assistance in Dying *

“A reasoned, data-based, and multidisciplinary caution about the implications of providing state-funded assisted suicide to people with disabilities who are not dying, to those experiencing mental illness, to those who no longer have the capacity to consent to MAiD, and to ‘mature’ minors. Compassion for human suffering and commitment to ethical practice shine out from every page.” Elizabeth Sheehy, author of Defending Battered Women on Trial: Lessons from the Transcripts

“Unravelling the story of MAiD in Canada is a daunting undertaking. It requires untangling misinformation, distilling complex data, and examining issues from a multitude of perspectives. It also demands reckoning with what drives suffering Canadians to no longer want to live. With editors Coelho, Gaind, and Lemmens and their carefully selected coauthors, this task couldn’t be in more capable hands.” Harvey Chochinov, co-founder of the Canadian Virtual Hospice, co-editor of the Handbook of Psychiatry in Palliative Medicine, and author of *Dignity in Care: The Human Side of Medicine *