Health Effects of Medical Assistance in Dying

• In Event: Mental Health in Context: Education, Healthcare, and End-of-Life Policy

Abstract

In 2015, the Supreme Court of Canada (SCC) ruled that criminal prohibitions on assisted suicide were unconstitutional because they violated people’s right to life, liberty, and security of the person. The Canadian Parliament responded by passing legislation legalizing a regulated form of assisted suicide called Medical Assistance in Dying (MAID). Take up of MAID grew from 1,018 to 15,343 deaths from 2016 to 2023 and is now provided in 4.7% of all deaths in Canada. MAID take up is higher among men and women and is concentrated among older adults with terminal illnesses.

 

In its decision, the Supreme Court argued that the criminal code prohibition on physician-assisted suicide “has the effect of forcing some individuals to take their own lives prematurely, for fear that they would be incapable of doing so when they reached the point where suffering was intolerable” (Carter v Canada, 2025). In this paper, we test they hypothesis that Medical Assistance in Dying acts as a substitute for regular (non-assisted) suicide among older adults. We use a difference in difference design to compare suicide rates in Canada before and after the creation of the MAID program with suicide rates in a control group of US states where assisted suicide is illegal. Preliminary analysis suggests that MAID reduced suicide rates in Canada among men over age 60. We do not find evidence to support substitution away from suicide among women.

Author

• Jennifer A Mangano, Indiana University
  Presenting Author