Are growing systemic risks undermining Canada’s Medical Assistance in Dying (MAID) program?

I reached out to Ontario’s Chief Coroner Dr. Dirk Huyer to get straight answers on transparency, oversight and compliance with this controversial euthanasia program.

Death certificates in Ontario are deliberately structured to obscure MAID as the cause of death, following legislation passed nearly a decade ago.

“For deaths involving MAID, the illness, disease, or disability leading to the request for assistance is to be recorded as the cause of death. This condition will be selected as the cause of death for vital statistics,” notes the Ministry of Government and Consumer Services Office of the Registrar General’s Handbook on Medical Certification of Death.

Dr. Huyer was clear: his office does not issue the certificates, and Ontario legislation ensures that nothing on the public document reveals that MAID was provided or where it happened. This is framed as a privacy measure to protect providers and institutions alike.

The coroner’s office does review every MAID death after the fact, a process that relies on just nine nurses responsible for examining every assisted death in the province.

Dr. Huyer confirmed his team only gets involved once death has occurred; they do not proactively audit the broader health system for red flags before death happens.

📌 Seniors are being offered euthanasia unprompted
📌 Governments are mandating the falsification of death certificates
📌 Slovenia, Scotland, and Alberta offer signs of hope for a change of course
📌 Everybody deserves a culture where life is the defaulthttps://t.co/X2sVEWu2ek

— Amanda Achtman (@AmandaAchtman) April 13, 2026

When asked about investigative journalist Alexander Raikin’s 2024 report “A Pattern of Noncompliance,” which highlighted hundreds of potential compliance failures in Ontario MAID cases, with questions of criminality, Dr. Huyer pushed back, noting his responses were not included in the report.

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He acknowledged finding issues — such as missing witness signatures or incorrect dates — but described many as minor administrative errors that his team resolves by following up with providers. Cases are assessed “in totality,” often resulting in education rather than serious sanctions, and his view was that there is not a pattern of widespread noncompliance.

Still, the coroner’s own MAID review committee has issued multiple reports raising serious concerns, and his perspective excludes cases like that of 84-year-old Miriam Lancaster — individuals who were offered MAID but went on to recover, thrive, and choose life.

I met an 84-year-old woman who was offered euthanasia at a Canadian hospital practically upon arrival.

Miriam didn’t want to die. She recovered well and travelled to Cuba, Mexico, and Guatemala.

Stop offering death to people who have adventures to lead! pic.twitter.com/ZjEfSaKmix

— Amanda Achtman (@AmandaAchtman) March 18, 2026

A 2025 “Lessons Learned” document on voluntariness warned that joint requests from people in close, dependent relationships make truly independent consent far more difficult to verify. It pointed to gaps in documentation and called for separate assessments and stricter safeguards.

Another review of Track 2 cases (where death is not reasonably foreseeable) found safeguards were sometimes misunderstood or skipped entirely, including premature approvals and misapplied eligibility rules.

A 2026 case study detailed a 62-year-old woman’s death marked by procedural breakdowns, visible patient distress, and a method that caused prolonged suffering, which is the very outcome MAID is supposed to prevent.

These internal reports repeatedly highlight vulnerable patients, complex cases, inconsistent oversight, and systemic vulnerabilities.

The office has issued dozens of recommendations on issues like dementia, reasonably foreseeable death criteria, and improving protocols, yet the questions keep mounting.

If post-death reviews by a small team treat repeated issues as paperwork slips, who is truly protecting Canadians before the lethal injection? And is the system really ready for the next Liberal planned expansion?

As of March 2027, MAID will become available to people whose sole underlying condition is a mental disorder, despite widespread psychiatric evidence that such conditions are often treatable and that determining “irremediable” suffering is deeply unreliable.

Canada’s euthanasia regime increasingly looks like it is normalizing death as a quick fix for pain, loneliness, inadequate care, and now, potentially mental health struggles.

Internal reviews and polite recommendations may not be enough when the stakes are human lives.