On December 5, Gov. JB Pritzker signed a bill making Illinois the 12th state in the United States to legalize medically assisted suicide. The United States can learn from Canada’s expansion of “medical assistance in dying (MAID)” over the past 10 years, says Amanda Achtman, patient advocate and creator of the website, “Dying To Meet You.” The organization recently shared “MAID Hurts,” a video of a man losing both of his grandmothers to suicide within two months. Achtman talked to Kenneth Artz of Health Care News on how “progressive and nihilistic elements“ “worked to push MAID in Canada and what this could mean for U.S. health care.
Health Care News: How did Canada shift from offering medically assisted death as an exceptional end-of-life option to promoting it as a broad social solution?
Achtman: Following a Supreme Court ruling in 2015, the federal government was given a deadline to scrap the prohibition on euthanasia. Part of the rationale in Carter v. Canada was that prohibiting assisted suicide infringes on a person’s “right to life, liberty, and security of the person.”
According to the ruling, this is because a 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.”
It is rather bizarre, then, that among the initial eligibility criteria for a state-sponsored suicide upon legalization in 2016 was the requirement that a person’s suffering already be “intolerable” to the person and cannot be relieved in a manner that they consider acceptable.
And so, the Criminal Code was amended to create an exemption to the criminally culpable offense of homicide in cases where a doctor or nurse euthanizes their patient according to the new parameters.
Health Care News: What institutions or cultural assumptions changed fastest—medicine, politics, economics, or public sentiment?
Achtman: Alexander Raikin has written some excellent pieces about the cultural and institutional capture by euthanasia lobby groups, one in 2023 in the National Review piece titled, “How Death Care Pushed Out Health Care,” and another, on September 16, 2025, in Cardus.
The biggest point I would make is that everything comes down to whether euthanasia, whether prematurely ending a patient’s life, is a good and reasonable thing to do or not. If it is reasonable and compassionate to end suffering, then why should it be limited? Why restrict it to particular eligibility lines? This is why, once legalized, euthanasia always gets expanded on the grounds of equality. That is certainly what we have seen in Canada with the passing of Bill C-7 in 2021, which expanded MAID to people with disabilities (beginning in March 2021) and to people for whom mental illness is the sole underlying condition (set to take effect in March 2027).
Unfortunately, euthanasia is also promoted often favorably in the media. U.S. disability advocate, Meghan Schrader, recently posted in reply to a People Magazine story on X: “As a disabled person, I resent @people’s constant euthanasia porn.” The coverage is depriving people of a balanced debate and ignoring the stories of disabled people being hurt by ‘MAID.’”
Health Care News: You’ve spoken about how grandchildren end up carrying the emotional burden—feeling like they didn’t love their grandparents enough to keep them here if they avail themselves of MAID. From your vantage point as a patient advocate, what are young Canadians telling you about the psychological and relational fallout of MAID?
Achtman: As a millennial, one of the main ways that euthanasia is affecting my peers and those younger than me is that people are increasingly losing their grandparents to MAID. Yet despite one in 20 deaths is now a death by euthanasia in Canada, there are extremely few stories in the public square about the intergenerational toll that MAID is having on children and grandchildren.
Health Care News: As Canada expands euthanasia criteria, what would you say real patient-centered care should look like at the bedside—care that honors dignity without resorting to medically administered death? Also, where is the system failing most acutely, palliative care, mental health, disability support, or something deeper?
Achtman: The number one kind of suffering leading people to request MAID, by their own admission and according to the federal government’s own data, is not physical pain or suffering but rather a “loss of ability to engage in meaningful activities.”
I think it is hugely revealing that the loss of meaning is consistently the most reported form of suffering. Euthanasia, then, represents more of an existential problem than a medical one. That is why I am focused on the cultural conversation around suffering, death, meaning, and hope.
We need ethical exemplars of aging and dying well, like the man who ran across Canada on a prosthetic limb to raise money for cancer.
Health Care News: Many Americans see Canada as foreshadowing where Western health systems might go. Do you believe the United States is 10 years to 20 years behind Canada on euthanasia expansion—or do you think it has the structural, cultural, or legal safeguards to stop this slide?
Achtman: In Canada, MAID encompasses both euthanasia (medical practitioner-administered) and assisted suicide (patient-administered).. In 2023, MAID was self-administered in fewer than five instances.” Currently, every state that has legalized assisted suicide requires patients to self-administer the lethal substance. This is a massive deterrent, which is good. However, it is a very precarious deterrent because as soon as there is a legal challenge by someone who cannot self-administer, that could usher in direct euthanasia across the United States very quickly
Editor note: Minor changes were made to this article on 12/18 for clarification.
Artz has more than 20 years’ experience in nonprofit organizations, publishing, newspaper reporting, and public policy advocacy.
