Canada Is Killing Itself: Unpacking the Rapid Expansion of Suicide and Its Human Cost

A new Atlantic feature titled “Canada Is Killing Itself” offers a deeply reported and unsettling examination of Canada’s PAS—Physician Assisted Suicide—program. Here are its key takeaways and their broader implications.

The Evolution of PAS: From Last Resort to Routine Choice

When PAS debuted in 2016, it was carefully scoped to terminally ill patients facing imminent death. Patients had to suffer from a “grievous and irremediable” condition with death being reasonably foreseeable, and a 10-day reflection period was mandatory. Only clinicians could legally provide a lethal injection—or assist suicide—after multiple safeguards were met.

Today, PAS comprises almost 1 in 20 deaths in Canada, outpacing even deaths from Alzheimer’s and diabetes. That number exceeds rates in countries where the practice has existed much longer.

Autonomy or Structural Failure?

While autonomy remains the law’s central pillar, the article details how patients like Marcia—who lives with debilitating chronic illnesses—opted for PAS not from desire, but from practical despair:

“I applied for PAS on ruthless practicality,” Marcia said. “The daily suffering... coupled with inadequate coverage for treatments, made survival untenable.”

Another haunting case involved a quadriplegic man unable to secure proper medical support, who eventually accessed PAS after developing a painful bedsore. “I don’t want to be a burden,” he famously said.

Ethical Slippery Slope and Systemic Gaps

The article raises tough questions: Are vulnerable Canadians choosing PAS because of unbearable suffering—or because Canada's healthcare and social systems have failed to meet their needs?

Critics argue that PAS can morph from a compassionate option into a tacit cost-saving measure, particularly when the state fails to invest adequately in palliative care or disability support.

What’s Next? Redefining Dignity

As Canada grapples with these moral and policy dilemmas, the article underscores the urgency of stronger safeguards and better transparency. It asks whether a death-lenient system might mask deeper societal shortcomings—and what real dignity looks like when care and access are still out of reach for many.

Why This Matters

  • Medical Ethics: How should autonomy be balanced against the risk of indirect coercion?

  • Policy Design: Could expanded PAS eligibility provide a false “solution” to healthcare inequity?

  • Global Implications: Canada’s experience serves as a cautionary model for other nations considering similar legislation.

NewsNH Coalition for Suicide PreventionPAS, Canada, New Hampshire