When the Supreme Court of Canada decriminalized euthanasia and assisted suicide, it tasked Parliament to create “a stringently limited, carefully monitored system of exceptions.” Instead, within a decade, Canada created the world’s largest and fastest-growing euthanasia program, a trend that we wrote about in a recent report for Cardus.

The trendline is staggering. In just six years, the number of deaths from euthanasia or MAiD increased thirteenfold, from 1,018 deaths in 2016 to over 13,200 deaths in 2022. More Canadians die by euthanasia than from liver disease, Alzheimer’s, diabetes, or pneumonia. In fact, MAiD is now effectively tied as the fifth leading cause of death in the country.

This rapid growth rate is a uniquely Canadian problem. While the number of euthanasia deaths is increasing in every jurisdiction that legalized permissive euthanasia, no other jurisdiction has ever seen such a rate of growth in euthanasia, especially not so soon after legalization.

It took the Netherlands, the first country to effectively decriminalize euthanasia in 1981 and to formally legalize it in 2002, 32 years for it to become the only jurisdiction in the world where more than 3 percent of total deaths were caused by euthanasia. Not even next-door Belgium, which legalized euthanasia two months after the Netherlands, has ever passed the 3 percent threshold.

But then Canada legalized euthanasia. It took Canada just six years after legalization to cross the 3 percent threshold. In the seventh year, Canada crossed the 4 percent line. By the time we receive the latest year of mortality data for 2023, if current trends hold, Canada is set to pass 4.7 percent of total deaths to be caused by euthanasia.

Proponents of MAiD frequently claim that these numbers were expected. Stefanie Green, the president of the Canadian Association of MAiD Assessors and Providers, for instance, claimed two years ago in a parliamentary committee that “data to date suggests that the expected number of Canadians are accessing and receiving MAID.”

Yet the reality is that no one expected this increase. Not the courts, who believed it would be limited, nor the lead lawyer for the plaintiff in Carter v. Canada who argued that it would only be a “last resort.”  Not the New England Journal of Medicine, which predicted in 2020 only 2,000 deaths annually (it was 7,511 MAiD deaths that year). Not Health Canada, which predicted in 2018 that Canada’s “steady state” of MAiD deaths would be 2 percent of total deaths, and even when Health Canada doubled its estimate in 2022, it predicted that Canada would reach 4 percent only in the 2030s—instead of just months after.

Not the Trudeau government, which continues to maintain that MAiD is only for those “where everything has been tried,” as then Minister of Justice David Lametti testified, or for those who “have tried everything imaginable to address their suffering,” as claimed Ya’ara Saks, then parliamentary secretary to the minister of Families, Children and Social Development. Not the Canadian Medical Association, which believed euthanasia would be only appropriate for “rare occasions.”

Not even the critics. Bioethicist Margaret Somerville testified to the Special Joint Committee on Physician-Assisted Dying on February 4, 2016, that she estimated that there could be “between 11,000 and 12,000 Canadians being killed by lethal injection” every year if Canada followed the Belgium and Netherlands model—although “I could almost not believe it when I worked out those figures.” It was intended to shock the committee, yet in 2022, we have already surpassed Somerville’s worst-case estimate.

MAiD is simply no longer exceptional or rare. Canada now serves as an international clarion call for what happens when governments prioritize an assisted death over an assisted life—as even supporters of euthanasia abroad distance themselves from Canada’s MAiD program.

It is a scandal, it seems, everywhere but here at home. In terms of funding, we simply prioritize death care over health care. The facts speak for themselves.

A million and a half Canadians have at least one chronic health condition. and yet do not have a primary care provider, according to the latest Commonwealth Fund Survey. Only 30.8 percent of Canadians can see a specialist in under a month and only 26 percent can receive an elective surgery in under a month, the lowest rate of all 10 high-income countries polled.

Yet while wait times for medical care have been increasing to all-time highs, the median number of days for MAiD, from request to death, is disturbingly short. Not even COVID-19 increased wait times for MAiD. The median number was only 11 days in 2022; the previous year it was nine days.

Based on this data, is it any surprise why so many Canadians are opting for assistance to die, rather than fighting for aid to live?

The Trudeau government has claimed that Canada “continues to have an enviable fiscal and debt position relative to international peers” because we have the lowest net debt-to-GDP ratio in the G7. But this is misleading. In reality, Canada is actually a highly indebted country relative to our international peers.

The government’s claim originates from the International Monetary Fund (IMF), which notes that Canada has the lowest level of net debt (as a share of its economy) among G7 countries including Germany, Italy, Japan, France, the United Kingdom, and the United States. But this specific measure of debt subtracts financial assets from total government debt.

Here’s why that’s a problem.

Again, when calculating net debt, you subtract financial assets because you assume those assets could be used to offset debt. The glaring problem here is that Canada’s financial assets include the assets of the Canada Pension Plan (CPP) and the Quebec Pension Plan (QPP), which substantially reduce Canada’s net debt. Indeed, according to the latest data from Statistics Canada, there were net assets of $716.7 billion in the combined CPP and QPP as of Dec. 31, 2023.

But the assets of the CPP and the QPP are used for payments to existing and future retirees and can’t be used to offset government debt without compromising the ability of the CPP and the QPP to provide benefits to retirees. So, Canada having the lowest net debt-to-GDP in the G7 doesn’t mean much when the CPP and the QPP assets are incorrectly used to make us look less indebted than we actually are.

Thankfully, there’s a much more accurate way to measure of Canada’s indebtedness—gross debt to GDP. Gross debt, according to the IMF, includes all “liabilities that require future payment of interest and/or principal by the debtor to the creditor.” And extending the analysis to include a broader group of advanced countries provides a more accurate assessment of Canada’s comparative indebtedness.

According to a new study, among 32 industrialized countries, Canada slides from the fifth-lowest debt ranking when net debt is measured to 26th when gross debt is used. Further, Canada’s gross debt exceeds the total size of the national economy by nearly 5 percentage points. In other words, Canada falls 21 positions in international rankings after switching from net debt to gross debt, the largest change by far of any country.

The consequences of fiscal imprudence are clear. Just like households, governments must pay interest on debt. In 2024, Canada’s federal debt interest costs are expected to eclipse $54.0 billion—equal to the entire amount of revenue the government collects from the Goods and Services Tax (GST).  And debt must be repaid by future generations of Canadians through tax increases or reduction in services.

When the Trudeau government claims that Canada is in an enviable position relative to our peers on government indebtedness, it is misleading Canadians. The data clearly show that Canada is among the most indebted advanced economies in the world. That’s not something to boast about.