Transcript: Ramona Coelho
My interview with the Canadian physician and member of Ontario's MAiD death review committee
As election day nears, Lean Out continues to highlight the issues that we feel have not received enough attention in this news cycle. My guest on the program today is a physician who serves on death review committee with Ontario’s Office of the Chief Coroner. In today’s emotional interview, we take a close look at medical assistance in dying, or MAiD — and her concerns about how it’s playing out in practice.
Ramona Coelho is a family doctor, and a founding member of Physicians Together With Vulnerable Canadians. She’s a senior fellow at the Macdonald-Laurier Institute, and has just co-edited a new book, titled Unravelling MAiD in Canada: Euthanasia and Assisted Suicide as Medical Care.
This is an edited transcript for paid subscribers. You can listen to the interview here.
TH: I've been wanting to talk about MAiD on the podcast for some time now. It seemed like the perfect time to have this conversation with you, given that there's an election and we are thinking in depth about a lot of big issues in the country right now. You are a family doctor as well as a founding member of Physicians Together with Vulnerable Canadians. To begin today, tell us about your practice in London, Ontario, and who you serve.
RC: I have a family practice in London, as you mentioned. I'm originally from Montreal and in Montreal I did home care. So, I took care of people who had end stage organ disease, or had dementia, or who had severe mental health issues and addictions. When I moved here, I naturally attracted a more marginalized practice. I take care of a lot of people who have incarceration in their history. I take care of a lot of refugees. A lot of my patients have disabilities, or struggle with mental illness or addictions. I also practice in an area that has a lower socioeconomic kind of standing. So, my patients also have financial barriers. I take care, I would say, of people — not all of them, but a lot — who do have barriers to care, barriers for their lives. That would be the kind of practice that I have.
TH: You've been very outspoken about MAiD. When the Medical Assistance in Dying program, or MAiD, was introduced in 2016, the public was told that the number of death requests per year would be very low. For those new to the conversation, or listening outside of the country, in 2021, it was expanded beyond the terminally ill to those with chronic illnesses and disabilities. And in 2027 it is set to be expanded to the mentally ill. We had more than 60,000 MAiD deaths by the end of 2023. In Canada right now, what are the numbers? What is the percentage of deaths that are made deaths?
RC: It's interesting. Just for our newcomers to the conversation about MAiD, because it's not a well-known international term, MAiD is assisted suicide and euthanasia. But there's about only five cases of assisted suicide for example, in 2023 — that's when a patient self-administers the drug. So, most of the time we have euthanasia. In terms of the numbers, they are very high.
You're quite right that Gaétan Barrette, when Quebec initially started this discussion, had predicted less than a hundred requests per year. And now, in Quebec, in Ontario and B.C., which make up the bulk of where MAiD practice is happening — 85% of MAiD happens across those three provinces — you have some regions that have MAiD death rates at 7%. The highest rates, I think, in the world. And numbers per population being the highest in the world.
TH: It really is astonishing, and it has happened very, very quickly. You started to reach out to politicians about concerns over this program in 2020. What caused you to take that step?
