CAnD3 Op-Ed

When Death is Easier to Access than Support: MAiD and Disability in Canada

By Leah Houseman, MA PhD student in Sociology, University of Saskatchewan This article is based on unpublished graduate research. All claims are supported by peer-reviewed literature, government reports, grey literature, and recent investigative journalism.

Content note: This article discusses MAiD, disability, and poverty, which some readers may find distressing.

In 2022, a 51-year-old woman in Ontario suffering from multiple chemical sensitivities chose Medical Assistance in Dying (MAiD) after years of unsuccessfully seeking accessible housing. Despite repeated pleas to local, provincial, and federal officials, she was unable to find a safe place to live. Her death was legal, but was it just? Canada’s MAiD system now includes people who are not dying, a change that raises urgent questions about choice and equity. Canada can lead the world in compassionate, evidence-based end-of-life care, but only if we address these questions.

Canada’s MAiD regime, once limited to those nearing the end of life, now includes people whose deaths are not “reasonably foreseeable.” This expansion, introduced in 2021 through Bill C-7, created a two-track eligibility system. Track 1 applies to those with terminal conditions. Track 2 applies to individuals with chronic illnesses or disabilities who are not dying but are suffering intolerably. While this change was framed as a victory for autonomy, it has raised serious concerns, particularly for disabled Canadians living in poverty.

Early academic studies, conducted under the original single-track system, found little evidence that poverty influenced MAiD provisions. But those findings are now outdated. The introduction of Track 2 has changed the landscape. A 2025 investigation by the Investigative Journalism Bureau analyzed over 11,000 Ontario coroner rulings and found that Track 2 MAiD approvals were disproportionately clustered in areas with high unemployment and poor healthcare access.

The question is no longer whether MAiD is being used. In every annual report produced by the federal government, including the sixth released in November 2025, MAiD provisions have increased year over year. If people are requesting assisted death because they cannot access adequate housing, income, or care, then we are not offering choice; we are offering resignation.

The federal government has taken steps in the right direction, introducing expanded data-collection rules in 2024 and delaying the expansion of MAiD eligibility for mental illness until 2027. These changes aim to improve oversight and protect vulnerable Canadians.

The 2025 annual federal report includes data on income, race, disability, and palliative support, but also contains several warnings to interpret the findings cautiously because of how the information was collected. Many disability and palliative care-related details are lumped into “vague” other categories, obscuring patterns where poverty and inadequate care may influence some MAiD decisions. Even so, the report shows more Track 2 cases, where the person was not immediately dying, occur in low-income, low-education and high residential instability neighbourhoods. These patterns suggest a troubling link between how poverty, disability, and inadequate care shape MAiD requests, but without better data, we cannot confirm or refute it.

This data gap is not a technical oversight; it is a policy failure, and we cannot stop demanding better. Without robust, comprehensive data, despite knowing that persons living with disabilities are more likely to experience unemployment and poverty, we cannot know whether Canadians are accessing Track 2 MAiD because they are truly out of medical options, or because they are out of money, housing, and hope. We still lack the policy infrastructure, affordable housing, accessible healthcare, and adequate disability supports to ensure that no one feels they must die because they cannot afford to live or cannot access the care they need.

The UN Committee on the Rights of Persons with Disabilities has taken notice. In April 2025, it called on Canada to repeal Track 2 entirely, citing the risk that disabled people are being indirectly pressured into MAiD due to systemic neglect. To be clear, this is not an argument against MAiD itself. The right to die with dignity is a critical component of bodily autonomy. But autonomy is only meaningful when people have real choices. If someone seeks MAiD because they cannot afford to live, that is not a free choice; it is a coerced one, shaped by policy decisions that have left too many Canadians behind.

As a sociologist working in disability studies and social demography, I believe our discipline has a critical role to play in this conversation. Sociology has long studied the social determinants of health, the politics of suicide, and the structural roots of inequality. Yet sociological voices have been largely absent from the MAiD debate. That must change. To move forward responsibly, Canada must:

• Expand and standardize MAiD data collection about income, housing status, and genuine access to care and support.
• Delay further eligibility expansions, including the planned 2027 expansion for mental illness, until this data is available and analyzed.
• Invest in accessible, timely supports, including palliative care, disability benefits, and housing, to ensure that MAiD is never a substitute for basic needs.

We need interdisciplinary research partnerships, improved data collection, and a renewed commitment to the principle that all Canadians, regardless of ability or income, deserve to live with dignity before they are offered the option to die with dignity. We must ask ourselves: What does it say about our society when death is easier to access than support? Until we can answer that question with confidence and with data, we cannot claim to be offering true choice.