We were warned.
There’s been a great deal of media attention this week on the professional discipline meted out to a Canadian physician who dispensed Medical Assistance in Dying (MAID) with what appears to have been an extraordinarily casual approach to the job. As the Toronto newspaper The Globe and Mail first reported, the College of Physicians and Surgeons of Ontario found that Dr. James MacLean medically assessed a Crohn’s Disease patient for euthanasia at a Tim Horton’s coffee shop, then later gave him a ride to the euthanasia facility. As the Globe and Mail also reported, “Dr. MacLean administered the lethal medications in a room at a holding facility in an industrial unit where cadavers are prepared for transport to funeral homes.”
A second complaint followed an at-home euthanasia procedure in which MacLean administered drugs to end a patient’s life, then pronounced the patient dead and left the home — returning to redo the procedure and pronounce death a second time after the patient started breathing again.
You can read MacLean’s disciplinary record here. To continue to provide MAID as a physician, he’ll be required to “practise under the guidance of a clinical supervisor or clinical supervisors … for at least six (6) months.” MacLean is also required to engage in “review, reflection, and discussion” with his clinical supervisor regarding the meaning of MAID guidelines, covering topics like “Maintaining Appropriate Boundaries.”
MacLean has repeatedly declined to comment on the charges or the disciplinary proceeding.
The website RateMD contains mixed reviews for MacLean, with many offering praise for his compassion and professional expertise. But another review describes him performing euthanasia procedures while wearing jeans and a “casual shirt,” with a nurse who was “wearing tight yoga pants and a tight t shirt.” (“The nurse stood there texting on her phone with a smile on her face as my son was dying. As soon as his heart stopped they couldn’t wait to get out.”)
Another review opens like this: “Dr. James MacLean may seem charming but so is Satan.”
Canadian doctors and health law scholars have warned for years that MAID keeps expanding, evading checks and balances. For clarity, this paragraph, from a 2023 paper in a medical journal, is quoted with parenthetical citations removed:
Since its legalization in 2016, the number of deaths by MAiD in Canada has risen dramatically each year. Within 3 years of its introduction, 2% of all deaths in Canada were by MAiD, and by 2021, MAiD had increased to 3.3% of all deaths in Canada. Some areas of Canada presently are reporting MAiD death rates upwards of 7%. In 2021, Canada had 10,064 deaths by MAiD, surpassing all other countries for yearly reported assisted deaths.
That same paper describes a long series of questionable MAID deaths, including a man euthanized for a “hearing and cognitive disability” with “recurrent episodes of depression” and a woman who received MAID after a concussion. Death is also being suggested as an option to people who require ongoing medical services: “A military veteran and former Paralympian who has been trying to get a wheelchair ramp installed at her home for the past 5 years testified that she was offered MAiD by her caseworker.”
You can read national guidelines for MAID here. Don’t miss sentences like this one on page 7: “There is debate about whether to consider a request for MAID as a form [of] suicidal ideation.”
Against growing opposition, MAID eligibility is expected to expand on March 17, 2027, to allow medically assisted euthanasia for those who only suffer mental illness, with no terminal illness or physical ailment. Euthanasia advocates also argue for expanding MAID eligibility to minors, though that proposal has not advanced.
