As euthanasia deaths soar in B.C., so does British Columbian taxpayers’ medical
assistance in dying bill. B.C. Catholic contributing writer Terry O’Neill
analyzes the hidden figures behind the cost of MAiD and finds they’re much
higher than the $283.85 The B.C. Catholic found last year. O’Neill also recently
reported on a B.C. government document that said overly-strict enforcement of
MAiD infractions might discourage MAiD when it’s in high demand.
ANALYSIS
It takes deep digging to find out what Canada’s permissive euthanasia regime is
costing B.C. taxpayers, but the figures are there, buried in the 514-page
Medical Services Commission Payment Schedule.
Pages 118-120 of the 2025 document
detail how much doctors are paid, every step of the way toward killing their
patients. Curiously, there’s no mention of medical assistance in dying (MAiD) in
the index of the 10-page listing, and the rate tables are not itemized. Instead,
the MAiD fee schedule has been slipped into the index’s “family medicine”
section under a subsection called “miscellaneous visits.”
What the numbers show is that British Columbia’s health system pays doctors much more to euthanize a
patient than the $327.48 listed in its public fee schedule. The cost of the
“MAiD event preparation and procedure”—10 to 15 minutes for the intravenous
lethal injection—is $327.48. That amount has increased 64 per cent from the $200
paid in 2017, when the government established its first permanent fee structure
for medical assistance in dying.
But the total cost of euthanizing a single
patient can be as much as eight times greater—about $2,600 per patient,
including assessment for and prescribing MAiD, a mandatory second assessment,
euthanasia drugs, explanation of the MAiD waiver form, and day-of “preparation
and procedure.”
All told, it means the B.C. government could spend up to $8.6
million enabling the estimated 3,300 MAiD deaths the province is on track to
record this year. The cost could also rise a further $600 per patient for rarer
and more complex “MAiD Track 2” cases, in which the patient’s death is not
reasonably foreseeable. “These figures aren’t trivial,” said Dr. Will Johnston,
a Vancouver family physician who heads the Euthanasia Resistance Coalition in
B.C..
“Some doctors are being really well paid to do this. They are very well
paid to just ask people if they want to die, and then to kill them.” The
province’s taxpayer-funded Medical Services Plan pays doctors for 100 per cent
of all MAiD-related “medical” services, and B.C.’s taxpayer-funded Pharmacare
plan pays all the costs of the three drugs most commonly used to take a
patient’s life. Cost breakdown B.C. doctors’ fees are found in the Ministry of
Health’s “Medical Services Commision [sic] Payment Schedule,” dated April 30,
2025.
For a Track 1 patient whose death is reasonably foreseeable, a doctor who
makes the original MAiD assessment and prescription can bill up to $453.15 for
nine 15-minute “units” worth $50.35 each. For a Track 2 patient they can get up
to $906.30 for 18 units.
A mandatory second assessment by another doctor can
cost up to $352.45 (seven units) for Track 1 and $503.50 (10 units) for Track 2.
A doctor can receive up to $174 for explaining and reviewing the optional
“Waiver of Final Consent” signed in advance by some patients who fear they won’t
be able to give the legally required final consent immediately before their MAiD
death. Finally, the “MAiD event preparation and procedure”—10 to 15 minutes for
the intravenous lethal injection—is worth $327.48 for both tracks.
All told,
that’s about $1,300 paid to doctors for a single MAiD death. This figure is
similar to the $1,225 paid to doctors for each MAiD death in Quebec in 2022—a
figure that was unearthed by pro-life blogger Patricia Maloney in 2023. (Maloney
reported that documents she obtained showed that Quebec doctors billed $5.88
million for MAiD-related services in 2022, a year in which Statistics Canada
cited MAiD as the cause of death for 4,801 persons in that province.) Three
drugs commonly used in euthanasia: midazolam, a sedative that causes sleep;
propofol, which causes a deep coma; and rocuronium, which paralyzes the patient,
causing death by suffocation.
The B.C. government does not publish the prices it
pays for the drugs. (Adobe) The government does not publish the price of the
three drugs commonly used in euthanasia: midazolam, a sedative that causes
sleep; propofol, which causes a deep coma; and rocuronium, which paralyzes the
patient, causing death by suffocation.
However, the federal government’s
Parliamentary Budget Officer estimated in a 2020 report that the cost of drugs
for a single MAiD case would be $1,324—$662 for the drugs used and $662 for a
“backup kit” of drugs. The B.C. Catholic based its $2,600 MAiD total-cost
estimate on figures for
two assessments for Track 1 (the most common MAiD
track), a waiver consultation, the preparation and procedure, and the drugs. The
estimate is remarkably close to the parliamentary report’s conclusion that a
“completed case” of MAiD would cost $2,337.32. The B.C. government’s most recent
annual report on MAiD shows that 2,767 persons died of MAiD in 2023, a 10 per
cent increase from the previous year. Projecting a similar increase this year,
the province would record 3,300 euthanasia deaths in 2025. The B.C. MAiD report
does not distinguish between Track 1 and Track 2 cases. However, the federal
government’s 2023 report said about 76 per cent o
f patients nationwide received
MAiD under Track 1 and 24 per cent under Track 2. At 40.2 per cent, the most
common place for B.C. patients to be euthanized in 2023 was in their own home.
Doctors performed 82.4 per cent of MAiD procedures. The rest were administered
by nurse practitioners, who are paid under a different system than doctors, one
which may see them perform all their duties for a set salary.
The B.C.
Catholic’s estimated MAiD costs assume that a nurse practitioner is paid the
same as a doctor for delivering MAiD. B.C.’s payment schedule for MAiD also
contains provisions for extra payments of $146.18 for physicians who pick up
MAiD drugs from off-site pharmacies, something more likely to happen if a doctor
is euthanizing a patient at home. MAiD providers were unhappy with the low rate
of pay they received when euthanasia was legalized in 2016. They now receive 64
per cent more per death. (Adobe) The B.C. Catholic filed a
freedom-of-information request last year for any Ministry of Health documents
comparing the cost of administering MAiD with any savings to the health system
from MAiD-facilitated deaths. The government’s Nov. 2, 2024, response did not
include any cost-benefit analysis but did contain several documents dated
between 2017 and 2021 that dealt with fee schedules.
The documents showed that
MAiD providers were unhappy with the low rate of pay they were receiving after
euthanasia was legalized in 2016. One document, appended to a briefing note to
an unnamed bureaucrat or politician, stated that “restricting billing” had led
to some MAiD providers quitting “because they did not feel they were adequately
compensated.” The document said there was “a very limited number of MAiD
providers” in B.C. and any reduction in numbers would “put an additional strain
on already overworked professionals.”
The document’s recommendations have been
redacted, but the FOI package contained a copy of a Globe and Mail story from
May 2018 reporting that B.C. had “effectively doubled the compensation” for MAiD
doctors in response to their complaints.
Johnston said in an interview that a
small number of enthusiastic doctors are responsible for the majority of MAiD
procedures in B.C. He did not mention any doctors by name, but news outlets have
reported that Dr. Ellen Wiebe of Vancouver has overseen more than 400 MAiD
procedures, and Dr. Stephanie Green of Victoria is responsible for more than 300
euthanasia deaths. MAiD saves ‘billions’ Johnston said it is ironic that MAiD
doctors receive such high pay.
“To kill people requires no particular medical
expertise. Anyone straight off the street could be trained in half an hour.”
MAiD 'could save billions'
The
cost of euthanasia pales in comparison to how much money it saves the Canadian
medical system, a fact that may be driving the movement to further liberalize
euthanasia.
Thanks to a report published by the Parliamentary Budget Officer in
2020, Canadians already know that in 2021 alone, the country’s medical system
saved an estimated $149 million because of MAiD’s widespread availability.
Now,
a recent study by two Western University academics shows that further
liberalization of euthanasia could save the medical system “on the order of
billions of dollars per year,” with “total savings of $1.273 trillion by 2047.”
Professors Uzair Jamil and Joshua Pearce said in a paper published in the
February 2025 edition of OMEGA—Journal of Death and Dying that extending MAiD to
vulnerable groups such as the mentally ill, the homeless, the elderly, and
Indigenous persons would produce massive savings.
They did not recommend
implementing the changes but rather cited many of the ethical considerations
opposing such liberalization. “Policymakers must carefully consider these
implications before moving forward with any further expansion of MAiD,” they
wrote. Alex Schadenberg, executive director of the Euthanasia Prevention
Coalition, said he was not particularly alarmed by the study because it seemed
to be an academic exercise more than a call to action.
He also noted that at
least one leading pro-euthanasia activist, Thaddeus Pope, a U.S. law professor,
thought the paper might actually have been designed to portray a “worst-case
scenario” to warn against further liberalization of MAiD law. Authors Jamil and
Pearce cite two academic papers that present MAiD as a way of cutting
health-care costs, writing that “several advocates of expanding MAiD have
argued, if MAiD is expanded to many marginalized populations within Canada, the
government would save money.”
Schadenberg said regardless of the motivation,
MAiD is a stain on society and any argument that it benefits society by cutting
medical costs is even more reprehensible. “Obviously,” he said, “I consider all
this disgusting.”