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.”
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