Editorial/legal note: Lawsuit allegations are allegations only unless proven in court. An interim injunction is not a final finding of malpractice, illegality or criminal wrongdoing. This article argues for public audit and oversight based on reported cases, official MAID data and public court records.
British Columbia has become one of the central battlegrounds in Canada’s medical assistance in dying debate.
The issue is not whether every assisted death is wrong. Many Canadians support MAID for adults who are dying, suffering intolerably, and clearly meet the law’s criteria. The harder question is whether Canada’s system is strong enough for the cases now testing its edges: high-volume providers, out-of-province patients, Track 2 cases where natural death is not reasonably foreseeable, psychiatric comorbidities, disability-support gaps, and patients previously refused elsewhere.
That question has become harder to ignore after recent B.C. court reporting involving Vancouver physician Dr. Ellen Wiebe, one of Canada’s most prominent MAID providers.
In testimony before Parliament’s Special Joint Committee on Medical Assistance in Dying in May 2022, Wiebe said she had assessed about 750 people for MAID and had “provided about 430.” National Post later described her as a physician who had helped more than 400 patients die.
To supporters, that reflects experience in a difficult area of medicine. To critics, it raises a sharper public-interest question: how does one provider become associated with hundreds of assisted deaths in a system supposedly built around caution, independence and safeguards?
The answer matters because MAID is no longer a narrow end-of-life exception.
Health Canada’s Sixth Annual Report on Medical Assistance in Dying says 16,499 people received MAID in 2024, bringing the national total since legalization to 76,475. In 2024, 5.1 per cent of people in Canada who died received MAID, though Health Canada cautions that MAID should not be treated simply as a conventional “cause of death.”
Quebec, Ontario and British Columbia accounted for nearly 85 per cent of all MAID provisions in 2024. B.C. recorded 2,997 MAID provisions.
Those numbers should force a public reckoning. Whatever one thinks about assisted dying in principle, a system that now touches roughly one in twenty deaths in Canada cannot be treated as a quiet administrative health service.
One of the most troubling issues is provider concentration.
Health Canada reported 2,266 unique MAID practitioners in 2024. About 102 practitioners, or 4.5 per cent of the total, provided MAID 31 or more times and accounted for 37.5 per cent of all MAID provisions. Health Canada also reported that British Columbia had the country’s highest proportion of practitioners who provided MAID 11 or more times.
That concentration does not prove wrongdoing. But it does raise an obvious question: are high-volume MAID providers becoming a specialized class inside a system where the most consequential review often comes after the patient is already gone?
Recent B.C. cases show why the question matters
In A.Y. v. N.B., 2024 BCSC 2004, Justice Simon Coval of the B.C. Supreme Court granted an interim injunction involving a 53-year-old Alberta woman who was scheduled to receive MAID in Vancouver.
The case involved urgent allegations from the woman’s common-law partner. The court identified serious issues, including whether the MAID criteria had been satisfied and whether a reasonable process had been followed by the doctors who approved MAID.
Reporting by The Guardian and other outlets said the woman had travelled from Alberta to B.C. after Alberta physicians did not approve her request. The Guardian reported that the judge described the potential death as a situation of “extreme irreparable harm,” while also recognizing that the injunction was a severe intrusion into the woman’s personal and medical autonomy.
The injunction was not a final finding that any doctor committed malpractice or acted illegally. But it is a serious warning sign when a court has to intervene the day before a scheduled assisted death.
Less than two months later, The Canadian Press reported that the family of a 52-year-old B.C. man had filed a B.C. Supreme Court civil claim alleging wrongful death after he received MAID while on a day pass from a Vancouver psychiatric hospital.
According to Canadian Press reporting, the man had chronic back pain and long-term mental illness. The civil claim accused Wiebe and her clinic of malpractice. None of the allegations has been proven in court.
These cases expose the fault line in Canada’s MAID regime: the law excludes MAID where a mental illness is the person’s sole underlying medical condition, but it can still allow MAID where physical and mental-health conditions coexist. That grey zone is where some of the hardest and most controversial cases now live.
Ottawa has already admitted part of the system is not ready
The federal government delayed MAID eligibility for people whose sole underlying medical condition is mental illness until March 17, 2027 through Bill C-62.
That delay matters. If Ottawa says the system is not ready for mental-illness-only MAID, Canadians are entitled to ask whether it is safely handling mixed physical-and-mental-health cases now.
The official safeguards sound strong on paper.
MAID eligibility must generally be assessed by two independent doctors or nurse practitioners. Track 2 cases — where natural death is not reasonably foreseeable — include additional safeguards such as a minimum assessment period, consultation with expertise relevant to the person’s condition, and discussion of reasonable alternatives.
But paper safeguards are only as strong as the culture enforcing them.
If a patient can be turned down in one province, seek another provider in another province, and receive approval through remote or limited assessments, the public deserves to know whether the system is preventing “doctor shopping” — or simply documenting it.
B.C.’s oversight is real, but much of it is retrospective
British Columbia has a Medical Assistance in Dying Oversight Unit within the Ministry of Health.
B.C. government guidance says all MAID provisions and discontinuations in the province are reviewed by the Oversight Unit for compliance with eligibility criteria, federal safeguards, provincial safeguards, regulatory college standards, and reporting requirements.
A practitioner who provides MAID in B.C. must report to the Ministry of Health within 72 hours of confirmation of the patient’s death. For some other outcomes, such as withdrawal, ineligibility or death from another cause, different reporting timelines apply.
This is not nothing. It is a real oversight process.
But the central weakness remains: much of the review is retrospective. A file can be reviewed. A form can be queried. A compliance concern can be flagged. But the patient cannot be brought back.
For a procedure that is irreversible by design, after-the-fact oversight is not enough.
What B.C. should audit publicly
NewsForBC believes B.C. should require a public audit of MAID provisions, with special attention to:
- high-volume providers;
- out-of-province patients;
- Track 2 cases;
- psychiatric comorbidities;
- disability-support access;
- patients who were previously denied MAID elsewhere;
- use of remote or video assessments;
- cases where poverty, loneliness, lack of housing, lack of disability support or fear of being a burden are documented factors;
- files flagged by the Oversight Unit;
- referrals to the College of Physicians and Surgeons, coroners, police or prosecutors.
British Columbians should know:
- How many B.C. MAID deaths involve out-of-province patients?
- How many approvals follow previous refusals by other practitioners or provinces?
- How many Track 2 patients cite inadequate housing, poverty, isolation or lack of disability supports?
- How often do assessments rely on Zoom or other remote tools?
- How concentrated is MAID provision among a small number of high-volume practitioners?
- How many files are flagged by the Oversight Unit, and what happens when concerns are found?
- How often are cases referred to regulators, coroners, police or prosecutors?
The point is not to deny compassionate end-of-life choice for people who clearly meet the law.
The point is to ask whether Canada has built a system that can reliably distinguish compassion from abandonment, autonomy from despair, and medical judgment from ideology.
When one physician testifies to hundreds of MAID provisions, when a judge has to intervene the day before a scheduled death, when families are suing after learning too late, and when the federal government itself says the system is not ready for full mental-illness expansion, the burden of public proof grows heavier.
It is no longer enough for officials to say safeguards exist.
They must prove they work before the irreversible act takes place.