Exploring Population Age as a Utilization Variable in Medical Assistance in Dying in British Columbia, Canada

International Journal of Nursing and Health Science
© 2022 by SSRG - IJNHS Journal
Volume 8 Issue 3
Year of Publication : 2022
Authors : Karen L. Courtney, Rosanne Beuthin, Gerry Bliss
How to Cite?

Karen L. Courtney, Rosanne Beuthin, Gerry Bliss, "Exploring Population Age as a Utilization Variable in Medical Assistance in Dying in British Columbia, Canada," SSRG International Journal of Nursing and Health Science, vol. 8,  no. 3, pp. 14-18, 2022. Crossref, https://doi.org/10.14445/24547484/IJNHS-V8I3P103


Since the legalization of medical assistance in dying (MAiD) in Canada in 2016, more than 4,674 British Columbians (BC) have chosen this end-of-life option (1). Among the BC Health Authorities (HA), the 2020 MAiD utilization rate ranged from 1.92 – 6.61%. Island HA has consistently had the highest utilization rate. Our research question: Could population age differences for regional health authorities be contributing to these differences in MAiD utilization rates? We used descriptive statistics and the direct method to calculate age-standardized MAiD mortality rates for Island HA. Agespecific Island HA mortality rates were then used for extrapolation to other BC HA. We used age-standardized rates to predict age-adjusted 2019 MAiD deaths per HA and found a considerable difference between the actual MAiD deaths of all deaths and projected percentages for each of the other four HA. Differences in population ages between BC HA are unlikely to be a significant reason for the differences in MAiD percentage of deaths. Differences may be due to HA variation in the provision of MAiD services or other socio-demographic characteristics. Further research is needed to understand better assisted dying utilization variability.


Assisted death, Utilization variability, Health/medical resource utilization, Medical Assistance in Dying, Population based study.


[1] Canada, “Second Annual Report on Medical Assistance in Dying in Canada 2020,” 210148, Health Canada, 2021. [Online]. Available: https://www.canada.ca/en/health-canada/services/medical-assistance-dying/annual-report-2020.html
[2] Canada, “Bill C 14 - An Act to amend the Criminal Code and to Make Related Amendments to other Acts Medical Assistance in Dying,” S.C. 2016, c. 3, 2016. [Online]. Available: https://laws.justice.gc.ca/eng/AnnualStatutes/2016_3/
[3] British Columbia, “Forms for Medical Assistance in Dying,” Victoria: Ministry of Health, 2021. [Online]. Available: https://www2.gov.bc.ca/gov/content/health/accessing-health-care/home-community-care/care-options-and-cost/end-of-life-care/medical-assistance-in-dying/forms
[4] Canada, “First Annual Report on Medical Assistance in Dying in Canada 2019,” 200125, Health Canada, 2020. [Online]. Available: https://www.canada.ca/en/health-canada/services/medical-assistance-dying-annual-report-2019.html
[5] A.S. Groenewoud, F. Atsma, M. Arvin, G.P. Westert T.A, “Euthanasia in the Netherlands: A Claims Data Cross-Sectional Study of Geographical Variation,” BMJ Supportive & Palliative Care, vol. 0, pp. 1-11, 2021. Doi:10.1136/bmjspcare-2020-002573
[6] United States, “Oregon Death with Dignity Act 2020 Data Summary,” Oregon Health Authority Public Health Division Center for Health Statistics, 2021. [Online]. Available: https://www.oregon.gov/oha/ph/providerpartnerresources/evaluationresearch/deathwithdignityact/Documents/year23.pdf
[7] J. Downar, R. Fowler, R. Halko, L. Huyer, A. Hill, J. Gibson, “Early Experience with Medical Assistance in Dying in Ontario, Canada: A Cohort Study,” Canadian Medical Association Journal, vol. 192, no. 8, pp. E173, 2020. https://doi.org/10.1503/cmaj.200016
[8] British Columbia, “BC Stats: Population Estimates and Projections for British Columbia.” [Online]. Available: https://bcstats.shinyapps.io/popApp/
[9] Akom Ilessan Dossou, "Effect of Universal Health Coverage on the Demand for Health Care in Togo," SSRG International Journal of Medical Science, vol. 8, no. 9, pp. 1-15, 2021. Crossref, https://doi.org/10.14445/23939117/IJMS-V8I9P101
[10] Canada, “Bill C 7 - An Act to Amend the Criminal Code and to Make Related Amendments to Other Acts Medical Assistance in Dying,” S.C. 2021, c. 2, 2021. [Online]. Available: https://laws.justice.gc.ca/eng/AnnualStatutes/2021_2/page-1.html
[11] E.T. Crumley, S. Kelly, J. Young, N. Phinney, J. McCarthy, G. Gubitz, “How is the Medical Assistance in Dying (MAID) Process Carried Out in Nova Scotia, Canada? A Qualitative Process Model Flowchart Study,” BMJ Open, vol. 11, pp. e048698, 2021. Doi: 10.1136/bmjopen-2021-048698
[12] J.L. Silvius, A. Memon, M. Arain, “Medical Assistance in Dying: Alberta Approach and Policy Analysis,” Canadian Journal on Aging, vol. 38, no, 3, pp. 397–406, 2019. https://doi.org/10.1017/S0714980819000175
[13] N.N. Naing, “Easy Way to Learn Standardization: Direct and Indirect Methods,” Malaysian Journal of Medical Sciences, vol. 7, no. 1, pp. 10-15, 2000. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/22844209/