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Record W4406233590 · doi:10.1080/15265161.2024.2441695

Canadian Medical Assistance in Dying: Provider Concentration, Policy Capture, and Need for Reform

2025· article· en· W4406233590 on OpenAlexaffabout
Christopher J. Lyon, Trudo Lemmens, Scott Y. H. Kim

Bibliographic record

VenueThe American Journal of Bioethics · 2025
Typearticle
Languageen
FieldMedicine
TopicPalliative Care and End-of-Life Issues
Canadian institutionsUniversity of Toronto
FundersIntramural Research Program
KeywordsIdeologyPerspective (graphical)Political scienceMedicineFamily medicinePublic administrationEnvironmental healthCriminologyMedical emergencyLawPsychologyPolitics

Abstract

fetched live from OpenAlex

Canada's rapid rise in deaths from euthanasia and physician assisted suicide, termed Medical Assistance in Dying (MAID) in the country, now ranks it second only to the Netherlands in terms of MAiD deaths as percentage of overall deaths, with one province already hosting the highest rate of all jurisdictions in the world. Analyzing Health Canada's annual MAID reports, which show that up to 336 out of 1837 providers are likely responsible for the majority of MAID deaths in a given year, we discuss how the rapid increase likely reflects not a broad Canadian consensus but the capture of a policy-making and implementation process by a small group of activists and clinicians colonizing medicine to become an ideologically driven vehicle for expanding MAID access and delivery. As a remedy and to reprioritize patient safety and protection against premature death, a more transparent, relevant, and safeguarded compliance regime based on evidence-based, multi-perspective policy-making is needed.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.051
metaresearch head score (Gemma)0.103
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Theoretical or conceptual · Consensus signal: Theoretical or conceptual
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.726
Threshold uncertainty score0.842

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0510.103
Meta-epidemiology (narrow)0.0000.001
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0040.007
Science and technology studies0.0330.017
Scholarly communication0.0160.007
Open science0.0070.012
Research integrity0.0070.012
Insufficient payload (model declined to judge)0.0080.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.081
GPT teacher head0.439
Teacher spread0.358 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designTheoretical or conceptual
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations35
Published2025
Admission routes2
Has abstractyes

Explore more

Same venueThe American Journal of BioethicsSame topicPalliative Care and End-of-Life IssuesFrench-language works237,207