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MAID’s slippery slope: a commentary on Downie and Schuklenk
  1. Tom Koch1,2
  1. 1 Department of Geography (Medical), University of British Columbia, Vancouver, British Columbia, Canada
  2. 2 Director, Information Outreach Ltd, Toronto, Ontario, Canada
  1. Correspondence to Professor Tom Koch, University of British Columbia, Toronto, BC V6T 1Z4, Canada; tomkoch{at}

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Canadian ethicists Jocelyn Downie and Udo Schuklenk seek to assess the effect of Canada’s decriminalisation of ‘medical assistance in dying’ (MAID) ‘to inform Canada’s ongoing discussions and because other countries will confront the same questions if they contemplate changing their assisted dying law.’1 Their assessment focuses on two arguments earlier levied against expansion of these procedures. The first is that of a ‘slippery slope’ and the second is what they disingenuously call, ‘social determinants of health’.

They conclude that, in both cases, the effect of legislation permitting first limited and then expanded options for medical termination has been benign. The argument in this brief commentary is that the ‘slippery slope’ is clearly evident and support for those with chronic, progressive diagnoses a clear contributor to the ever increasing number of persons seeking MAID.


Downie and Schuklenk first review the legal and legislative history of MAID. In Carter v Canada (Attorney General), the courts found …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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