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Takeaways from AP's report on euthanasia, doctors and ethics in Canada

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Takeaways from AP's report on euthanasia, doctors and ethics in Canada

TORONTO (AP) — Canada has arguably the world’s most permissive system of euthanasia — the practice of doctors and nurse practitioners killing patients with an injection of drugs at their request. Canada allows euthanasia for people who aren’t terminally ill but are suffering unmanageable pain.

As Canada pushes to expand euthanasia and more countries move to legalize it, health care workers here are grappling with requests from people whose pain might be alleviated by money, adequate housing or social connections. And internal data obtained exclusively by The Associated Press from Canada’s most populous province suggest a significant number of people euthanized when they are in unmanageable pain but not about to die live in Ontario’s poorest areas.

Here’s a look at the main takeaways from an AP investigation into euthanasia in Canada, commonly known there as medical assistance in dying, or MAiD.

Some doctors fear providing euthanasia, even in legal cases

Canada allows euthanasia for people with “irremediable suffering” from serious but nonfatal medical conditions and disabilities.

After euthanasia was legalized in 2016, doctors and nurses set up email discussion groups as confidential forums to discuss potentially troubling cases, with limited patient details. They’re now run by the Canadian Association of MAiD Assessors and Providers, an educational and research organization.

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Dozens of messages provided to the AP by a participant in the forums — on condition of anonymity, due to the confidential nature of the messages and cases — show a fraught process where medical professionals test the limits of what conditions warrant euthanasia.

In one case, a middle-aged worker whose ankle and back injuries made him unable to resume his previous job told his doctor the government’s measly support was “leaving (him) with no choice but to pursue MAiD.” His doctor told forum participants the patient met legal criteria, with severe pain, strained social relationships and inability to work.

Others agreed, but the doctor hesitated because the man cited reduced government payments as a key factor — and the doctor noted fear of being portrayed in the media as having euthanized someone “in a case where services were inadequate.”

Case of homeless people spark debate

Cases of homelessness appear regularly on the private forums.

One doctor wrote that although his patient had a serious lung disease, his suffering was “mostly because he is homeless, in debt and cannot tolerate the idea of (long-term care) of any kind.” A respondent questioned whether the fear of living in a nursing home was truly intolerable. Another said the prospect of “looking at the wall or ceiling waiting to be fed … to have diapers changed” was sufficiently painful.

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One provider said any suggestion they should provide patients with better housing options before offering euthanasia “seems simply unrealistic and hence, cruel,” amid a national housing crisis.

Data suggest marginalized people are affected

Government officials have largely refuted the idea that socially disadvantaged people are being euthanized.

But in Ontario, more than three-quarters of people euthanized when their death wasn’t imminent required disability support before their death in 2023, according to data from a slideshow presentation by the province’s chief coroner, shared with AP by both a researcher and a doctor on condition of anonymity due to its sensitive nature.

Of people killed when they weren’t terminally ill, nearly 29% lived in the poorest parts of Ontario, compared with 20% of the province’s general population living in the most deprived communities, the data show.

The figures suggest poverty may be a factor in Canada’s nonterminal euthanasia cases.

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But Dr. Dirk Huyer, Ontario’s chief coroner, told AP that the data was only an early analysis and “it’s tough to know exactly what it means,” saying that his job was only to present the statistics.

Poverty doesn’t appear to disproportionately affect patients with terminal diseases who are euthanized, according to the leaked data. Experts say no other country with legal euthanasia has seen a marked number of deaths in impoverished people.

Overall for Ontario, the data show, nonterminal patients account for a small portion of all euthanasia cases: 116 of 4,528 deaths last year. But the presentation and discussion among Ontario officials and medical professionals show rising awareness of euthanasia deaths for social reasons.

Privately, officials admit concern

Canadian officials have examined worrisome cases that haven’t been publicly disclosed.

A document from the Ministry of the Solicitor General in Ontario sent to all euthanasia providers in the province in May noted two cases of “lessons learned” in nonterminal cases. The document was shared with AP by a doctor on condition of anonymity because it wasn’t authorized for release.

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In one, a 74-year-old patient who’d suffered blood pressure, a stroke and blindness was increasingly dependent on their spouse. The patient told their doctor they were interested in euthanasia, citing deteriorating vision loss and quality of life.

Among other issues identified, officials wrote the patient’s euthanasia was scheduled “based on the spouse’s preference of timing” and questioned whether “the patient’s death was genuinely voluntary.”

Canada pushes boundaries

Theo Boer, professor of health care ethics at Groningen University in the Netherlands, said that unlike other countries with legal euthanasia, Canada appears to be providing it for social reasons in some cases.

“That may be what Canadians want, but they would still benefit from some honest self-reflection about what is going on,” he said.

Some of that reflection is happening in the confidential providers’ forums. They’ve debated whether it’s valid to euthanize people for obesity in several cases. They’ve also beem divided over ending the lives of people in mourning.

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Canada’s government said it legalized euthanasia to reduce suffering and support individual autonomy — and polls have consistently shown public approval.

But its laws are now being challenged on all sides. The advocacy group Dying with Dignity filed an August lawsuit in Ontario, alleging it’s “discriminatory” to exclude mentally ill people from euthanasia. Meanwhile, a coalition of disability-rights organizations in another lawsuit argued that euthanasia legislation has resulted in the premature deaths of people with disabilities.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. This story also was supported by funding from a Pulitzer Traveling Fellowship grant. The AP is solely responsible for all content.

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Sen. Cruz wants restrictions on military flights approved soon to prevent another midair collision

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Sen. Cruz wants restrictions on military flights approved soon to prevent another midair collision

WASHINGTON (AP) — Republican Sen. Ted Cruz says he wants restrictions on military flights approved before government funding runs out at the end of next month to prevent another midair collision like the one over Washington, D.C., that killed 67 people in January.

Cruz and Democratic Sen. Maria Cantwell held a news conference Monday with some of the victims’ families to denounce provisions in a massive defense bill that’s expected to pass this week. The provisions would allow military aircraft to get a waiver to return to operating without broadcasting their precise location, just as they were before the Jan. 29 crash between an airliner and an Army helicopter.

Cruz and Cantwell want the provisions removed, but changing the bill would send it back to the House, potentially delaying raises for soldiers and other key provisions. With that unlikely, Cruz said he’ll seek action to reimpose the restrictions on military flights as part of a government funding package in January.

“I’m seeking a vote on the ROTOR Act as part of any appropriations measure before the current continuing resolution expires at the end of next month,” Cruz said. ROTOR stands for “Rotorcraft Operations Transparency and Oversight Reform.”

The provision in the defense bill has rekindled debate over air safety near the nation’s capital. Before the crash in January, military helicopters routinely flew through the crowded airspace around the nation’s capital without using a key system called ADS-B to broadcast their locations. The Federal Aviation Administration began requiring all aircraft to do that in March.

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National Transportation Safety Board Chairwoman Jennifer Homendy, senators, airlines and key transportation unions all sharply criticized the new helicopter safety provisions in the defense bill when they came to light.

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Cruz said the defense bill provision “was airdropped in at at the last moment,” noting it would unwind actions taken by President Donald Trump and Transportation Secretary Sean Duffy to make the airspace around D.C. safer.

“The special carve-out was exactly what caused the January 29th crash that claimed 67 lives,” Cruz said.

The families of the crash victims said that bill would weaken safeguards and send aviation safety backwards. Amy Hunter, who lost her cousin and his family in the crash, said Trump and his administration had worked to implement safety recommendations from the NTSB, but warned those reforms could be lost in the military policy bill.

Hunter said it “now threatens to undo everything, all the progress that was already made, and it will compromise the safety around Reagan National Airport.”

The NTSB won’t release its final report on the cause of the crash until sometime next year, but investigators have already raised a number of key concerns about the 85 near misses around Ronald Reagan National Airport in the years before the crash and the helicopter route that allowed Black Hawks to fly dangerously close to planes landing at the airport’s secondary runway.

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The bill Cruz and Cantwell proposed to require all aircraft to broadcast their locations has broad support from the White House, the FAA, NTSB and the victims’ families.

Senate Majority Leader John Thune, R-S.D., said he hoped the air safety legislation Cruz and Cantwell introduced last summer, called the ROTOR Act, could be added to the funding package that the Senate may start considering this week ahead of the holiday break.

“I think we’ll get there on that, but it would be really hard to undo the defense authorization bill now,” Thune, R-S.D., said.

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This story has been updated to delete erroneous reporting that Sen. Ted Cruz was threatening another federal government shutdown if new restrictions on military flights are not approved by the end of January. Rather, Cruz said he’ll seek action to reimpose the restrictions as part of a government funding package. AP members must NOT use earlier versions of US–Aviation Safety.

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Pope Leo XIV condemns ‘antisemitic violence’ after massacre in Sydney: ‘We must eliminate hatred’

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Pope Leo XIV condemns ‘antisemitic violence’ after massacre in Sydney: ‘We must eliminate hatred’

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Pope Leo XIV on Monday condemned “antisemitic violence” in the aftermath of the mass shooting in Sydney, Australia, in which a father and son opened fire on a crowd attending a Hanukkah celebration.

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The pope prayed for the victims and the “gift of peace and fraternity” this holiday season as he spoke during an audience with the donors of the Vatican’s Christmas decorations.

“We pray for those who suffer from war and violence, in particular today I want to entrust to the Lord the victims of the terrorist attack in Sydney against the Jewish community,” the pontiff said on Monday.

“Enough of these forms of antisemitic violence!” he continued. “We must eliminate hatred from our hearts.”

AUSTRALIA TERROR ATTACK: 16 DEAD, INCLUDING GUNMAN, AFTER FATHER-SON DUO OPENS FIRE ON JEWISH COMMUNITY

Pope Leo XIV hugs a child at the end of an audience with donors of the Christmas tree and nativity scene set up in St. Peter’s Square, in the Paul VI Hall, at the Vatican, Monday, Dec. 15, 2025. (AP)

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Leo made similar prayers in an official telegram of condolence sent to the archbishop of Sydney, Most. Rev. Anthony Fisher.

The pope prayed “with renewed hope that those tempted to violence will undergo conversion and seek the path of peace and solidarity,” according to the telegram signed by the Vatican secretary of state.

At least 15 victims were killed and dozens more were wounded in the massacre over the weekend on Sydney’s Bondi Beach, where hundreds had gathered for a “Chanukah by the Sea” event celebrating the beginning of the Jewish festival. One of the gunmen was shot and killed by police while the other was hospitalized with injuries.

A man identified as Ahmed al Ahmed has been praised as a hero for tackling and disarming one of the gunmen. He was shot but is recovering in a hospital.

Australian Prime Minister Anthony Albanese denounced the shooting as an act of antisemitic terrorism and vowed to strengthen the country’s already strict gun laws.

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Pope Leo XIV shakes hands with Sister Raffaella Petrini, President of the Vatican City State at the end of an audience with donors of the Christmas tree and nativity scene set up at the Vatican, Monday, Dec. 15, 2025. (AP)

The attack was an “act of pure evil, an act of antisemitism, an act of terrorism,” Albanese said.

Leo also issued a strong anti-abortion message during the audience with the donors of the Vatican’s Christmas decorations, which he described as a sign of “faith and hope.”

The pope said the evergreen fir trees donated by various Italian regions “are a sign of life and recall the hope that isn’t lacking even in the winter cold.”

He said another sign of life was reflected in the Nativity scene in the Vatican’s audience hall, which was donated by Costa Rica. It featured 28,000 ribbons representing embryos that were not aborted.

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GAL GADOT, ASHTON KUTCHER CONDEMN ANTISEMITIC TERROR ATTACK AT BONDI BEACH HANUKKAH EVENT

Ribbons representing lives saved from abortion according to Catholic groups are seen on Nacimiento Gaudium, a nativity scene set during an audience led by Pope Leo XIV at the Vatican, Monday, Dec. 15, 2025. (AP)

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“Each of these 28,000 colored ribbons that decorate the scene represent a life saved from abortion thanks to the prayer and support provided by Catholic organizations to many mothers in need,” the pontiff said.

Leo thanked the artist for the message affirming that “life is protected from conception.”

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The Associated Press contributed to this report.

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All eyes on Italy as Mercosur deal hangs in the balance

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All eyes on Italy as Mercosur deal hangs in the balance

Italy’s silence on the Mercosur trade pact is deafening – and potentially decisive. Rome could become the kingmaker between supporters of the deal and countries seeking to block it.

European Commission President Ursula von der Leyen plans to fly to Brazil on December 20 to sign off the agreement. France, facing farmer anger over fears of unfair competition from Latin America, opposes the deal and wants to postpone the EU member states vote scheduled this week to allow the signature.

The trade pact with Mercosur countries – Argentina, Brazil, Paraguay, and Uruguay – aims to create a free-trade area for 700 million people across the Atlantic. Its adoption requires a qualified majority of EU member states. A blocking minority of four countries representing 35% of the EU population could derail ratification.

By the numbers, Italy’s stance is pivotal. France, Hungary, Poland and Austria oppose the deal. Ireland and the Netherlands, despite past opposition, have not officially declared their position. Belgium will abstain.

That leaves Italy in the spotlight. A diplomat told Euronews the country is feeling expose but that may not be a bad position to be in if it plays its cards rights to get concessions.

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Coldiretti remains firmly opposed to the agreement

Rome’s agriculture minister had previously demanded guarantees for farmers.

Since then, the Commission has proposed a safeguard to monitor potential EU market disruptions from Mercosur imports. The measure, backed by member states, will be voted on Tuesday by EU lawmakers at plenary session in the European Parliament in Strasbourg.

Italy’s largest farmers’ association, Coldiretti, remains firmly opposed.

“It’s going to take too long to activate this safeguard clause if the EU market is hit by a surge of Mercosur’s imports,” a Coldiretti representative told Euronews.

On the other side, Prime Minister Giorgia Meloni faces a delicate balancing act between farmers and Confindustria, the industry lobby, while Italy remains the EU’s second-largest exporter to Mercosur countries.

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This was also made clear by Agriculture Minister Francesco Lollobrigida a few days ago in Brussels. “Many industrial sectors and parts of the agricultural sector, such as the wine and cheese producers, would have a clear and tangible benefit [from the deal]. Others could be penalized,”he said.

This is why Italy has not taken a clear stance up to now. “Since 2024, we tried to protect everybody”, Lollobrigida argued, “while remaining ambiguous on the country’s position”.

Supporters of the deal are wooing Meloni, seeing her as the path to get the agreement done and open new markets amid global trade obstacles, including nationalist policies in the US and China.

“As long as the Commission president is preparing to go to Brazil to the Mercosur summit, we need to do what’s necessary for that to happen,” an EU senior diplomat from a pro-deal country said.

Yet uncertainty lingers. No one wants to schedule a vote that might fail, and Italy’s prolonged silence is rattling backers, sources told Euronews.

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One diplomat familiar with the matter speaking to Euronews conceded “it’s hard, looks difficult”.

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