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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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Russia, Ukraine to discuss territory as Trump says both sides ‘want to make a deal’

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Russia, Ukraine to discuss territory as Trump says both sides ‘want to make a deal’

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The U.S., Russia and Ukraine are meeting in Abu Dhabi, United Arab Emirates (UAE), to discuss one of the major sticking points stopping a deal to end the nearly four-year war: territorial disputes. The talks in Abu Dhabi are the first trilateral talks since 2022.

The trilateral sit-down comes after Ukrainian President Volodymyr Zelenskyy’s meeting with Trump in Davos and Russian President Vladimir Putin’s meeting with Special Envoy Steve Witkoff and the president’s son-in-law, Jared Kushner.

Witkoff and Kushner traveled to the UAE for the talks after their meeting with Putin in Moscow on Thursday.

ZELENSKYY BLASTS GLOBAL INACTION ON IRAN, CLAIMS EUROPE STUCK IN ‘GREENLAND MODE’

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President of the United Arab Emirates Sheikh Mohamed bin Zayed Al Nahyan receives the heads of delegations participating in the UAE-hosted trilateral talks involving the United States, Russia and Ukraine on Jan. 23, 2026.  (Hamad Al Kaabi/UAE Presidential Court/Handout via Reuters)

Zelenskyy and Putin are under increasing pressure to reach a peace deal as the fourth anniversary of Moscow’s invasion approaches and President Donald Trump pushes to end the war.

While Russia has demanded Ukraine cede the Donbas, Zelenskyy has stood firm in his opposition to making land concessions, though the discussions in Abu Dhabi suggest that he could be ready to negotiate. Putin is demanding Ukraine surrender the 20% it holds of the Donetsk region of the Donbas, according to Reuters.

The U.S., Ukraine and Russia are holding the first trilateral meeting in years. (Sputnik/Vyacheslav Prokofyev/Pool via Reuters; Denis Balibouse/Reuters; Ukrainian Presidential Press Service/Handout via Reuters)

UKRAINIAN AMBASSADOR SAYS PEACE TALKS ARE ‘GOING IN THE RIGHT DIRECTION,’ TRILATERAL TALKS PLANNED IN UAE

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“The question of Donbas is key. It will be discussed how the three sides… see this in Abu Dhabi today and tomorrow,” Zelenskyy told reporters via WhatsApp, according to Reuters. The outlet added that an aide for Zelenskyy said the talks are expected to continue Saturday.

The envoys are meeting as Ukrainians face below-freezing temperatures after Russian strikes damaged the country’s power supply.

Maxim Timchenko, the head of Ukraine’s top private power producer, told Reuters that the situation was nearing a “humanitarian catastrophe.”

Russian President Vladimir Putin and Ukrainian President Volodymyr Zelenskyy have both met separately with President Donald Trump. Despite a peace deal agreement being close, territorial disputes remain, Zelenskyy said.   (Julia Demaree Nikhinson/AP; Christian Bruna/Getty)

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While speaking with reporters on Air Force One, Trump was asked if the trilateral meeting could lead to one with himself, Putin and Zelenskyy. He would not commit but said that “any time we meet, it’s good.” He also expressed doubts about whether Putin wanted to take over all of Ukraine.

“What’s happened here is there were times when Putin didn’t want to make a deal, times when Zelensky didn’t want to make a deal, and it was opposite times. Now, I think they both want to make a deal. We’ll find out,” Trump said.

The president also acknowledged that the topics of the discussions that were happening had been debated for months.

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‘Electrifying everything’ is key to Europe’s future, says IEA chief

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‘Electrifying everything’ is key to Europe’s future, says IEA chief

Europe must electrify “everything” in the coming years, Fatih Birol, Executive Director of the International Energy Agency (IEA), said during a Euronews panel at the World Economic Forum in Davos, sharing a vision of a continent powered by clean power rather than fossil fuels.

“When we look at energy security in Europe, and Europe’s goals, such as reaching our climate goals, but also at the same time being affordable, I see one future for Europe,” Birol said. “Electrify everything, as much as you can, electrify everything. Transportation, industry and so on.”

The IEA chief suggested a two-fold strategy to this end. The first is to massively invest in grid infrastructure, and the second is to lower energy prices.

“One is grids, grids, grids,” Birol said, emphasising the importance of revamping the power grids in Europe.

He noted that there are significant bottlenecks, as permits remain difficult to obtain, undermining the development of the vast, interconnected networks that deliver power to homes, businesses, and factories. Birol called this “the main barrier to the electrification of the European economy”.

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“I will give one shocking number. Last year in Europe, we installed a record 80 gigawatts of renewable capacity. More than 400 gigawatts of renewable capacity were ready. But we couldn’t connect it to the grid. And it didn’t go to the households or the factories. This is completely crazy. Economically, it doesn’t make sense at all.”

Birol compared this push for green energy to developing the necessary infrastructure to build a fancy, efficient car, while forgetting to build roads.

Grid failures were also tied to the Iberian Peninsula blackout that left 60 million people without power in April 2025.

EU ‘Grids Package’

The ageing European grid was highlighted in a study by energy think tank Ember published this week, which found that the EU doesn’t have an issue generating green power — wind and solar generated more EU electricity than fossil fuels for the first time in 2025 — but that its “outdated” grid means it has a problem moving that power around.

In light of these issues, the European Commission unveiled a “Grids Package” at the end of last year to revamp the bloc’s obsolete electricity grid to increase electricity transmission across the EU27.

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This move was lauded by Birol, who said he hoped this package would see the light of day, as this could “unblock many of the problems” faced by Europe.

Kıvanç Zaimler, CEO of Sabancı Holding, a leading Turkish investment holding company, who joined the panel, echoed that grid investment is “a must” but stated this must be an in-depth transformation using another car-themed analogy.

“We also have to think about efficiency through digitalisation. It’s like managing (road) traffic. You not only need additional roads, but you also need to solve traffic problems with navigation systems,” he said.

Tackling high energy costs

Another key issue in Europe, Birol said, is the high cost of electricity, which represents a major challenge for the competitiveness of European industry.

“Electricity prices in Europe are very high compared to, I don’t know, the competitors such as the US, such as China. They are three to four times higher here than in those countries,” he told Euronews.

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Romanian Energy Minister Bogdan Ivan said the solution to high energy prices was to double energy resources in Europe.

“We (in Romania) are paying (among) the highest energy prices adjusted for people’s income,” Bogdan said.

He said this should be done by diversifying resources. “I want to use EU resources to finance nuclear power,” Ivan said. “That’s one of the best ways to bring cheap and baseline energy.” He argued that if the EU put too much emphasis on investing solely in wind and solar, it would “definitely have an issue”.

EU energy ministers have pledged to level energy prices across member states and prevent discrepancies between countries during their last official meeting in December.

Sweden’s Vattenfall President and CEO Anna Borg, who was also a panelist, agreed that diversification is key, also putting forward nuclear as a key component.

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“We will need all the fossil-free technologies that we get our hands on. But it is important to understand that the European economy can, in the long run, only be competitive if we phase out fossil fuels.”

Challenging regulations

Reviewing regulations is central to addressing all the underlying challenges delaying European energy sovereignty, the panellists agreed, especially in lowering prices.

Borg argued that overlapping legislation should be addressed, as it often impedes the swift development of key projects.

“Sometimes when we want to build something, we first have to get approval according to one regulation and then another. And they are overlapping in looking at the same thing, but you can get different results,” she said, calling for a more holistic approach.

The Vattenfall representative said what is really needed are “stable regulatory and policy frameworks” that are long-term: “(Energy) investments are made to be there for many decades. And the best thing that we can do from a European perspective is to keep an alignment between the countries so that policies don’t differ too much within the EU.”

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She argued that a lack of such frameworks and the back-and-forth on regulations creates uncertainty, risking market investments.

Zaimler agreed that companies find Europe’s regulatory processes tedious. “Europe has the longest permission or process time from zero to build a new renewable plant in terms of permissions.”

He compared the process to that of the US, which he claims is more focused on awarding permits. “I see more motivation in the US to speed up (these processes) compared to Europe.” This issue is also expected to be targeted by the EU’s Grid Package presented in December.

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Exclusive: EU-Mercosur deal likely to take effect provisionally from March, says EU diplomat

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Exclusive: EU-Mercosur deal likely to take effect provisionally from March, says EU diplomat
  • EU lawmakers refer deal to European Court of Justice, delaying it by two years
  • France opposes deal, citing impact on domestic farmers
  • Germany backs deal to offset US tariffs, reduce reliance on China

BERLIN, Jan 22 (Reuters) – The EU’s free trade deal with South American countries will probably be applied on a provisional basis as ‌soon as March, an EU diplomat told Reuters on Thursday, despite a looming challenge at the bloc’s top court.

EU lawmakers dealt a blow to the bloc’s contentious trade agreement with Brazil, Argentina, Paraguay and Uruguay on Wednesday by referring it to the European Court of Justice, potentially delaying it by two years.

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“The EU-Mercosur agreement shall be applied provisionally once the first Mercosur country has ratified it,” an EU diplomat told Reuters.

“That ‌will probably be Paraguay in March,” the diplomat added.

GERMAN BUSINESSES, CHANCELLOR MERZ CONDEMN DELAY

The EU signed its largest-ever ​trade pact with the Mercosur members on Saturday after 25 years of negotiations, and the delay has dismayed Germany’s government and many businesses.
Supporters argue that the deal is important to offset business lost to U.S. tariffs and to reduce reliance on China. They are worried ‍that a delay will hurt Europe’s economy.

“The setback undermines Europe’s competitiveness and jeopardizes European jobs and prosperity,” Tobias Meyer, CEO of the logistics group DHL, told Reuters. He said it would be good if the pact could be enacted while the court investigated.

“Europe cannot afford to fall behind further,” he ⁠added.

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Chancellor Friedrich Merz told delegates at the World Economic Forum in the Swiss Alpine resort of Davos on Thursday that he ‍regretted the European Parliament’s decision.

“But rest assured: We will not be stopped. The Mercosur deal is fair and balanced. There is no alternative to ‌it if ‌we want to have higher growth in Europe,” Merz said.

Critics of the deal, led by France, say it will increase imports of cheap beef, sugar and poultry and undercut domestic farmers.

French farmers have staged major demonstrations in Paris against the trade deal with hundreds of tractors blocking roads and landmarks such as the Eiffel Tower.

FRANCE SAYS PROVISIONAL IMPLEMENTATION WOULD BE UNDEMOCRATIC

The head of France’s CGB ⁠sugar beet producers’ lobby rejected any ⁠possibility of the accord taking ​effect provisionally.

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“That would be a denial of democracy. Unacceptable!” Franck Sander told Reuters.

A spokesperson for France’s farm minister declined to comment.

Applying the pact provisionally, pending the ruling and parliamentary approval, could prove politically difficult given the likely backlash, and the European Parliament would retain the power to annul ‍it later.

“If (European Commission President) Ursula von der Leyen, the European Union, were to force through a provisional application, given the vote that took place in Strasbourg, it would constitute a form of democratic violation,” French government spokesperson Maud Bregeon told CNews TV, speaking before the EU diplomat’s comments.

The European Commission ​has said it will engage with EU governments and lawmakers before deciding what ‍to do next.

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EU leaders are meeting later on Thursday in Brussels to discuss strained transatlantic relations in light of U.S. President Donald Trump’s demands over Greenland.

Additional reporting by ​Sybille de La Hamaide in Paris and Matthias Inverardi in Duesseldorf
Writing by Madeline Chambers
Editing by Thomas Seythal, Sharon Singleton and Gareth Jones

Our Standards: The Thomson Reuters Trust Principles., opens new tab

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