World
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.
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.
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.
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.
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.
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.
World
Keir Starmer reportedly considering stepping down as PM and could announce timetable for departure
British PM Keir Starmer could face leadership challenge amid internal troubles
British Prime Minister Keir Starmer faces significant internal pressure following Andy Burnham’s special election win, potentially triggering a leadership contest. Starmer is under fire for economic pressures, illegal immigration issues, and controversies surrounding his previous role in prosecuting grooming gangs. Elon Musk also accused Starmer of complicity.
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British Prime Minister Keir Starmer is reportedly considering stepping down and could announce a timetable for his departure as early as Monday, according to a report published Saturday.
Britain’s Observer newspaper reported that Starmer was discussing his future with his wife at his Chequers country residence before making a final decision.
The outlet reported that senior Labour Party figures expect a statement addressing his future as early as next week.
A government source told Reuters that Starmer remains focused on governing and pointed to previous comments in which he vowed to remain in office.
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British Prime Minister Keir Starmer awaits Switzerland’s Federal President Guy Parmelin on the sidelines of the G7 summit, in Evian-les-Bains, France, Tuesday. (Isabel Infantes/Pool Reuters via AP)
Fox News Digital has reached out to the prime minister’s office for comment.
Pressure on Starmer has been building for months amid growing dissatisfaction within his party and concerns over the government’s handling of the economy and cost-of-living issues.
The political threat to Starmer intensified Friday after rival Andy Burnham won a seat in Parliament, positioning him to mount a formal leadership challenge.
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Britain’s Labour party candidate Andy Burnham speaks to supporters after the Makerfield by-election in Ashton in Makerfield, England, Friday. (Jon Super/AP)
Starmer congratulated Burnham following the victory, writing on X that voters, “chose Labour’s campaign of hope and optimism over division and hate.”
When asked about Burnham’s apparent ambitions to replace him, Starmer insisted he intends to remain in office.
“I’ve said repeatedly I’m not going to walk away from that,” Starmer said.
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Sir Keir Starmer is battling to save his position and refusing to stand aside despite dozens of Labout MP’s demanding he resigns. (Leon Neal/Getty Images)
Starmer has led the Labour Party since 2020 and became prime minister in 2024.
Calls for his resignation intensified last month, with more than 100 Labour lawmakers publicly urging him to step aside or set out a timetable for his departure. Several parliamentary aides also resigned in protest.
The internal revolt followed a series of disappointing local election results for Labour, which lost hundreds of council seats across England, surrendered long-held ground in Wales and fell behind political rivals in Scotland.
UK Prime Minister Keir Starmer speaks a news conference at Downing Street in London, March 5. (Tolga Akmen/EPA/Bloomberg via Getty Images, File)
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Starmer’s popularity has also declined amid a persistently high cost of living, sluggish economic growth and criticism over his acceptance of gifts from wealthy donors.
Fox News Digital’s James Cirrone and Emma Bussey, and Reuters contributed to this report.
United States President Donald Trump has pledged there will be no tolls for passage through the Strait of Hormuz, unless they are collected by his own country.
Trump’s statement, made in a Saturday afternoon post on Truth Social, is the latest sign that a recently signed memorandum of understanding (MOU) may be unravelling.
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“There will be NO TOLLS in the Hormuz Strait for 60 days during the Cease Fire Period, and there will be NO TOLLS after the 60 day period has expired,” Trump wrote, “unless they are imposed by and for the United States of America.”
Since the US and Israel launched a war against Iran on February 28, Iran has successfully used the Strait of Hormuz as a pressure point, closing the strategic waterway to traffic.
But under the terms of Wednesday’s ceasefire memorandum, the strait is supposed to reopen for an interim period of 60 days. During that time, Iran is barred from charging vessels for passage.
On Saturday, however, Iran’s joint military command said it had closed the Strait of Hormuz, citing a “clear breach” of the memorandum’s commitments.
US Central Command (CENTCOM), the agency that oversees military operations in the region, denied that report and maintained that the traffic continues to flow through the waterway.
The Strait of Hormuz has long been a flashpoint in the conflict between the US and Iran. Nearly 20 percent of the world’s oil and natural gas is transported through the strait, as well as about 30 percent of the global fertiliser trade.
Closure of the strait has caused global fuel costs to soar and has tested agricultural sectors across the world.
Trump had responded to Iran’s chokehold over the strait by imposing a US naval blockade on Iran’s ports in the region.
But that naval blockade was lifted under the terms of Wednesday’s memorandum. The deal also paused fighting on all fronts in the regional conflict, including in Lebanon.
The memorandum, though, was not intended as a long-term deal. It serves as a launching point for negotiations on key issues, including the future of Iran’s nuclear programme.
Several points of divergence also went unaddressed in the memorandum. Nowhere does the memo say that future tolls cannot be collected from the strait after the 60-day period expires.
Before the war, there was no charge for passage through the strait. Trump himself said in an interview with The New York Times that the waterway should remain “permanently toll-free”.
But he appeared to reverse course in Saturday’s post, once again floating the possibility that the US could extract tolls in the strait, while barring Iran from doing so.
No fees should be levied, Trump wrote, “unless they are imposed by and for the United States of America, should the deal not be completed”.
He explained that such a charge would compensate the US “for services rendered as the Guardian Angel to the countries of the Middle East for purposes of both past, present, and future reimbursement of costs”.
Trump used similar language in his New York Times interview earlier this week, floating the US becoming “the guardian of the Middle East” in exchange for 20 percent of its revenue.
Saturday’s post is not the first time Trump has mused about the US imposing tolls in the strait, either.
In April, for instance, he discussed the idea with reporters, saying, “What about us charging tolls? I’d rather do that than let them have them. Why shouldn’t we? We’re the winner. We won.”
There has been no indication that Trump’s plans have been officially presented to countries in the region, many of whom have struck a careful balance in their dealings with both the US and Iran during the war.
Iranian officials, meanwhile, have repeatedly said they will not rule out imposing tolls in the strait, framing the issue as a matter of sovereignty and regional negotiation. The strait sits between Iran and Oman.
Further discussions are expected on the matter in the coming weeks.
But such negotiations have been thrown into jeopardy amid ongoing Israeli military operations in Lebanon, which threaten to violate Wednesday’s ceasefire memorandum.
Iran claimed that Saturday’s closure of the strait was a result of new Israeli attacks in southern Lebanon, which killed dozens of people after the ceasefire was announced.
Iranian officials have also said that any upcoming talks should focus on proper implementation of the initial memorandum, and that the 60-day negotiating period stipulated in Wednesday’s deal would begin after that was settled.
Pakistan, a top mediator between the US and Iran, has said that follow-up talks are set to begin in Switzerland on Sunday.
Switzerland’s Federal Department of Foreign Affairs has confirmed that an Iranian delegation, led by parliamentary Speaker Mohammad Bagher Ghalibaf and Foreign Minister Abbas Araghchi, has already arrived for the negotiations.
On the US side, Trump’s son-in-law Jared Kushner, special envoy Steve Witkoff and Vice President JD Vance are expected to attend.
Vance departed for Switzerland late Saturday.
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