Anticipated Immigration Rate Changes Necessary to Maintain Canadian Population with Proposed Expansion of Medical Assistance in Dying for Mental Health Disorders

Recent legalization and normalization of euthanasia through the government program of medical assistance in dying (MAiD) is impacting Canada's population dynamics and is now the fifth leading cause of death. Ongoing proposals suggest expanding MAiD eligibility to mental illness. A knowledge gap exists to determine to what degree this expansion of MAiD may exacerbate the existing challenges associated with an aging population and declining birth rates. It may also complicate meeting national population targets of 100 million by 2100 set by the Century Initiative. To fill these knowledge gaps, this study conducts a comprehensive evaluation of the prevalence of mental illness in Canada. The results show that if MAiD is expanded to mental disorders under the high MAiD scenario by mid-century it will impact about 12.3% of the population. The low MAiD scenario projects an increase from 45,786 to 227,024 additional deaths/year. The likely scenario shows MAiD growing from 214,499 to approximately 896,312 by mid-century. Thus, if MAiD is expanded to mental illness under the likely scenario, more than half a million additional immigrants will be needed per year. These results emphasize the importance of integrating immigration policies with MAiD practices to ensure demographic stability and achieve long-term population objectives.