When suicide becomes healthcare

I cannot get past his age.

Twenty-six.

In the United States, if a 26-year-old man walks into a hospital and says he wants to die because he is depressed, the response is not paperwork for assisted death. It is psychiatric evaluation. It is suicide watch. It is intervention.

We step in during those moments because severe depression can impair judgment. A person in crisis may not be able to weigh the future clearly or assess consequences in a stable way. Protection, not permission, is the standard response.

In Canada, that same 26-year-old was approved for death.

Kiano Vafaeian lived with Type 1 diabetes, significant vision loss, and a history of depression. He was not terminally ill. He was not in the final days of life. According to public reporting and statements from his family, he sought access to Canada’s Medical Assistance in Dying program. After reportedly being denied at first, he was later approved.

On December 30, 2025, his life was ended through the Canadian healthcare system.

It is important to be precise about how this happened.

Under current Canadian law, mental illness alone does not yet qualify someone for MAID. Parliament approved in principle an expansion to allow eligibility where mental illness is the sole underlying condition, but implementation has been delayed and is now scheduled for March 17, 2027.

However, since 2021, individuals who are not terminally ill may qualify under what is known as Track 2 if they have a serious and incurable illness, disease, or disability that causes enduring suffering they find intolerable, and if two independent practitioners determine they are capable of making the decision.

Depression may coexist with such conditions. Capacity is the hinge.

To receive MAID, a person must be deemed capable of understanding relevant information and appreciating the reasonably foreseeable consequences of the decision. In this case, two practitioners concluded that threshold was met.

That is the legal pathway.

The moral question is whether severe depression can coexist with stable, fully reliable judgment about ending one’s life.

For decades, Western societies have treated suicidal ideation as a psychiatric emergency. Public health campaigns urge intervention. In many American jurisdictions, individuals in acute suicidal crisis can be placed under temporary involuntary holds precisely because their judgment may be impaired.

Consent requires capacity. Capacity requires clarity.

Canada’s euthanasia regime now operates in visible tension with that long-standing principle.

The expansion of eligibility did not happen quietly. In 2016, assisted death was legalized following the Supreme Court’s Carter decision, initially tied to reasonably foreseeable death. In 2021, Parliament passed Bill C-7, removing that requirement. Since then, eligibility has extended beyond the terminally ill.

The numbers reflect the shift. Health Canada reports 15,427 MAID deaths in 2023, representing 4.7% of all deaths in the country that year. The 2024 report shows 16,499 MAID deaths, accounting for 5.1% of all deaths.

This is not a marginal exception. It is an established part of the healthcare system.

Canada operates under a government funded single payer model. The state finances psychiatric care, chronic disease management, disability support, and long-term treatment. The state also finances assisted death. No accusation of motive is necessary to see the structural tension. When the provider of care is also the payer, and when long-term treatment is costly while assisted death is definitive, the safeguards protecting the vulnerable must be exceptionally strong.

Instead, eligibility has broadened.

The Christian understanding of human dignity begins with a truth older than modern autonomy: human beings bear the image of God. That dignity does not fluctuate with health, independence, productivity, or emotional stability. It does not disappear when a person feels burdensome or overwhelmed. It does not evaporate in the darkness of depression.

Suffering does not erase worth.

The fact that Parliament approved in principle the expansion of assisted death to those whose sole underlying condition is mental illness, even while repeatedly delaying implementation over safety concerns, reveals how far the debate has already moved.

A society that once treated suicidal despair as a condition demanding intervention is now constructing legal frameworks that can, under certain circumstances, validate it.

Kiano Vafaeian was 26 years old. In many American jurisdictions, his declaration that he wanted to die would have triggered immediate intervention and protection. In Canada, it triggered approval.

That contrast should not simply unsettle us. It should alarm us.

When a nation moves from preventing suicide to facilitating it, the shift is not procedural. It is civilizational. We have crossed from guarding the vulnerable to agreeing with their despair.

The words compassion and dignity remain, but they no longer mean what they once did. Care used to mean standing between a suffering person and irreversible harm. Now it can mean signing the authorization.

I know suicide firsthand. I have seen what depression can do to a person’s judgment. I have seen the devastation it leaves behind. Despair is not clarity. It is illness.

A young man clouded by depression did not need the state to confirm that his darkest thoughts were reasonable. He needed a society strong enough to say no.

If despair can be certified as consent, then protection has collapsed. And when protection collapses for the mentally ill, no one who suffers deeply is truly safe.

This is not mercy. It is abandonment dressed in the language of care.