'A doctor took my son': This 26-year-old was denied assisted death in Ontario, but died by MAID in B.C.

A grieving Toronto-area mother is pushing for answers after her 26-year-old diabetic son, who was struggling with vision loss and depression, was granted a doctor-assisted death in British Columbia in December after his family says he was deemed ineligible for euthanasia in his own province.

Canada’s medical assistance in dying (MAID) law allowed their son to doctor shop until he found a willing enabler on the other side of the country, the family says.

The controversial case, which has garnered international media attention, highlights how malleable Canada’s MAID system has become. “Is it too malleable?” asked University of Toronto bioethicist Kerry Bowman, who works in end-of-life care. “That’s the question.”

Kiano Vafaeian died by MAID on Dec. 30 in a Vancouver funeral home. According to his family, his request for medical assistance in dying was approved and administered by Dr. Ellen Wiebe, one of Canada’s most prominent MAID physicians , who told parliamentarians in May 2022 that she had by then provided MAID to more than 430 people.

Three years ago, Vafaeian’s mother, Margaret Marsilla, intervened to prevent her then 23-year-old son’s planned MAID death at a Toronto clinic. After her daughter discovered an email confirming the scheduled date of death, Marsilla launched a social media campaign and online petition identifying the doctor, who later postponed, then pulled, his approval.

But her son continued to pursue MAID.

Under Canada’s MAID law, those seeking an assisted death are assigned either Track 1, meaning they have a terminal illness and their natural death is reasonably foreseeable, or Track 2 — death is not reasonably foreseeable.

In November 2023, doctors at a Toronto hospital declined Vafaeian’s request for a MAID assessment because he did not have a terminal illness “and/or” wasn’t nearing a natural death, according to a document shared by the family. It’s not known if the doctors assessed him for only a Track 1 death, or also thought he did not meet the criteria for Track 2.

“Regardless, he wasn’t able to get MAID here in Ontario after 2022,” Marsilla said.

There were other doctors, his family said. “We don’t have all the records yet. We know this by his own account, saying to his mother that anyone that he would go see for MAID declined him,” said his step-father, Joseph Caprara.

“Every breath hurts without him,” Marsilla posted on Instagram days after her son’s death. “And I am angry. So angry that I don’t even feel like I’m allowed to grieve properly.

“I am angry that a doctor took my son. Angry that we are expected to blindly trust doctors. Angry that the people who never lived with him, never loved him, never knew his darkest nights, were allowed to make a final decision about his life.”

When contacted by National Post, Wiebe said she could not comment on a particular person but said Canada’s MAID law requires a person to have a grievous and irremediable condition that causes unbearable suffering.

“No specific diagnosis makes someone eligible or ineligible,” she said. “Each person must be capable of making decisions about their medical care.”

“No specific diagnosis makes them incapable,” Wiebe added. “These assessments are done by clinicians.”

Under Track 2, while natural death doesn’t have to be foreseeable, the person must be in an advanced state of irreversible decline from a serious and incurable condition, disease or disability that is causing “enduring physical or psychological suffering” that’s intolerable to the person and that can’t be relieved under conditions they consider acceptable.

People could still have years, if not decades, of life.

In 2024, 732 Canadians were euthanized under Track 2 — about four per cent of the country’s total 16,499 MAID deaths that year. In addition to neurological conditions, “other” conditions like frailty, chronic disease and diabetes were the most commonly cited medical illnesses for Track 2, according to Health Canada’s most recent annual MAID report.

Track 2 also requires a minimum 90-day assessment period, between the time of the first assessment and the provision of MAID. Two assessors must agree the person meets eligibility criteria, and one must have expertise in the person’s condition. If neither do, they must consult with someone who does.

But critics say the law allows for overly loose interpretations of eligibility and gives broad discretionary judgment.

While people self-refer for MAID, the federal law sets out qualifying criteria. Those whose sole underlying medical condition is a mental illness aren’t eligible for MAID until March 17, 2027. Marsilla and her husband are now supporting a federal private member’s bill seeking to stop that expansion.

Her son “had a whole life ahead of him,” she told reporters at a virtual press conference this week.

“We lost a son because of the Canadian system. The Canadian system is wrong.”

Vafaeian’s medical certificate of death lists the underlying medical conditions for MAID as diabetes-related blindness and severe peripheral neuropathy — nerve damage from high blood sugar that can cause intense pain and numbness, most often in the feet and legs but also the hands.

But Vafaeian’s family said he never complained about suffering severe nerve pain. Marsilla is in health care. She said she has a patient with severe peripheral neuropathy who suffers from blindness who can’t hold a spoon or fork and needs constant care. “That was not my son,” she said.

“Anybody that knows Kiano or has been following him on TikTok or Instagram or other social media outlets would know he was independently walking; he was able to stand, walk, travel, carry on with his activities of daily living without any signs of suffering whatsoever,” Caprara, Marsilla’s husband, said.

“None of the medical records in Ontario ever mentioned anything about nerve problems with any of his extremities.”

However, in an interview with Juno News in March 2023, one day after he turned 24, Vafaeian said he was experiencing nerve damage in the endings of his hands and feet, pain that was sensitive to the winter cold. “When I go outside, I don’t really feel that it’s getting bad — it’s really cold, I don’t feel that — but as soon as I get inside it’s just severe pain from the temperature change.” He also described needing a dozen eye drops daily to manage the pain and symptoms of a severe form of glaucoma.

At the time, Vafaeian said he was pursuing MAID in Switzerland.

Her son would occasionally mention numbness, which is common with diabetes, Marsilla said. But he never described it as severe pain, nor did he seek emergency care or request medication for it, she said.

“For these reasons, I strongly believe that Kiano was coached, whether directly or indirectly, on how to frame his symptoms in a way that would meet MAID eligibility criteria,” she said.

“He was clearly on a mission. He knew MAID was there and was an easy way out for him. It was very evident that he was obsessed with getting MAID, he had such an obsessive type of personality.”

Although legally blind — he lost vision in his left eye  — his family said Vafaeian still had some vision in his right eye and could navigate his surroundings.

While he wasn’t approved for MAID on the basis of mental illness, which remains illegal in Canada, Kiano, who was diagnosed with Type 1 diabetes when he was four, struggled with emotions and anger that often overwhelmed him, his mother said.

“I blamed his blood sugars but realized, and was told, it was from depression, ADHD and other mental illness disorders he was facing.”

Her son was not terminally ill, making it crucial to ensure that his decisions weren’t being driven by untreated mental distress, she said. But “there was no sign of any doctor saying that he has to undergo some sort of (mental health) treatment.” He briefly saw a psychiatrist once a month, she said.

Vafaeian had been using medical marijuana since age 17, when he rolled his car in an accident, before he lost his eyesight, and suffered a concussion. He started using other drugs as he got older.

His moods fluctuated, his mother said. In the summer months, he was more “accepting.” He’d join family dinners. In winter, “he was just a different person.”

“When Kiano was on a high, he felt like, ‘I can live life,'” she said. “When he was on a low, he would close himself up in his room, in his home. He didn’t want to talk to people. He was miserable. He would fight with everyone.”

When he began losing his vision in 2020, he didn’t complete a series of laser surgeries. “Had he done his lasers like he was supposed to have he could have had his full eye sight for at least 10 to 20 years,” Marsilla said.

“Obviously, Kiano was trying to self-sabotage to try to get through the (MAID) system.”

He was angry when his mother intervened publicly to stop his first MAID approval. But last summer “we were coming together,” Marsilla said. They went to therapy together. They agreed in September 2025 that she would provide him with a fully furnished apartment, a live-in caregiver of his choosing, a gym membership, training sessions, a monthly allowance and “all the organic food that he wanted, all the vitamins he wanted,” Marsilla said.

“We had set up his future,” she said. He seemed optimistic. “Until something changed. Obviously, it was his approval for MAID.”

At one point, when doctors in Ontario declined his MAID request, Vafaeian was sent a en email saying he was free to apply in other provinces, and provided a link for a search, “which is very contradicting and very disturbing,” Caprara said. “He was already denied here. Why would you suggest for him to go out of province?”

In addition to struggles with mental health, Vafaeian was facing criminal charges, including for alleged indecent exposure when he was high on drugs and an altercation involving his father.

In December, he travelled to Mexico. “He had pictures and videos of Mexico and next thing he’s telling us he’s in Vancouver,” Caprara said. Vafaeian told them he was scheduled to die by MAID on Dec. 18 — the following day. “We didn’t know where he was … we didn’t believe it,” Marsilla said. They called police, who took down their information. On Jan. 3, they received a call from a law firm representing her son “indicating that he had succumbed to the MAID procedure,” Caprara said.

Two years ago, Vafaeian posted a YouTube video saying he recognized the gravity of his decision to seek MAID but that “even before blindness I knew diabetes was a burden onto my life that I wanted to end through medical assistance in dying.”

Some on social media have said it was “his body, his choice.” “We’re not disagreeing with that,” Caprara said.

“What we do disagree with is that he didn’t give treatment an opportunity. He didn’t listen to the individuals that were trying to guide him and provide him with assistance. He became obsessed with getting MAID for all the wrong reasons.

“Quite frankly, the medical system failed him and gave him the edge and that support to say, ‘Hey, I want to die. I can apply. I feel like it’s my choice to die,’ and we’re saying, ‘Yes, it’s your choice to die. But it’s not dying with dignity when someone is providing you with MAID,'” he said.

“It’s actually allowing a state-approved physician to kill you.”

Marsilla said that when she was told her son had died by MAID, “I thought it was a prank. I didn’t believe it.”

“If I knew what I know now, that you can go from province to province to shop for MAID doctors, I would have had a closer eye on my son,” she said. “I wouldn’t think other provinces would have entertained my son.”

If people persist long enough, they can often find a way to get MAID, Bowman said. “You can have eight out of 10 people that think you’re not acceptable for medical assistance in dying, but if you find two out of 10 it’s going to be okay.

“You can fly across this massive country of ours and get reassessed on the other side of the country.”

Bowman has seen MAID cases declined because of family conflict. “You’ve got physicians that are very concerned. A lot of seasoned clinicians, when they sense these really conflicted situations, they get cold feet fast, because they can see how those things play out. So they may be reacting to non-clinical factors.”

Dr. Ramona Coelho, a family doctor and member of a specialized MAID death review committee struck by Ontario’s Chief Coroner’s office, said most people with diabetes would not meet all conditions as set out under federal law.

She’s also troubled by out-of-province MAID provisions. “It raises red flags about the completeness and thoroughness of the assessment and whether all the information and collateral information could be accurately collected. That’s really worrisome to me.”

Wiebe said each provincial doctors’ licensing college regulates virtual care of patients across provincial boundaries.

Coelho said that, for families, “it’s very hard to have any kind of normal recourse if you have concerns about the MAID process.”

“I find it hugely problematic that a physician approves a young man from another province with whom she appears to have no prior treatment relation based in part on a relatively vague diagnosis and, in this case, with a patient who had just been travelling around and may be struggling with mental health issues and adjustment to his vision loss,” said Trudo Lemmens, a U of Toronto professor of health law and policy.

“Can that be reconciled with ‘an advanced state of irreversible decline of capability?’ His “peripheral neuropathy’ clearly didn’t prevent him from travelling. So, what was the ‘advanced state of irreversible decline’?”

“The vagueness of our MAID access criteria appear to enable some MAID providers to find all too easily a physical illness connection to offer MAID for people who may be struggling with mental illness and suicidal ideation,” Lemmens said.

He questioned whether severe neuropathy was included as an underlying medical condition “to make it a little less obvious it really was about blindness, which reflects a terrible ableist and stigmatizing judgment about the capability of a person with such a disability to conclude that ending their life is an appropriate therapy.”

It explains in part, he said, why a coalition of disability rights groups have launched a Charter challenge against Track 2 expansion. “Because it gives idiosyncratic physicians such discretionary judgment to conclude that people who are blind or otherwise disabled are indeed understandably better off dead.”

National Post

• This doctor has helped more than 400 patients die. A judge just blocked one of her cases
• 76,475 Canadians have died by MAID. Is that too many?

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