Canada’s MAiD program has expanded rapidly—Dr. Ramona Coelho argues the system increasingly serves vulnerable people, with uneven safeguards and serious ethical, legal, and social risks.

Dr. Ramona Coelho (MDCM, CCFP) is a family physician in London, Ontario, a senior fellow with the Macdonald-Laurier Institute, and co-editor of Unravelling MAiD in Canada: Euthanasia and Assisted Suicide as Medical Care. She has provided testimony and policy input on MAiD and serves on Ontario’s MAiD Death Review Committee with the Office of the Chief Coroner.

• How MAiD began in Canada (Carter decision → 2016 legislation)
• Track 1 vs. Track 2 and how eligibility broadened
• Euthanasia vs. assisted suicide (Canada vs. U.S. models)
• Oversight gaps, “doctor shopping,” and variable interpretations of the law
• Disability, loneliness, poverty, and access-to-care concerns
• Dementia, capacity, voluntariness, and family conflict
• Proposed/possible expansions (mental illness; mature minors; advance requests)
• Social messaging and suicide contagion risk
• Why jurisdictions (Oregon vs. Canada/Quebec/Netherlands) show different rates

• MAiD expanded from “reasonably foreseeable death” to include non-terminal cases (Track 2), increasing reach to people with disabilities and complex social suffering.
• Canadian safeguards and clinical interpretations vary widely, and the ability to “try again” with different assessors can make approvals easier to obtain.
• Canada’s model is overwhelmingly euthanasia (clinician-administered), which she argues changes the social dynamics compared with assisted-suicide regimes.
• She raises concerns about capacity/consent assessments—especially in dementia—and about insufficient access to palliative care and supports before MAiD occurs.
• She argues the policy’s public framing (“choice/compassion”) can obscure structural vulnerabilities (poverty, isolation, lack of services) and broader social harms.

• “MAiD has become one of the top five ways to die in Canada.”
• “A patient who is very determined…can call back our centralized care coordination service and just keep getting another MAiD practitioner until they find one.”
• “Assisted suicide and euthanasia is sold as compassion and choice, but actually it is accessed by vulnerable people.”

Disclaimer: The views and opinions expressed by Dr. Ramona Coelho in this interview are her own and do not necessarily reflect those of her employer, affiliated institutions, advisory committees, or any organization with which she is associated.

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A lively tour from Cold War “The Thing” to today’s surveillance capitalism—showing how audio capture, too much data, and automation pressures helped turn listening into AI.

• Dr. Toby Heys — Professor at the School of Digital Arts (SODA), Manchester Metropolitan University; co-founder of the AUDINT sonic research unit; co-author of Listening In
• Dr. David Jackson — Senior Lecturer in Digital Visualisation at SODA, Manchester Metropolitan University; researches AI’s cultural impact; founded the Storytellers + Machines conference (2023); co-author of Listening In.
• Marsha Courneya — Canadian writer/editor; teaches Digital Dramaturgy at the International Film School of Cologne; doctoral researcher in Digital Culture and Communication at Birkbeck, University of London; co-author of Listening In.

• “The Thing” (1945): passive bugging, resonance, why it went undetected
• Cold War escalation: normalization of listening, Five Eyes, PRISM/Snowden
• Stasi data glut: informants, dossiers, “collecting as mania,” behavior change
• Language under surveillance: cryptolects, slang, coded speech, hip-hop as evasion
• Surveillance capitalism: smart homes, smart toys, wearables, “data promiscuity”
• Kids + data: baby monitors/crib cams, school biometrics, “data twins” before birth
• AI training + intimate life: accidental recordings, human review, terms-of-service reality
• Future tensions: convenience vs autonomy, regulation lag, ownership erosion (“enshittification”)

• Audio surveillance scales into an “automation problem.” Once you can record everything, the bottleneck becomes listening fast enough, pushing intelligence services toward automated analysis.
• Surveillance changes behavior—even when nobody is actively listening. The possibility of being overheard bends speech, jokes, and self-presentation (Stasi dynamics → modern smart devices).
• “Too much data” doesn’t make it harmless. The danger isn’t only what’s heard today, but the creation of a searchable “permanent record” that can be reinterpreted later.
• The home becomes the most valuable capture zone. People drop the public mask at home; that intimacy makes in-home audio uniquely revealing and therefore lucrative/powerful.
• Children are captured early—often via “safety” and parental anxiety. Baby tech, smart toys, school systems, and medical records create a data trail before kids can consent or understand it.
• Snowden shocked—but didn’t trigger lasting mass refusal. The episode argues leaks often lead to resignation/memeification (“the intel officer listening”) rather than sustained backlash.
• AI + ownership is the next front. Beyond privacy, the guests worry about erosion of ownership (you can’t fully “own” digital goods or refuse totalizing platforms as easily).

• Toby: “There was nothing to detect.”
• Marsha: “It ruptures language completely.”
• David: “data isn’t secure and safe.”

🎙 The Pod is hosted by Jesse Wright
💬 For guest suggestions, questions, or media inquiries, reach out at https://elpodcast.media/
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A former Silicon Valley insider explains how MBA-style “spreadsheet management” is breaking software—and why it’s making tech, AI, and everyday products worse.

Darryl Campbell is a former tech industry insider who spent 15 years in Silicon Valley at companies including Amazon and Uber and at early-stage startups. He’s the author of Fatal Abstraction: Why the Managerial Class Loses Control of Software.

• What “managerialism” is and how MBAs took over tech
• Why software moved from serving users to extracting value
• Industrial-era management vs. internet-scale systems
• Boeing 737 MAX, Uber self-driving, and systemic risk
• Enshittification and the decline of product quality
• AI hype, weak ROI, and incentives to do harmful things
• Monopoly power, captured regulation, and why markets don’t self-correct
• Whether real innovation has slowed since the 1970s
• What comes next: backlash, regulation, or a paradigm shift

• The “managerial class” optimizes for financial metrics that don’t capture safety, quality, or real-world harm.
• Industrial-era management worked better because physical constraints forced slower feedback and respect for expertise.
• Software removes constraints: you can ship instantly at global scale, so errors and incentives can become catastrophes.
• Enshittification is a predictable outcome when monopoly power + financial targets replace user value.
• AI is under extreme financial pressure (huge capex vs. limited revenue), which encourages risky monetization.
• Traditional checks—shareholders, competition, regulators—often fail against near-monopolies.
• Meaningful improvement may require a broader public backlash or a major “paradigm shift.”

• “Anything, literally anything, is permissible as long as it makes you more money.”
• “It’s impossible to ignore… the only way to stay current is to pay us $200 a year for the rest of your life.”
• “It feels like we’re in a black and white phase right now, and I’m really interested to see what the color phase afterward looks like.

🎙 The Pod is hosted by Jesse Wright
💬 For guest suggestions, questions, or media inquiries, reach out at https://elpodcast.media/
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