The rate of medical assistance in dying – also known as euthanasia – has grown in Canada for the fifth straight year, albeit at a slower pace.

The country released its fifth annual report since legalising assisted dying in 2016, which for the first time included data on the ethnicity of those seeking euthanasia.

Around 15,300 people underwent assisted dying last year, accounting for 4.7% of deaths in the country. Canada lawmakers are currently seeking to expand access to euthanasia to cover people with mental illnesses by 2027.

Canada is among a few countries that have introduced assisted dying laws in the past decade. Others include Australia, New Zealand, Spain, Austria.

The figures released on Wednesday by Health Canada show that the rate of assisted dying in Canada increased by nearly 16% in 2023. This number is a sharp drop from the average increase of 31% in previous years.

The report cautioned that it is too early to determine what caused the rate to slacken.

Nearly all of those who requested assisted dying – around 96% – had a foreseeable natural death. The remaining 4% were granted euthanasia due to having a long-term chronic illness and where a natural death was not imminent.

The average age of those seeking assisted dying was around 77 years old, with cancer being the most frequent underlying medical condition.

For the first time, the report delved into race and ethnic data of those who died by euthanasia.

Around 96% of recipients identified as white people, who account for about 70% of Canada’s population. It is unclear what caused this disparity.

The second most reported ethnic group was east Asians (1.8%), who account for about 5.7% of Canadians.

Assisted dying continued to have the highest usage rate in Quebec, which accounted for nearly 37% of all euthanasia deaths, despite the province holding just 22% of Canada’s population.

Quebec’s government launched a study earlier this year to examine why its euthanasia rate was so high.

While the number of assisted deaths in Canada is growing, the country still falls behind the Netherlands, where euthanasia accounted for around 5% of total deaths last year.

UK MPs voted late last month to pass a similar bill that gives terminally ill adults in England and Wales the right to have an assisted death, though it will face months of further scrutiny before it could become law.

As British MPs debated the legislation, Canada was cited by some as a cautionary tale due to its perceived lack of safeguards.

Like the UK, Canada initially only legalised assisted dying for those whose death was “reasonably foreseeable”.

However, Canada expanded access in 2021 to people who may not have a terminal diagnosis, but want to end their life because of a chronic, debilitating condition.

It was set to broaden access once again to people with mental illnesses earlier this year.

But that was delayed for the second time after concerns were raised by Canadian provinces, which oversee healthcare delivery, about whether the system could cope with such an expansion.

On Wednesday, Health Canada defended the procedure, saying that the criminal code sets out “strict eligibility” criteria.

But Cardus, a Christian think tank, said the latest figures were “alarming” and showed Canada has one of the fastest growing euthanasia programmes in the world.

A report released in October by Ontario – Canada’s most populous province – has since shed some light on controversial cases where people were granted assisted dying when they were not nearing their natural death.

One example included a woman in her 50s with a history of depression and suicidal thoughts who had a severe sensitivity to chemicals.

Her request for euthanasia was granted after she failed to secure housing that could have met her medical needs.

Another case made headlines in recent months of a Nova Scotia cancer patient who said she was asked if she was aware of assisted dying as an option twice as she underwent mastectomy surgeries.

The question “came up in completely inappropriate places”, she told the National Post.

Canadian news outlets have also reported on cases where people with disabilities have considered assisted dying due to lack of housing or disability benefits.