In “Euthanasia and Health Reform in Canada,” Michael Stingl argues that the legalization of euthanasia can be made reasonable social policy only in the context of healthcare reform to deliver primary- and community-based care. Stingl accepts that euthanasia “is in effect a treatment for unbearable suffering caused by a patient's health condition” and that includes not only pain, but “a personal response to a medical situation that the individual finds unbearable given his or her beliefs and values about the meaningfulness of human life.” He is not worried “about the reasonableness or validity of their request, but about the validity of the situation which leads to their request.” The failure of the healthcare system to adequately respond to the needs of people who are suffering with chronic or terminal conditions may lead competent people to elect euthanasia. Stingl argues that it is the institutionalization of care for dying people that reduces their ability to find meaning in prolonged life, and thereby makes it more attractive to consider ending one's life sooner. Options such as palliative care at home that significantly improve quality of life and make euthanasia less attractive are currently only available to those who can privately subsidize healthcare services. If an emphasis is placed on community-based initiatives and well-supported self-help, then there would be less inequality of healthcare and the voluntariness of choices, including euthanasia, would be more equal for all people under the healthcare system.