This morning, I sent an email to Health Canada and copied many elected officials.

As I learned more about Vanessa’s Law, I came to a difficult but important realization. Even when good laws are passed, they cannot protect people if they are not enforced or if those responsible do not comply with them.

That realization made me think about Madi’s Law. I have poured my heart into advocating for this legislation because I never want another family to experience the loss and heartbreak that ours has endured. But I now understand that passing Madi’s Law is only part of the journey. If it is not enforced, if participation is limited, or if accountability is lacking, it will not provide the protection that Canadians deserve.

As Madi’s mother, I carry both the grief of losing my daughter and the responsibility of trying to create meaningful change in her memory. This path has taught me that there is so much more that needs to be done to improve our health care and regulatory systems. The work doesn’t end with one law—it continues until those systems are transparent, accountable, and truly focused on protecting patients.

I remain committed to this mission. For Madi, for every family who has suffered a preventable loss, and for every person who deserves to know that the medications they take are monitored with the care, transparency, and accountability they expect.

Here’s a copy of the email 

Please pass this message to the individuals within Health Canada who are in a position to make meaningful policy changes.

Has Health Canada considered that if Vanessa’s Law is not working and compliance remains inadequate, it should stop assuring the public that adverse drug reaction data are being effectively collected and instead develop a solution that does?

Although information available online describes Vanessa’s Law as mandatory legislation, this is misleading if its reporting and compliance requirements are not being consistently enforced. A law that exists on paper but is not effectively implemented does not provide Canadians with the level of medication safety and surveillance they reasonably expect.

One policy that deserves serious consideration is the approach used in Northern Ireland.

In Northern Ireland, when prescription medications or illicit drugs contribute to a person’s death, the specific substances are recorded on the death certificate whenever they are determined to have caused or contributed to the death. Rather than using broad terms such as “drug toxicity” or “overdose,” the certificate identifies the actual medications or drugs involved. If multiple substances contributed to the death, each is documented.

This approach has significant public health benefits. Because the exact drugs are recorded, health authorities can identify emerging safety signals, monitor trends involving individual medications, recognize dangerous drug combinations, and respond more quickly to prevent future deaths. The information provides an objective, population-wide source of evidence that does not depend on voluntary adverse event reporting.

Canada should adopt a similar policy.

Recording the specific prescription medications that contribute to a person’s death would create a far more accurate national database of medication-related mortality. It would strengthen pharmacovigilance, improve regulatory oversight, and help Health Canada identify safety concerns that may otherwise go undetected. Most importantly, it would provide families, clinicians, researchers, and policymakers with reliable information to guide decisions and protect Canadians.

Vanessa’s Law was intended to improve medication safety through better reporting and surveillance. However, if adverse drug reaction reporting remains incomplete or inconsistent, Canada should supplement that system with mandatory recording of contributing medications on death certificates. Doing so would provide an independent and comprehensive source of data, reducing reliance on voluntary reporting alone.

Every preventable medication-related death represents an opportunity to learn. By adopting Northern Ireland’s approach, Canada would move toward a more transparent, evidence-based system that better protects patients and strengthens public confidence in medication safety.

I urge Health Canada to carefully examine Northern Ireland’s policy and work with provincial and territorial governments, coroners, medical examiners, and vital statistics agencies to implement a comparable national standard. Canadians deserve a system that accurately measures medication-related deaths and uses that knowledge to prevent future harm. It’s also valuable information to aid with creating new, improved medications. Lack of data hinders the advancement of medicine. 

Thank you for your consideration.

Louise Carter
Aka Madi’s Mom from MADI’s LAW