Conservative and New Democratic members of the Joint Committee on Medical Assisted Dying (MAID) want the expansion of MAID eligibility to people with mental illness to be paused indefinitely.
The government has already suspended this extension of medical assistance in dying once, but this measure ends on March 17.
This parliamentary committee, made up of 15 representatives and senators from several parties, was commissioned by the federal government last fall to determine whether the health system is ready for this expansion. He must submit his report by January 31, then the government will make a decision.
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Federal Health Minister Mark Holland has not ruled out a further delay in opening the euthanasia program for people with mental illnesses. (archive photo)
Photo: The Canadian Press / Christine Muschi
An extension of this pause would require the government to enact legislation that is expected to receive royal assent before the March 17 deadline.
“We are fully aware that there is an equivalence between physical and mental suffering,” states Minister Holland. But we have to make sure that the support is there, that the training is there.
The committee is catching up
The parliamentary committee was formed in 2021 after Parliament passed a bill extending medical assistance in dying to people with mental illness.
The bill was amended when senators voted to set an 18-month deadline for mental illness exclusions to give federal, provincial, territorial and medical associations time to develop appropriate policies and protections.
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New Democratic MP Alistair MacGregor believes the federal government should slow the expansion of the medical aid-in-dying program. (archive photo)
Photo: The Canadian Press / Justin Tang
British Columbia NDP MP Alistair MacGregor, one of the committee's co-chairs, believes the law was changed without proper consultation, leaving parliamentarians and many civil society actors in the lurch.
All this shows that the Liberals have mismanaged this file from the start, which now leaves us in a kind of legal limbo.
Witnesses from the legal and medical communities gave committee members a wide range of perspectives from both sides on this very sensitive issue.
Committee member Michael Cooper, Conservative MP for St. Albert-Edmonton, admits he was influenced by psychiatrists who told the committee that it was difficult, if not impossible, for health professionals to decide that a mental illness should not be treated or that an application for MAID by a person suffering from mental illness is rational or motivated by suicidal thoughts.
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Conservative MP Michael Cooper points out that his party opposed the planned expansion of the euthanasia program to include mental illness. (archive photo)
Photo: The Canadian Press / Adrian Wyld
Canada is not ready […]. These liberals prioritize ideology over evidence-based decision making.
For his part, Nova Scotia Senator Stanley Kutcher, also a member of the committee, believes that Canadians suffering from terminal mental illnesses deserve the same rights as those suffering from serious physical illnesses.
I think we need to be guided by…compassion […]. “We cannot ignore the fact that some people are allowed to make end-of-life decisions,” said Mr. Kutcher, a trained psychiatrist.
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Senator Stanley Kutcher is calling on the federal government to allow additional health insurance for people whose only medical problem is mental illness. (archive photo)
Photo: CBC / Photo provided
Federal Health Minister Mark Holland acknowledged that questions had been raised by the two experts who testified before the committee, as well as by the provincial and territorial governments, and did not rule out another postponement.
The Quebec government, which has addressed the issue in the past, is not considering extending medical assistance in dying to people with mental illnesses. The province has stated that mental illness is not considered a disease under MAID.
Is Canada ready?
Helen Long, CEO of Dying With Dignity Canada, believes the government is ready to move forward. She emphasizes that he has met three essential requirements in order to extend the right to medical assistance in dying to mental illnesses:
- expand data collection;
- create a national curriculum for health professionals;
- Develop practice standards.
Only a small number of people whose only health problem is mental illness would be eligible for MAID, namely people who have suffered for many years and tried multiple treatments.
Dr. Jitender Sareen is one of a group of eight university chairs of psychiatry who have written to federal ministers urging the committee not to extend medically assisted euthanasia to people with mental illness.
He says the standards of conduct that guide psychiatrists and clinicians are inadequate and that Canada lags behind other countries in funding mental health and addiction treatment.
Offering death to a person who had no chance of recovery with or without treatment is, in our opinion, unacceptable.
Protect the most vulnerable
Dr. Sonu Gand, a professor at the University of Toronto and head of psychiatry at Sunnybrook Health Sciences Centre, believes there were not enough safeguards to protect the most vulnerable.
If the draft law is implemented, it would be completely irresponsible, complains Dr. Gand.
Green Party leader Elizabeth May supports expanding MAID, but not without better social and economic programs, including a guaranteed minimum income.
At this point, we cannot be sure that a Canadian will not seek medical assistance in dying because they do not have a place to live or cannot afford the rent.
Since the federal law was passed in 2016, 44,958 Canadians have received medical assistance in dying.
Health Canada's latest annual report (New Window) shows that 13,241 people received medical assistance in dying in 2022, an increase of 31.2% compared to 2021.
Additionally, in 2022, 9% of MAID recipients suffered from dementia – also called severe neurocognitive disorder – which is characterized by a loss of mental abilities.
With reporting by Olivia Stefanovitch, CBC News