The federal government is considering whether to pause its original plan to broaden the rules that govern medically assisted dying so they include patients whose only underlying condition is a mental disorder.
“We’re weighing our options,” Justice Minister Arif Virani said Thursday.
It would be the second time the federal Liberals have hit pause on the plan. The first came in February, when the government decided to impose a one-year delay amid widespread public and political concern.
That decision established a new deadline of March 2024 – one that now appears in jeopardy. Cabinet will consider the input of a joint parliamentary committee, as well as medical experts and other stakeholders, Virani said.
“We’ll evaluate all of that comprehensively to make a decision whether we move ahead on March 17, or whether we pause,” he told The Canadian Press in a wide-ranging interview.
Both options are “on the table,” he added.
Back in February, Virani’s predecessor David Lametti said the government could have pressed ahead with its schedule, but opted instead to give medical professionals more time to prepare for the change.
“We strongly believe,” Lametti said at the time, that an extension would “provide sufficient time to ensure our health-care system protects those who may be vulnerable and support autonomy and freedom of choice.”
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Medical assistance in dying was effectively legalized in Canada in 2016. Three years later, the Superior Court of Quebec declared the original criteria – adults with a “reasonable foreseeability of natural death” – unconstitutional.
Senators, too, argued that excluding those with a qualifying mental disorder was a violation of their rights. Prime Minister Justin Trudeau’s government ultimately agreed to expand eligibility in 2021.
That ushered in a two-year sunset clause that was set to expire last March, before the Liberals moved to delay it by an extra year.
Virani says the idea is either to let the provision sunset on March 17 “or to pause it further.”
“Those are the two options that we’re looking at.”
A small handful of countries in Europe already allow adults whose sole medical condition is a mental disorder to seek medical assistance in dying. Whether Canada should follow suit is a question that has sparked fierce debate.
Supporters say expanding the regime provides choice for those who are suffering and have no other options; denying it violates their rights. Some disability advocates, however, say proper mental-health supports are a better option.
Other organizations, like the Centre for Addiction and Mental Health, note there is no clear medical consensus on what constitutes a “grievous and irremediable” mental illness, or on how to distinguish that from suicidality.
Virani says the first step will be to evaluate what a special joint committee of MPs and senators studying the matter will recommend. The committee was reconvened after the government imposed the original delay.
Members of the committee have adopted the report but have until the end of January to present it to the House of Commons, co-chair Rene Arseneault, a Liberal MP from Quebec, said in a statement.
“Canadians should be following what that committee recommends, because we’re very keen on ensuring that the system is ready,” Virani said.
“That will inform what we do on March 17 – whether we move ahead with mental illness as a sole underlying condition – or not.”
The decision to seek medical assistance to end one’s life is a “fundamental personal choice,” he added.
The government, he said, is “very actively listening” to those voices that say Canada is not ready for an expansion into mental illness.
Federal Conservative Leader Pierre Poilievre has already committed to scrapping the expansion plans if he forms the next government.
Some Liberal MPs also oppose the idea.
Eight of them broke ranks in October and backed a Conservative private member’s bill that would have amended the Criminal Code to expressly prohibit the use of a mental disorder as a basis for choosing medical help to end one’s life.
The bill went down to defeat, with the majority of Liberal and NDP MPs and all Bloc Quebecois MPs opposing it.
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