Parliamentary panel studying MAID mental health expansion is biased: expert

An expert in Canada’s assisted dying laws is warning that the committee of MPs and senators tasked with studying whether the country is ready to allow people with mental illness to access MAID has “gone off the rails.”

Jocelyn Downie, a professor emeritus of law at Dalhousie University who has studied medical assistance in dying for decades, said the committee is hearing testimony that’s unrelated to its mandate and is heavily weighted toward people opposed to extending MAID to cover mental illness.

“The risk is that they will make their decision based on an incomplete set of evidence, and that’s inappropriate for public policy,” she said.

The committee’s mandate is “to undertake a comprehensive review relating to the eligibility of persons whose sole underlying medical condition is a mental illness to receive medical assistance in dying.”

Its work is set to wrap up in time to give advice to Parliament before March 2027, the date that MAID is set to become legal for that group.

Canada legalized medical assistance in dying in 2016 following a ruling from the Supreme Court of Canada that struck down sections of the Criminal Code that made it illegal to help someone end their life.

In 2021, the Liberal government passed a new law in response to a ruling in Quebec Superior Court that found it was unconstitutional to restrict assisted dying to people whose deaths were reasonably foreseeable.

The expanded legislation included a clause that would allow people suffering solely from a mental disorder to be considered for an assisted death, provided they meet a stringent set of eligibility criteria.

After concerns were raised by mental health professionals and provinces about the complicated nature of those assessments, the government decided to delay the extension until 2027 to give provincial health systems and health care workers time to prepare.

The committee is supposed to determine if that preparation has happened.

2:50 Federal government delays MAiD for mental health until 2027

Downie spoke to the committee alongside Dr. Trudo Lemmens, a professor of health law and policy at the University of Toronto who opposes the extension.

Lemmens argued that Canada lacks adequate mental health treatment options and told the committee that “Canada’s MAID law and policy emphasize access over protection.”

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That disagreement is important for the committee to consider, Downie said, but “since then, it’s gone off the rails.”

The Canadian Psychiatric Association, which has developed a clinical guidance document for MAID assessments, has not been invited to the committee.

The association sent a letter to the committee this week to refute what it said were a series of false statements made in testimony on April 14 about its clinical guidance.

The letter ends with an offer.

“The CPA would be pleased to testify before the committee to provide accurate information about the development of this document and its purpose,” said the letter, signed by MAID guidance development committee chair Paul Links and chair of the association’s board of directors Alison Freeland.

At the most recent meeting on Tuesday, some committee members and one witness openly expressed their concerns.

Daphne Gilbert, a law professor at the University of Ottawa and board chair of the advocacy group Dying with Dignity, began her remarks Tuesday by noting she was “the odd person out” among the 10 witnesses.

Gilbert also said she had planned to focus on MAID where mental illness is the sole underlying condition, “as I understand this committee’s mandate to be limited to that issue,” noting the previous panel was focused on disability advocates speaking about issues with the existing system.

“The testimony has been quite imbalanced,” Sen. Pamela Wallin said toward the end of the three-hour meeting.

The committee’s co-chairs, Liberal MP Marcus Powlowski and Conservative Sen. Yonah Martin, are both opposed to the extension.

Powlowski said in an interview the witnesses are chosen from a list suggested by all members.

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The four Conservative members include Tamara Jansen, who introduced a private member’s bill to stop the extension, and Andrew Lawton, who has shared his personal story of recovery from mental health struggles in supporting Jansen’s bill.

There are also four Liberal members, one from the Bloc Québécois, and five from the Senate.

If there’s more opposition to the extension than in past years, Powlowski said, “perhaps (that’s) because the membership and the beliefs of those on the committee have changed.”

On Tuesday the committee heard from Christopher Lyon, an environmental social scientist who has been opposing MAID since his father died with medical assistance.

Lyon argued during the meeting that MAID is “creating a legal form of serial killing,” a notion that Wallin rejected.

Downie said spending time “relitigating” the existing law is “entirely inappropriate” and risks undermining the current system.

Powlowski argued opinions on the existing legal framework are relevant to the committee’s work.

“If people feel that the existing regime has holes in it, then that may have direct relevance to expanding the system,” he said.

The concerns about the committee are not new.

When a previous iteration reported to Parliament in 2024 that the country was not prepared for the extension, three senators wrote a dissenting opinion urging the government to reject the conclusion because “the committee failed to do its work objectively and in an unbiased manner.”

A spokesperson for Health Minister Marjorie Michel did not answer specific questions but said in a statement that the government is closely following the committee’s work.