Canada won’t expand MAID for mental illness alone, minister says

Canada will not extend medical assistance in dying (MAID) for people who are seeking it on the basis of mental illness alone, Justice Minister Sean Fraser said.

Currently, the law excludes MAID for people seeking it on the grounds of mental illness as a sole criteria, but that rule is set to expire in March 2027. The federal government plans to table legislation this fall that will maintain that exclusion “on an indeterminate basis,” Fraser said.

“Canada has made a decision not to move forward with the expansion that is scheduled in the Criminal Code of medical assistance in dying in circumstances where mental illness is the sole basis,” he said.

A parliamentary committee was tasked with studying whether people with mental illness alone should have access to medical assistance in dying. In a June report, the committee concluded that the controversial planned eligibility expansion should not move ahead.

The previous Liberal government passed legislation in 2021 that revised eligibility criteria for MAID, but gave an additional two-year extension for mental illness eligibility to allow for further study.

That 2023 deadline was extended three more times, with the expansion previously set to come into effect in March 2027.

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“While there is not a perfect consensus on this issue, we believe this is the correct approach at this particular time,” Fraser said.

The Conservatives called for more transparency from Fraser.

“We have no idea what his bill is going to say. He’s telling us all sorts of things. He hasn’t even seen the bill himself,” Conservative MP Tamara Jansen told reporters after Fraser’s announcement.

The Bloc Quebecois welcomed the announcement but said limiting further expansion would be “abandoning patients who are suffering.”

“We have a responsibility to those who are suffering, and it is our duty not to let them down and to continue the dialogue,” Bloc MP Luc Theriault said in a statement in French.

1:00 Canada to exclude people who solely suffer from mental illness from MAiD

Fraser also said the government will “grant access to medical assistance in dying to people who have provided consent at a time when they still have capacity but know that they have been diagnosed with an illness that will take that capacity from them subsequently.”

This is sometimes referred to as “advance directive” or “advance request” in medical parlance. It often involves a competent person making a written request for MAID, with the intention that it would be honoured later, if and when they lose the capacity to make the decision for themselves: for example, in people suffering from worsening Alzheimer’s or dementia.

Currently, Canadians cannot make these decisions ahead of time.

1:45 MAID should not be allowed solely for mental illness, committee recommends

More details on the new bill would follow in the coming days, Fraser said, but added that it would include changes to the Criminal Code to ensure that a doctor who provides medical assistance in dying to someone who is eligible on an advance directive “will not be treated as a criminal in Canada going forward.”

Fraser said the federal government was following the committee’s recommendations, but some advocates have said the report had its limitations.

Advocacy group Dying With Dignity Canada raised concerns about the testimony heard by the committee. It claimed the committee selected witnesses who were opposed to allowing MAID for people with mental illness and chose not to hear from people with mental disorders who wanted to speak about why they would seek a MAID assessment.