Expansion of assisted dying for mental illness to be delayed until 2024 in new bill

Click to play video: 'Expansion of assisted dying for mental illness in Canada to be delayed until 2024'
Expansion of assisted dying for mental illness in Canada to be delayed until 2024
WATCH: Expansion of assisted dying for mental illness in Canada to be delayed until 2024 – Feb 2, 2023

The Trudeau government has tabled a bill that will delay by a year an expansion of medically assisted dying to people with mental disorders as their only underlying condition.

The bill seeks to delay the expansion until March 17, 2024.

Justice Minister David Lametti, who tabled the bill Thursday, announced in December that Ottawa intended to seek the delay after hearing concerns the health-care system might not be prepared for an expanded regime.”

“It is clear that more time is needed to get this right,” Lametti told reporters in Ottawa Thursday.

“The proposed one-year expansion is necessary to ensure that we move forward on this sensitive and complex issue in a prudent and measured way.”

Expansion of medical assistance in dying (MAiD) was set to include patients with mental illness in March due to a two-year sunset clause that was built into an update to the law in 2021.

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Most stakeholders involved in administering assisted dying would have been ready to allow the expansion to go ahead next month, Lametti said, but some provinces and regulatory bodies needed more time, due in part to delays caused by the COVID-19 pandemic.

“The safety of Canadians must come first, that’s why we’re taking the additional time necessary to get this right.”

The way the current MAiD law is written, if the bill tabled Thursday does not pass before March 17 of this year, it will have no effect and assisted dying will become available to those with mental illness under existing provisions for those whose deaths are not foreseeable.

Those provisions have more rigorous safeguards than MAiD applications from individuals whose natural deaths are imminent and foreseeable.

Lametti says he is confident the bill to delay the expansion of MAiD will pass, as he believes it has the support of both the NDP and Bloc Quebecois.

He urged the Conservatives to support it, given that they have been vocal in calling for more time.

“We call on all parliamentarians to give this bill the swift and urgent consideration it requires,” Lametti said.

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The issue led to some testy exchanges in the House of Commons Thursday, when Conservative Leader Pierre Poilievre raised concern about an increasing number of Canadians affected by increased costs of living and poverty now suffering from depression.

Click to play video: 'Veterans Affairs Canada: Agent involved in MAID controversy no longer employed'
Veterans Affairs Canada: Agent involved in MAID controversy no longer employed

He pointed to controversy that erupted in August over a Veteran’s Affairs employee who discussed MAiD with a veteran and concerns raised by the CEO of the Mississauga Food Bank saying people had come to her facility asking about assisted dying.

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In December, Veterans Affairs Minister Lawrence MacAulay said the employee had discussed MAiD with at least four veterans and was no longer employed with the department.

“Now they’ve announced that a year from today (the Liberals) will introduce measures to end the lives of people who are depressed,” Poilievre said.

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“Will they recognize that we need to treat depression and give people hope for a better life, rather than ending their lives?”

Mental Health and Addictions Minister Carolyn Bennett took strong issue with this interpretation of the MAiD expansion, calling it “irresponsible” and a misrepresentation.

“All of the assessors and providers of MAiD are purposely trained to eliminate people who are suicidal,” she said.

Government House Leader Mark Holland rejected the assertion that anyone involved in assisted dying is in favour of people taking their own lives.

“When we are talking about issues like MAiD, it is below this place to assume that any person anywhere in this country supports the idea of suicide as a way through dark times,” he said.

Medical assistance in dying was first passed into law in 2016 for Canadians suffering from physical injuries and illness, but the federal government was forced to make changes to the law in 2021 after a Quebec court ruled the law was too restrictive.

The Quebec Superior Court 2019 ruling said limiting MAiD to those whose deaths were “reasonably foreseeable” was unconstitutional.

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The government did not originally plan for the law to extend assisted dying eligibility to people whose sole underlying condition is mental illness, but the Senate added this provision to the law, arguing that excluding people with mental illness would violate their right to equal treatment.

Federal officials say the one-year delay is needed to allow the federal government to complete work underway to develop practice standards and clinical expectations for physicians and nurse practitioners who administer MAiD to complex cases involving those seeking assisted dying for mental illness.

Work on these standards began last year, and Ottawa plans to release them next month to give time to provincial and territorial regulatory bodies to determine how they will interpret and incorporate these standards into their own regulations.

The federal government is also developing a “MAiD curriculum” to help train medical professionals administering and consulting on assisted dying. These education modules will cover everything from the basic legal framework of the MAiD system to more complex issues, such as dealing with vulnerabilities of applicants.

In addition, last month, new regulations for the current assisted dying law came into effect that require more detailed reporting from provinces and territories and all assessors and providers involved in MAiD cases.

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Ottawa will collect this information in an effort to understand more about the people who are accessing MAiD and the reasons why they may be choosing this option, federal officials said Thursday.

Click to play video: 'Poilievre worried about ‘slippery slope’ for medical assistance in dying for mental health'
Poilievre worried about ‘slippery slope’ for medical assistance in dying for mental health

Additional information collected will include the race and ethnicity of applicants, whether they have a disability and what supports were offered to them.

Official data on how many Canadians accessed MAiD in 2022 have not yet been released, but federal officials said Thursday only about 500 Canadians whose deaths were not foreseeable were granted assisted dying – a number they said could indicate that uptake of the mental health extension could be similarly low.

The delay comes despite the findings of a federal expert panel that determined proper safeguards are in place and a delay was not needed.

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In December, Dr. Mona Gupta, chair of the federal MAiD expert panel, told Global News she did not believe the delay was necessary.

She noted the federal government has already followed through with its commitment to study the expansion of the law and questioned what will be accomplished by the delay.

“I do know that there are people who are opposed to this practice,” said Gupta, who is a psychiatrist and associate professor at l’Universite de Montreal.

“I do not believe that anything that could possibly happen in three months, or a year or two years, or whatever the time period is going to be, is going to change their point of view.”

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