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Claire Brosseau has been denied access to Canada’s Medical Assistance in Dying program.COLE BURSTON/AFP/Getty Images
The federal government is prepared to table legislation that would pause the expansion of medical assistance in dying to people whose sole condition is mental illness if a parliamentary committee that is studying the issue recommends it, three sources told The Globe and Mail.
The government expects that the committee will make such a recommendation based on evidence presented in hearings and questions from MPs over the past two months, the sources said. The committee was hearing its final witnesses on Tuesday. It will write a report, with its recommendations, to be tabled in the weeks or months ahead.
The Globe is not identifying the sources, who were not authorized to disclose the government’s plans on the issue.
The potential expansion has emerged as one of the most contentious policy debates since MAID was legalized a decade ago.
Toronto woman with bipolar disorder asks Ontario court to grant her emergency MAID access
The government opened up MAID to people who were not facing imminent death in 2021, but the legislation carved out a temporary exclusion for mental illness. This meant people without physical ailments were still unable to qualify for assisted death.
That exemption was extended twice by former prime minister Justin Trudeau and is currently set to end in March of next year.
Mark Carney has not spoken about the issue, but the Prime Minister has been under pressure, including from religious figures and disability advocates, to delay it further – or scrap it altogether.
The committee has heard from physicians and Health Canada officials that the country may not be ready to move ahead, that the health care system isn’t ready for the expansion and that determining eligibility would be complex.
Ahead of Tuesday’s meeting, the Senate vice-chair of the committee, Pierre Dalphond, said he anticipates that there will be discussion on three possible recommendations: pause the expansion indefinitely, pause it for a finite period of time or allow the expansion to go ahead. Mr. Dalphond was appointed by Mr. Trudeau and is a member of the Independent Senators Group.
The final report, which will include recommendations on how to proceed, must be tabled in Parliament by Oct. 2, but it could come before the House of Commons rises in June. That would give the government the summer to draft legislation, which could then be presented to the House in the fall.
Mr. Dalphond said he personally thinks it should be paused – for now. He cited several reasons, including continuing litigation, reluctance on the part of the provinces and testimony before the committee on the complexity around mental-health diagnoses.
The parliamentary committee’s co-chairs, Liberal MP Marcus Powlowski and Conservative Senator Yonah Martin, have both previously spoken out against the expansion.
During the final hearing on Tuesday evening, two Dutch psychiatrists urged parliamentarians not to expand MAID to mental illness alone. Jim van Os, a professor of psychiatry at Utrecht University Medical Center, said the Dutch experience offered “a warning for Canada.”
Dr. van Os noted that requests for what he described as “psychiatric euthanasia” for people under 30 increased to nearly 900 per year from 30 in the past six years. Completed deaths rose five-fold. Most of those people, he noted, were traumatized, marginalized and living in poverty.
Dutch law, he said, requires that a patient exhaust all other options first. No such safeguard is in place in Canada, he added. “That single difference will in our assessments drive Canadian numbers beyond ours.”
Wilbert van Rooij, a Dutch psychiatrist with 30 years of experience, spoke of the moral toll on the psychiatry profession. Asking psychiatrists to determine when a patient should die, he said, “is a burden psychiatry was never designed to carry.”
A third Dutch psychiatrist, Sisco van Veen, took a more nuanced approach. He argued that it is “hard to justify excluding patients with psychiatric disorders whose suffering can be immense.” Dr. van Veen said that psychiatric euthanasia remains relatively rare at about 2 per cent of all cases.
The heads of psychiatry at 13 Canadian medical schools wrote to the committee last week calling for the federal government to halt the expansion to mental illness. They argued that there is no accurate way to determine when a mental disorder is incurable or to adequately protect vulnerable patients.
Psychiatry chairs at medical schools oppose expanding MAID for mental illness
In April, Sarah Lawley, an assistant deputy minister at Health Canada, told the joint committee that “capacity remains a central concern” across jurisdictions, including access to psychiatrists for consultation and broader access to services and treatments.
The concerns are also being raised outside the committee proceedings. Archbishop Frank Cardinal Leo wrote letters to the Prime Minister and MPs to support a private member’s bill, Bill C-218, that would amend the Criminal Code to bar MAID from being provided when mental illness is the sole underlying condition.
The bill was introduced by Conservative MP Tamara Jansen last June and is currently at second reading in the Commons. Ms. Jansen is among the Conservative MPs on the committee.
Last year, the UN Committee on the Rights of Persons with Disabilities also recommended that Ottawa repeal MAID for anyone without a terminal illness, warning that allowing people to access it for mental health conditions would harm people with disabilities.
Proponents of MAID access, including advocacy organization Dying with Dignity, have argued for the law to be expanded to people with mental illness. The group contends that the current prohibition is discriminatory and could lead some patients to turn to suicide.
Canada’s original MAID law was enacted in June, 2016, after a decision from the Supreme Court of Canada. It allowed patients whose deaths were deemed “reasonably foreseeable” to seek the help of medical professionals to end their lives.
In 2021, the law was updated after a Quebec court decision to allow patients with incurable conditions such as multiple sclerosis to seek to end their lives. At the same time, the government excluded people whose only condition is mental illness for two years to allow for more time to study how MAID could be delivered to such patients.
Patients living with mental illness, including 49-year-old Toronto resident Claire Brosseau, say it is unacceptable for the government to delay granting MAID to patients who live with mental illness.
Ms. Brosseau, who was diagnosed with Bipolar 1, a type of bipolar disorder, 35 years ago, filed for “emergency relief” in Ontario Superior Court on Monday for permission for a physician-assisted death.
In August, 2024, Ms. Brosseau filed a lawsuit with Dying with Dignity Canada in Ontario Superior Court, arguing that her rights are being violated because she cannot legally access the procedure. That lawsuit remains before the courts.
