OTTAWA—Canada has announced that it will delay extension of medically assisted death to people suffering exclusively from mental health issues. The Investigative Journalism Bureau published an analysis that shows Canada is outpacing all 10 other countries who have adopted the contentious ‘end of life’ program, offering assisted death to terminally and chronically ill patients. The plan to extend the program to persons with mental illnesses has been met with criticism, citing a lack of adequate psychiatric care and likening the program to eugenics against those suffering with mental illness. The expansion was slated to take effect on March 17, 2024, after then-justice minister David Lametti paused the expansion last year.
Some critics attribute the issue to an insufficient availability of proper psychiatric care in the nation. The contentious policy in Canada would permit individuals with an incurable medical condition to seek assisted suicide, even if the ailment is not terminal, positioning the law as one of the most lenient assisted suicide programs globally. Canada adopted medically assisted dying following a 2015 Supreme Court decision, asserting that compelling individuals to endure intolerable suffering violated fundamental rights to liberty and security. In 2021, the law was expanded to encompass individuals facing “grievous and irremediable” conditions, including depression and other mental health concerns. More than 13,000 Canadians were euthanized during the pilot in 2022.
Health Minister Mark Holland said that provincial and territorial ministers of health have unanimously asserted that their health systems are not prepared to integrate the expansion. Health authorities are delaying the expansion of the program, citing a shortage of doctors, particularly psychiatrists, in Canada to assess individuals with mental illnesses seeking assisted dying.
“Although the curriculum is present, although the guidelines are set, there has not been enough time for people to be trained on them, and provinces and territories are saying their systems are not ready and need more time,” he added.
Justice Minister Arif Virani emphasized that although healthcare is administered provincially, MAiD legislation pertains to the Criminal Code of Canada, and any expansion cannot occur on a province-by-province basis. He highlights the significance of implementing MAiD nationally, rather than on a province-by-province basis, as seen since 2016 when the legislation was first introduced and expanded. Minister Virani underscores the national approach in the implementation and expansion of MAiD.
The program has become a divisive topic among Canadians. In a poll conducted in September of 2023 by the Angus Reid Foundation in partnership with Cardus, a non-partisan think tank found that among a representative randomized sample of 1,872 Canadian adults, more than eight in 10 Canadians agree that euthanasia and assisted suicide eligibility “should not be expanded without improving access to mental health care first.”
The survey also revealed the following: 88 percent believe individuals with mental illness should be presented with all treatment options before considering euthanasia or assisted suicide; 52 percent are concerned that prioritizing eligibility for euthanasia and assisted suicide may diminish the focus on treating mental health; and 64 percent express apprehension that expanding eligibility could increase vulnerability for those already facing challenges in accessing mental health care.
Rebecca Vachon, the health program director at Cardus, emphasizes the importance of addressing the current challenges in the availability and accessibility of mental health care in Canada before proceeding with the expansion of MAiD.
Ms. Vachon criticizes the federal government’s expansion plans as irresponsible, particularly the intention to allow MAiD solely for mental illness as of March 2024. She asserts that Canadians are expressing a clear desire for improved access to mental health services, urging the federal government to prioritize addressing this need before advancing with MAiD expansion.
Dying With Dignity Canada, a proponent of medical assistance in dying, has released a statement in response to the recent news, calling on the Canadian government to clarify its course of action.
Expressing disappointment, the group empathizes with individuals nationwide grappling with treatment-resistant mental disorders. They voice frustration at the persistent exclusion, stigmatization, and discrimination based on diagnosis, particularly for those who have patiently awaited changes in Canada’s MAiD law.
