Committee to recommend Liberals indefinitely pause expanding MAID for mental illness: sources

A special parliamentary committee is expected to recommend the federal government halt the expansion of MAID to those whose sole condition is a mental disorder, the latest development in a drawn-out and controversial chapter in the country’s assisted-death regime.

The joint committee of senators and MPs struck to revisit Canada’s preparedness for medical assistance in dying for those with mental illness alone is expected to recommend an “indefinite pause” on the expansion, two sources told National Post. They spoke on the condition of anonymity as they are not authorized to speak on the committee’s behalf.

A temporary exclusion is set to be lifted in March 2027.

In total, the committee heard from 44 witnesses and received 32 briefs, many opposed to granting MAID eligibility based solely on mental illness over several core issues, including whether it’s possible to determine with any degree of certainty when psychiatric suffering has become “irremediable,” essentially incurable, and a lack of access to mental health care and supports.

Three senators on the 17-member committee are expected to issue a dissenting report.

In February 2024, the Liberal government passed legislation delaying the implementation of MAID for mental illness until next March. The joint committee was reconvened earlier this year to once again re-assess the country’s readiness for the expansion.

Ottawa is currently awaiting the committee’s final report, expected to be tabled in the House of Commons Wednesday — the 10th anniversary of the legalization of assisted death in Canada — before deciding whether to continue with the 2027 timeline.

Sixteen current and former chairs of psychiatry departments across Canada, and more than 90 disability and mental health organizations, appealed to the joint committee to halt extending MAID to include mental disorders as the sole underlying medical condition.

Signatories to the letter from psychiatrists warned that there is no broadly accepted definition of irremediability and that “people can and do recover from prolonged suffering” from depression, anxiety, schizophrenia and other mental health disorders when provided appropriate treatments and support.

Alberta is moving to exclude MAID for mental illness alone. In June 2023, Quebec’s Bill 11 passed stating that a mental disorder other than a neurocognitive disorder does not make a person eligible for MAID in Quebec.

A medical leader from Nova Scotia said the maritime province was ready to expand MAID for mental illness, while Quebec’s minister of health and social services wrote to the committee, expressing Quebec’s opposition to the expansion. But no other province made themselves available to testify at the committee, sources said.

Proponents of expansion told the joint committee people with mental illness can experience distress as profound as those with physical illnesses and should not be discriminated against or treated as “second-class citizens.” Some warned people would die by suicide if there is a further extension or permanent exclusion.

Leaders of Canada’s MAID assessors and providers said MAID for mental illness would only be available in rare circumstances and only after careful evaluation.

Senators and MPs face several options: allow the “sunset” clause to expire, which would open MAID for mental illness after March of next year; call for an indefinite pause; or recommend another temporary pause followed by another mandatory review — “which would basically be kicking the can down the road a couple more years,” committee co-chair Liberal MP Marcus Powlowski said in an interview with National Post in May following the final day of testimony from witnesses.

Powlowski was not giving interviews in advance of the report’s release Wednesday.

An indefinite pause would mean the issue “could recur in three or four or five or 20 years, but for the time being, we would say that we are not allowing MAID for mental illness,” Powlowski said in May.

“Some might argue a clear ‘yes’ or ‘no’ is a preferable answer. Some might argue we have to find more consensus. There are some issues that have been identified as key issues, like the issue of irremediability, the issue of being able to differentiate suicidality versus a genuine request for MAID for mental illness.

“Some people might believe in two or three years we might be better able to answer that question,” he said.

“But I am also sensitive to the suggestion that we should come to a conclusion rather than revisiting this in two or three years” a decision he said would be left to the committee as a whole, “not just me.” Powlowski, a doctor who practised emergency medicine for 35 years, is opposed to the expansion of MAID for those whose sole underlying condition is a mental disorder.

The committee also heard concerns about the regulatory infrastructure for dealing with complaints related to MAID. “We’ve heard that. I think that is relevant. I don’t want to comment on where that leads in terms of a decision,” Powlowski said.

While the current temporary exclusion is facing constitutional challenges in court, “I think the big question is, is not allowing MAID for mental illness a reasonable limitation under Section 1” of the Canadian Charter of Rights and Freedoms, he said. Section 1 states that rights and freedoms under the Charter are not absolute and can be reasonably limited “to protect other rights or important national values,” according to an official government website.

“That’s really the question,” Powlowski said in May. “And we, the elected representatives I think, are the appropriate people to be making that analysis. We are in the process of trying to come to a conclusion collectively on that issue.”

The Globe and Mail has reported that the federal government is prepared to table legislation halting the 2027 expansion if recommended by the joint committee.

A private member’s bill introduced by Conservative MP Tamara Jansen last year would amend the Criminal Code to permanently stop the expansion.

The committee’s final report comes amid recent reports of several controversial MAID deaths, including an Ontario man with Crohn’s disease and a history of depression who was assessed for MAID outside Tim Hortons and, six months later, driven by the MAID provider to an industrial-like complex where bodies are prepared for funerals for the MAID provision, and the December death of 26-year-old Kiano Vafaeian, who was denied MAID in Ontario multiple times but died by MAID in a Vancouver funeral home.

National Post

• Ontario man dies of MAID after being assessed outside Tim Hortons
• ‘My message to Canada: do not expand’: Dutch psychiatrists warn on MAID

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