Liberals announce bill to prohibit MAID for mental illness alone

OTTAWA — The federal government intends to permanently bar people with mental illness alone from accessing an assisted death, settling a decade-long controversial debate.

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But the Liberal government is moving forward to allow people to make advance requests for MAID if they are diagnosed with an illness that would threaten their ability to provide final consent before the lethal injection.

The announcement was made Wednesday by Justice Minister Sean Fraser and Health Minister Marjorie Michel on the same day the House of Commons is set to vote on a Conservative bill on the topic.

The ministers said they intend to table legislation this fall that will maintain the indefinite exclusion of mental illness as a sole condition for a medical assistance in dying (MAID) application. The exclusion was currently suspended until March.

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

Whether to open up euthanasia to people whose sole underlying medical condition is a mental illness has been one of the most heated issues in the history of legalized assisted death in Canada.

In June, a special parliamentary committee recommended the Liberal government draw a line in the sand and indefinitely exclude people with mental illness alone from eligibility for MAID. Expanding MAID for mental illness, set to take effect March 17, 2027, had already been deferred, twice.

The joint committee of MPs and senators said key issues haven’t been addressed, including whether it’s possible to predict with any certainty whether a person’s mental illness is incurable. Dr. Sonu Gaind, past chief of psychiatry at Toronto’s Sunnybrook Health Sciences Centre, testified that doctors are right less than half the time, comparing the ability to predict long-term prognosis to a coin toss.

Current and former chairs of psychiatry departments at universities across Canada warned the committee that making MAID available to people with depression, anxiety, schizophrenia, substance abuse and other mental illnesses would facilitate avoidable deaths and erode suicide prevention efforts.

The committee said “grave concerns and deep divisions” continue to exist. A recurring theme was the pressing need for better access to mental health services and concerns long waits for care could exacerbate suffering, driving MAID requests. The committee also heard stories of “questionable conduct” by some MAID providers, as well as doctors “with a seemingly cavalier attitude toward ending a life,” committee co-chair Liberal MP Marcus Powlowski wrote in a supplemental opinion.

However, the committee’s decision wasn’t unanimous. Three senators as well as a Bloc Québécois MP, Luc Thériault, wrote dissenting opinions and called on the government to bring the question of expansion to the Supreme Court of Canada.

Earlier this week, Fraser told reporters he’d heard “a range of different views” since the committee’s report was released in June and that he wanted to take the time “to line things up the appropriate way” in deciding on such a serious issue.

First legalized in 2016 for people whose deaths are “reasonably foreseeable,” Canada’s MAID law was amended in 2021 to remove the “reasonably foreseeable” provision. The amendments under Bill C-7 also included a restriction on mental illness alone as a qualifying condition for MAID, an exclusion that was originally set to expire on March 17, 2023, but was later pushed back to 2024 and then a third time, to March 2027.

National Post

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