Liberals tabling bill to prohibit MAID for mental illness alone on Tuesday

OTTAWA — The Liberal government will table its bill permanently barring people with mental illness alone from accessing an assisted death on Tuesday, National Post has learned.

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A senior government source confirmed that the long-awaited bill would be put on the House of Commons notice paper on Friday evening and that the bill is expected to be tabled during Tuesday’s sitting. The source was granted anonymity as they were not authorized to discuss the bill publicly.

Two weeks ago, Justice Minister Sean Fraser took the unusual step of telegraphing what he expected to put into the bill, including making permanent the prohibition to medical assistance in dying (MAID) for people seeking it on the sole basis of a psychiatric illness.

Whether to open up MAID 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. Once tabled, the bill will certainly be hotly debated by MPs as well as advocates and critics of MAID.

He also announced the bill would allow people to make advance requests for MAID if diagnosed with an illness that would threaten their ability to provide final consent, up to the last moments before the lethal injection.

On Friday, the source reaffirmed that that would be done by decriminalizing the act for doctors who administer MAID to patients who made an advance request. It will then be up to provinces to determine if they want to allow advance requests for MAID.

Outside Quebec, euthanizing someone in the absence of capacity is a serious offence in the absence of a valid waiver of final consent. While Quebec has permitted the practice since 2024, Alberta has already banned advance requests.

Foreshadowing the bill, Fraser said on Oct. 7 that the legislation will grant access to MAID “to people who have provided consent at a time when they still have capacity but know that they have been diagnosed with an illness that will take that capacity from them subsequently.

“These are not easy decisions. But we believe they are the correct ones,” the minister said.

Following the announcement, some groups expressed concern that individuals might be coerced into signing advance requests for MAID and called for further safeguards.

In a statement Wednesday, Dementia Justice Canada called on the government to require an independent legal assessment by a lawyer before death.

“Requiring independent legal advice before an advance request is signed could help ensure that the person understands the request and makes it freely,” reads a release by group chair and lawyer Heather Campbell Pope.

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, told the committee 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. Fraser has declined to do so.

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 again, to March 2027.

Currently, dementia is an eligible diagnosis for MAID in Canada, provided people have the capacity to make a reasoned request and don’t lose that capacity before they want their lives ended. Dementia is considered a neurological disorder, not a mental illness.

National Post, with files from Sharon Kirkey

Cnardi@postmedia.com

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