Federal government seeking another pause on planned expansion of medical assistance in dying
MAID won't be extended to cover cases of mental illness before next election, sources say
The federal government has announced it is seeking another pause on medical assistance in dying (MAID) provisions that would cover those suffering solely from mental illnesses.
This is the second time the government has sought to delay the expansion of MAID since the Superior Court of Quebec struck down the government's original 2016 MAID legislation because it was limited to those whose deaths were "reasonably foreseeable."
Health Minister Mark Holland and Justice Minister Arif Virani made the announcement Monday outside the House of Commons. Holland said Canada's health system is still "not ready" for the MAID expansion.
"The system needs to be ready and we need to get it right," he said. "It's clear from the conversations we've had that the system is not ready and we need more time."
Holland didn't say how long the government is seeking to delay the expansion. He indicated the timeline would be outlined once the government tables new legislation.
Two government sources have told Radio-Canada the expansion won't happen before the next federal election.
New legislation passed in 2021 delayed by two years the extension of MAID to include those who suffer from mental illness. That deadline was later pushed back to March 17 of this year.
A special committee, made up of 15 MPs and senators, was tasked by the federal government last fall with determining whether the health-care system is prepared for the expansion.
After hearing from dozens of witnesses, the committee released a report Monday concluding that Canada is not ready for such an expansion.
Although the committee noted that some steps have been taken to prepare for the expansion — including the development of national guidelines — it questioned whether there are enough trained practitioners, including psychiatrists, to assess patients and administer MAID for those with mental illnesses.
The report said assisted dying for those with mental illnesses should be delayed until the government is "satisfied, based on recommendations from their respective departments and in consultation with their provincial and territorial counterparts and with Indigenous Peoples, that it can be safely and adequately provided."
Holland said the government will table its response to the report. He added he agrees with the committee.
"Although the guidelines are set, there has not been enough time for people to be trained on them. Provinces and territories are saying their systems are not ready and need more time," he said.
Conservative MP Michael Cooper, a member of the special committee, called on the government to pause the expansion indefinitely. He pointed to testimony from psychiatrists who told the committee it would be difficult — if not impossible — for medical professionals to decide whether a mental illness is beyond treatment.
"Kicking the can down the road … is completely insufficient," he said. "I don't see any indication that the fundamental issues that are at the heart — or should be at the heart — of putting a pause on this expansion will be resolved."
Three senators from the committee – Sen. Stan Kutcher, Sen. Marie-Françoise Mégie and Sen. Pamela Wallin – wrote a dissenting report arguing that delaying the expansion would discriminate against those suffering from mental illness.
"This is genuinely a matter of life and death. The government should not renege on its promise to respect an individual's right to choose," Wallin said in a statement.
Dying with Dignity Canada called on the government to quickly present a "clear plan of action" for moving forward.
"For the people across the country who live with treatment-resistant mental disorders who have patiently waited for this change in Canada's MAID law, Dying With Dignity Canada is disheartened and shares the frustration of the continued exclusion, stigmatization and discrimination based on diagnosis," the advocacy group said in a media statement.
Asked about those with mental illnesses who have been waiting to access MAID, Holland said he "cannot imagine their circumstance" but insisted the government needs to ensure the health-care system is prepared for the expansion.
"I have not had the opportunity to directly talk with such individuals, but I have an opportunity to talk to their physicians and it's an absolute nightmare and it's horrid that anybody could be in that circumstance," he said.
"This is going to mean those individuals are going to have to wait a little longer. But I think those individuals would understand the broader need to get it right and make sure our system is prepared."
The government will have to pass new legislation in order to push the deadline back again. Holland said legislation will be tabled "imminently" and Virani said they're aiming to pass it before the deadline.
"We understand the necessity of acting quickly because of the date that is currently prescribed in legislation," Virani said. "We intend on meeting that deadline."
Health Canada reported 13,241 people received medically assisted deaths in 2022 — a 31.2 per cent jump over 2021.
It said 44,958 people have received medically assisted deaths since the introduction of federal legislation in 2016.
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With files from Louis Blouin