Committee recommends indefinite exclusion
Canada should ‘indefinitely exclude’ people with mental illness from assisted dying, report says
Canada’s assisted dying laws should “indefinitely exclude” people whose sole condition is a mental illness, a new parliamentary committee report recommends.
The debate around expanding medical assistance in dying, known as MAID, to people with mental illness is one of the most contentious in Canada since the country allowed the end-of-life policy a decade ago.
Wednesday’s report by the joint House and Senate committee on Medical Assistance in Dying could guide how – and if – Canada chooses to move forwards on the already twice-delayed expansion of the programme.
Last month, Prime Minister Mark Carney said he would wait for the report before deciding on next steps.
The joint parliamentary committee’s 98-page report contains a single recommendation: that Canada “indefinitely exclude persons whose sole underlying medical condition is a mental illness from eligibility for medical assistance in dying”.
It noted that there are a “divergence of perspectives” on the issue, and that a recurring point raised in testimony before the committee was the “pressing need for increased and more equitable access to adequate mental health services”.
Some committee members, however, disagreed with the findings and published a dissenting report, arguing the process was “fundamentally flawed”, “biased” and favoured testimony from those opposed to the expansion.
“When you have bad inputs, you have bad outputs,” Kristopher Wells, a dissenting senator from Alberta, told the BBC. “That is why we’re calling into question the reliability and the credibility of the report and the recommendation.”
Canada’s government must respond to the report by 11 July.
Expansion delayed twice
In 2023, Canada first delayed eligibility for MAID for people suffering solely from a mental illness for a year over concerns the health system was not ready for the expansion, before again delaying it again to 17 March 2027.
Along with the second delay, the government recommended a parliamentary committee undertake a comprehensive review of the plans.
Earlier this year, that committee held a series of hearings where medical experts and advocates testified on the current assisted dying scheme and the potential impact of its expansion.
The committee also heard from European experts whose countries allow assisted dying solely for mental illness, such as the Netherlands, Belgium and Luxembourg.
Their recommendation was hailed by the Conservative opposition as one that “will save thousands of lives”.
“Moving forward with this expansion is reckless and dangerous,” said Conservative MP Tamara Jansen on Wednesday.
She called for an expansion for people solely with mental illness to be “permanently repealed”.
The prime minister has not yet taken a public position on the matter.
Carney’s government would need to pass new legislation if it wanted to further delay the MAID expansion.
Legal challenges continue
But whatever his government decides may not end the debate.
Dr Sonu Gaind, a University of Toronto professor and a witness who testified to the panel against expanding MAID for mental illness, told the BBC that such a move “would have started providing death to suicidal people struggling with mental illness who could have gotten better”.
“Assessors cannot predict when a mental illness won’t improve, in fact flipping a coin would be more accurate,” he added.
There are several legal challenges against Canada’s mental illness exemption, including one launched by Claire Brousseau, a 49-year-old Toronto woman with bipolar disorder and PTSD who wants access to MAID.
Canada’s current assisted dying laws are a result of similar legal challenges.
It first allowed medically assisted dying for terminally ill adults whose death was “reasonably foreseeable” in 2016 following a successful Supreme Court challenge.
Three years later, following a Quebec court battle, it was extended to people with chronic illnesses whose natural death is not imminent.
Wells and the other dissenting senators argued the latest debate over MAID and mental illness should be decided by the Supreme Court.
Speaking to the BBC on Wednesday, Brousseau said she was not surprised by the committee’s recommendation to halt the expansion of MAID.
She added she hopes she will be granted access to the procedure through her legal challenge, arguing the exclusion of people with mental illness is unconstitutional.
“Every time they delay it, people like me live it in real time. Those are days and years that we suffer,” Brousseau said.
Public opinion divided
MAID makes up around 5% of all deaths in Canada, according to 2024 figures, the latest available.
About 96% of MAID requests were granted to people whose death was foreseeable – mostly terminal cancer patients.
The remaining 4% were patients whose death was not imminent, but who had a “grievous and irremediable medical condition”.
A poll by Canadian firm Angus Reid released earlier this month suggested that the majority of Canadians supported MAID – about 77%.
But that support fell to 42% when it came to allowing access for those whose sole condition is a mental illness.
Source: BBC
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