Canada Parliament urged to expand assisted dying to patients with mental illness

The Canadian Civil Liberties Association on Thursday urged the federal government to affirm the right to seek medical assistance in dying (MAiD) of patients whose sole underlying medical condition is mental illness. The statement comes after Parliament received a report from its special joint committee, suggesting an indefinite exclusion of patients with mental illness.

In the statement, the group maintained that Parliament must not defer a constitutional right to dignity and autonomy. The group argued that the proposed exclusion would infringe their right to life, liberty, and security under Section 7 of the Canadian Charter of Rights and Freedoms. The categorical exclusion would also amount to discrimination based on mental disability under Section 15 of the Charter, the group contended.

However, the group does not dismiss concerns that Canada’s social support systems–including housing, poverty measures, and disability support–are inadequate. It may prompt MAiD requests even though the patients’ sufferings are remediable. The statement urged the government to address the system’s shortage and allow patients whose sole medical condition is mental illness to have access to MAiD.

A special joint committee reported back to Parliament on June 17. In its report, the committee concluded that medical experts across the country have not reached a consensus on its readiness. The report cited conflicting opinions in Canada’s ability to establish: evidence-informed and consensus-based criteria to differentiate a reasoned MAiD request and suicidal intent; a well-resourced mental health support system; and sufficient regulatory safeguards. The report ended with the committee’s recommendation to shelve the expansion indefinitely.

In 2015, the Supreme Court of Canada held that the criminal prohibition of MAiD violates the constitutional right to life, liberty, and security. The court reasoned that the right entails the liberty to make medical decisions and prevent intolerable suffering without having to take their lives prematurely.

After the ruling, Parliament decriminalized the provision of MAiD by medical practitioners to patients with a terminal medical condition. In 2021, Parliament removed the requirement that the patient’s natural death be reasonably foreseeable. It also attempted to make patients whose sole medical condition is mental illness eligible for MAiD. Parliament twice delayed the expansion to March 2027, citing concerns in the committee report.

The provision of MAiD to people whose sole medical condition is mental illness remains controversial across the country. In 2016, the Alberta Court of Appeal affirmed that a patient can seek MAiD if they are suffering from a grievous and irremediable medical condition, even if the condition is psychiatric. In April, the provincial legislature banned the provision of MAiD to patients whose sole medical condition is a mental illness, among other limits. Quebec also enacted a similar restriction in 2023.

The federal government is also facing a lawsuit in the Ontario Superior Court of Justice. Disability rights groups argued that the 2021 expansion “increases the risk that persons with a disability will be induced to end their lives as a response to suffering.” Inclusion Canada, one of the petitioners, renewed its appeal in May to halt the expansion to patients whose sole medical condition is a mental illness.