Arif Virani, the Federal Justice Minister, has indicated that the government is currently deliberating whether to proceed with the planned expansion of medical assistance in dying to individuals whose sole underlying condition is mental illness. Virani shared his thoughts during an interview held in Ottawa on Wednesday, December 13, 2023. The discussion surrounds the potential extension of assisted dying measures in Canada. (Photograph by Sean Kilpatrick/The Canadian Press)
As the March 2024 deadline approaches, the Canadian federal government, led by the Liberals, grapples with a pivotal decision regarding the expansion of eligibility for medical assistance in dying (MAID). The choice at hand involves allowing a sunset clause to come into effect, broadening access to MAID for adults seeking it solely due to a mental disorder. Alternatively, they may opt to follow the 2023 precedent and further postpone or potentially abandon the expansion.
Justice Minister Arif Virani acknowledges that the government is carefully weighing its options, with the initial step being to consider recommendations from members of Parliament and senators after fall committee hearings.
The readiness of Canada's healthcare system has been a focal point of discussions among assessors, medical providers, and regulators. Gus Grant, CEO and registrar of Nova Scotia's College of Physicians and Surgeons, emphasizes that the system is prepared for an expanded eligibility, dismissing concerns that suggest otherwise. However, some voices, like Sonu Gaind, chief of Sunnybrook Health Sciences Centre's psychiatry department, advocate for a pause in the expansion to reevaluate key factors, such as assessing poverty and the potential for improvement in mental health conditions.
Consensus on the matter remains elusive, with divisions among MPs and senators evident during committee hearings. Conservative MP Ed Fast highlighted the lack of expert consensus, leading to the failure of his private member's bill seeking to exclude mental disorders from the assisted-dying regime. Psychiatrist Jitender Sareen suggests focusing on improving access to mental health care rather than expanding MAID.
Provincial stances vary, with Quebec passing a law in June excluding adults with a mental disorder from accessing medically assisted death. Questions regarding whether the issue has been thoroughly studied persist, as critics argue that the scope of the 2021 law's expert panel was too narrow, lacking sufficient scrutiny.
The potential for another delay prompts concerns from those advocating for the expansion. Justice Minister Virani expresses openness to extending the sunset clause, but critics argue that further delays may lead to the expansion never happening, potentially resulting in legal challenges.
The prospect of a ban on assisted dying for mental disorders could face constitutional challenges, as critics argue it may violate the equality, security, and liberty guarantees in the Canadian Charter of Rights and Freedoms. While some assert that a constitutional right to assisted dying for mental health patients may not be recognized, others warn of inevitable future court challenges.
As the government contemplates its next steps, the complex and contentious issue of expanding assisted dying eligibility for mental disorders continues to stir debate among Canadians and legal experts alike. The outcome of this decision will undoubtedly have profound implications for individuals facing intolerable suffering due to mental health conditions.
