In a recent development, the federal government has declared its intention to once again postpone the expansion of medical assistance in dying (MAID) provisions to include individuals solely suffering from mental illnesses. This marks the second delay sought by the government since the Superior Court of Quebec invalidated the initial 2016 MAID legislation, deeming it restrictive to cases where death was "reasonably foreseeable."
Health Minister Mark Holland and Justice Minister Arif Virani unveiled this decision outside the House of Commons on Monday, citing Canada's health system unprepared for the proposed MAID expansion. Holland emphasized the necessity of ensuring the system is adequately equipped and operational, stating, "It's clear from the conversations we've had that the system is not ready, and we need more time." However, no specific timeline for the delay was disclosed, with details expected to accompany the introduction of new legislation.
Insider sources indicate that the expansion is unlikely to proceed before the next federal election. In 2021, new legislation postponed the MAID extension for individuals with mental illness by two years, subsequently extended to March 17 of the current year. A special committee composed of 15 MPs and senators was convened by the federal government last fall to assess the healthcare system's readiness for the proposed expansion.
Following consultations with numerous witnesses, the committee released a report on Monday affirming that Canada is not adequately prepared for such an extension. While acknowledging some progress, such as the development of national guidelines, the committee questioned the availability of trained practitioners, including psychiatrists, to assess and administer MAID for individuals with mental illnesses. The report recommended delaying assisted dying for this demographic until the government is satisfied with safety and adequacy.
Health Minister Holland indicated that the government concurs with the committee's findings and will present its response to the report. He emphasized the need for additional time for training on the guidelines and expressed agreement with provinces and territories citing their unpreparedness.
Conservative MP Michael Cooper, a committee member, called for an indefinite pause, highlighting challenges faced by medical professionals in determining untreatable mental illnesses. Three senators from the committee submitted a dissenting report, arguing that delaying the expansion would discriminate against those with mental illnesses.
Dying with Dignity Canada urged the government to present a clear plan for moving forward, expressing disappointment for those affected by the continued exclusion. Health Minister Holland acknowledged the plight of individuals awaiting MAID access but stressed the broader need to ensure the system's preparedness.
New legislation must be passed to effect the delay, with Health Minister Holland assuring its imminent tabling. Justice Minister Virani stated their commitment to meeting the prescribed deadline.
In 2022, Health Canada reported a 31.2% increase in medically assisted deaths, with 13,241 individuals receiving this assistance. Since the introduction of federal legislation in 2016, a total of 44,958 people have undergone medically assisted deaths.