Canada says it will not extend assisted dying to people with mental illness alone

Canada's justice minister announced on Wednesday that the government will not extend medically assisted dying (MAID) to people whose sole underlying condition is mental illness. The BBC and the South China Morning Post (SCMP) both reported the announcement.

Assisted dying became legal in Canada in 2016 for people at the end of life or with terminal illnesses. In 2021, eligibility was extended to people with serious and incurable conditions whose death was not imminent or reasonably foreseeable. That change followed a court case in Quebec, according to the BBC. The expansion to people with mental illness alone had already been postponed. The most recent planned date was 2027.

The planned law

The BBC identifies the minister as Sean Fraser. According to the BBC, Fraser said a new law will be introduced in the coming weeks to suspend the expansion indefinitely. The government cited a lack of consensus on who would be eligible, the BBC reports. The SCMP describes the decision as Canada not allowing such access. The reports reviewed by Vocemundi do not say whether the measure is meant to be permanent. They do not include the bill's text.

According to the BBC, the bill would also let patients with a progressing incurable illness consent to assisted dying in advance, before losing capacity. Provinces would make the final decision on this. Advance requests are not legal under federal law but are allowed in Quebec, the BBC reports.

A parliamentary committee report earlier this year recommended to "indefinitely exclude persons whose sole underlying medical condition is a mental illness", according to the BBC. Some members released a dissenting report. A federal court case challenging the earlier delay is pending. Fraser acknowledged the Supreme Court could weigh in, the BBC reports.

What is disputed

The BBC says the expansion was first set for 2023 and was delayed twice. The SCMP says it was initially set for 2024 and pushed back three years.

What each side says

The BBC quoted Fraser as saying: "while there is not a perfect consensus on this issue, we believe this is the correct approach at this particular time." He also said a lack of medical consensus on whether certain mental illnesses are irremediable "gives me real cause for concern". The SCMP reports the government had said earlier delays were meant to ensure the mental health system was ready.

The group Dying with Dignity called the decision "profoundly disappointing". Its CEO, Helen Long, said the suffering of the few people likely to be eligible "is no less real than those who live with physical illnesses", according to the BBC.

Michael Fenrick, a lawyer for plaintiff Claire Brosseau, told the BBC on Wednesday: "People will continue to suffer intolerably while the case goes through the courts." Brosseau, who has treatment-resistant bipolar 1 disorder, told the BBC earlier this year that assisted dying would offer her "a safe death".

Critics question whether medicine understands mental illnesses well enough to set eligibility. Some experts, not named in the reports, worry MAID is used where better access to housing and healthcare would serve people better. Supporters say exclusion violates constitutional rights.

According to the BBC, polls suggest most Canadians support assisted dying, but support falls for mental illness alone. The reports do not identify the polls.

Analysis

By suspending the expansion indefinitely, the announcement appears to shift the question from when it will happen to whether it will happen at all. Several paths remain open. Fraser said the bill will be introduced in the coming weeks, but the reports reviewed by Vocemundi do not describe when it might pass or its final wording. The pending federal court case could test the exclusion against constitutional rights, and the minister has acknowledged the Supreme Court could become involved. The advance-request provision, if enacted, could lead to different rules across provinces. As the BBC reports it, the debate pits concerns about whether medicine understands mental illness well enough to set eligibility against advocates' argument that people with mental illness alone should have the same rights as other patients.

Produced by the Vocemundi newsroom with AI assistance.