Photo: Sean Kilpatrick The Canadian Press Federal Health Minister Mark Holland presented a bill Thursday morning that would postpone this change until well after the next federal election, scheduled for 2025.
The Canadian Press in Ottawa
February 1, 2024
- Canada
Canadian adults who wish to cite mental illness as the sole reason for obtaining medical assistance in dying will likely have to wait at least three more years, the Liberal government said Thursday.
Federal Health Minister Mark Holland has introduced legislation that, if passed, would delay until March 2027 the government's intention to expand the medically assisted dying program to include people whose ” the only medical problem is mental illness.”
This would then be the second postponement for this enlargement; Last March, the Liberals added a year to the deadline, just before this change came into force. The next implementation date, in March 2027, has now been pushed back well beyond the next federal election, which must take place no later than fall 2025.
Also read
- Canada not ready to extend assisted dying to mental disorders
- Canadian provinces call to suspend the expansion of assisted dying
- Quebec relieved by the postponement of the expansion of medical assistance in dying by Ottawa
If he forms the next government, Conservative leader Pierre Poilievre has promised to completely abandon this enlargement.
Nearly three years have passed since the Liberals first passed legislation that would no longer exclude mental disorders as valid grounds for obtaining medical assistance in dying in Canada.
But Minister Holland said Thursday that the country was still not ready for the change. “It’s extremely difficult. It’s extremely sensitive,” he stressed at a press conference in Ottawa.
Minister Holland and his Justice colleague, Arif Virani, say they agree with the conclusion of a “special joint committee” on this issue, which found that Canada was simply not ready.< /p>
Doubts persist about the number of properly trained health professionals in the country, as well as how clinicians could tell the difference between a person who harbors temporary suicidal thoughts and another who asks for help. “rational” way medical assistance in dying to escape an incurable mental illness.
Some also wonder if clinicians could determine whether a person with mental illness is likely to improve.
More time, but not indefinitely
Minister Holland indicated that each province and territory had reservations and that his government had decided to give them more time.
Following the publication of the special joint committee's report on Monday, almost all provinces and territories asked Ottawa, in a joint letter, for an “indefinite pause” in this draft enlargement.
But the Minister of Health ruled out this idea of an “indefinite” postponement, because this would remove any incentive to prepare for the possible implementation of this enlargement. “There must be an imperative to evolve towards a condition that recognizes the equivalence between mental and physical suffering,” he argued Thursday. By announcing a delay, Ottawa is “signaling that systems must move toward a state of readiness,” Holland said.
Canada could also expose itself to a legal challenge if it did not announce a possible expansion of eligibility, added the minister.
The Supreme Court of Canada ruled in 2015 that adults suffering from a “serious and irremediable health problem” were entitled to medical assistance in dying, leading the Liberal government to introduce its first law in 2016.
In 2019, in the Truchon-Gladu case, Judge Christine Baudouin, of the Superior Court of Quebec, invalidated the criteria of “natural death becoming reasonably foreseeable” and “end of life” for obtain medical assistance in dying.
The Liberals updated the law in 2021 to reflect court decisions. As part of this process, the government accepted a Senate amendment to remove the exclusion of people “whose only medical condition is mental illness.” It took two years for provincial health systems and professionals to prepare for this change.
The senators had argued that excluding mental illness was a violation of individual rights. But some legal experts have since pushed back, saying nothing in the law required Canada to further expand eligibility.
Quebec also adopted its own law last year to exclude from medical assistance in dying adults whose only medical problem is mental illness.
No piecemeal policies
A Manitoba government spokesperson said Thursday it welcomes the three-year delay, while Alberta maintains that medical assistance in dying for mental disorders has no place at all in a system health care. A spokesperson for the Saskatchewan government said Thursday that the province is still requiring an “indefinite postponement.”
But the two federal ministers warned Thursday that they did not want a piecemeal application in Canada. “We have a unitary system of criminal law in this country, we do not provide for exceptions province by province,” said Minister Virani.
In a statement, Dying with Dignity Canada said it was “discouraged” and “frustrated” by the postponement. The organization maintains that despite what the provinces claim, “medical, clinical and regulatory authorities” have said they are ready.
Minister Holland's bill calls for the creation of another special joint committee to study the issue again over the next two years. If this committee recommends changes, it will have to table a report before both houses of Parliament.
In the meantime, Parliament must act quickly to pass the new bill, before the previously planned enlargement automatically comes into force on March 17 — in just over six weeks . The Conservatives said they would support the bill in the House.
But this bill could face more difficulty in the Senate. “There is historical precedent in the Senate for treating some of these issues [differently] from the way the House approaches them,” said independent Sen. Stan Kutcher. A member of the special joint committee that recommended a postponement, he fiercely disagreed with the majority's conclusions.
Mr. Kutcher and two senators who were also members of the special joint committee, Pamela Wallin and Marie-Françoise Mégie, contest both the government's decision on Thursday and the way in which the committee carried out its work.
The Bloc Québécois, which agreed with a postponement of enlargement, believes for its part that a period of one year, and not three years, should be sufficient to “hear the experts, patients and make recommendations that can help patients.”
“Women and men are currently suffering and are demanding that Ottawa act,” MP Luc Thériault, who was one of the vice-presidents of the special joint committee, said in an email.
The Bloc Québécois also calls on the federal government to allow medical assistance in dying for advance requests in the case of degenerative cognitive diseases, by reforming the Canadian Criminal Code. “Quebec acted on this issue in June 2023, with the support of all parties in the National Assembly,” writes Mr. Thériault.