Canada seems set to shelve assisted dying for mental illness indefinitely

Canada’s government has decided to keep its assisted-dying law closed to people whose only condition involves mental illness, and to keep it closed with no sunset date. Justice Minister Sean Fraser told reporters in the foyer of the House of Commons on Wednesday, October 7, that “Canada has made a decision not to move forward with the expansion” of MAID that the Criminal Code schedules, CBC News reports. He said the government will introduce legislation this fall. The announcement came before any bill text existed; Fraser said he spoke early partly to explain why Liberals would vote against a Conservative bill on the same subject that afternoon, according to CBC and The Canadian Press.

The change would end a deadline that Ottawa has pushed back twice. Parliament legalized MAID in 2016 for people whose deaths had become reasonably foreseeable. After a Quebec court struck down that limit in 2019, Bill C-7 in March 2021 widened access to people with incurable conditions whose deaths lay further off, and set a temporary exclusion for mental illness alone, first to March 2023, CBC reports. That date moved to 2024 and then to March 17, 2027. The Canadian Press notes that the new bill must clear both the House of Commons and the Senate before that March date, or the expansion takes effect under current law.

Fraser gave two reasons, CBC reports: “very real concerns about people who live in communities with inadequate access to mental health services,” and a lack of agreement among doctors over when a mental illness counts as incurable. He cited a special joint committee of MPs and senators, which reported in June and recommended that Canada “indefinitely exclude” such patients, according to The Canadian Press and BBC News. The BBC reports that the committee also flagged a “pressing need for increased and more equitable access to adequate mental health services,” and that some members filed a dissent calling the process “fundamentally flawed” and “biased.”

The second half of the plan moves in the opposite direction. The bill would decriminalize advance requests, written instructions that let a person diagnosed with a serious, incurable illness such as dementia or ALS ask for an assisted death once that illness has taken away the capacity to consent, The Canadian Press reports. Current federal law requires consent at the time of the procedure. Fraser, who spoke with visible emotion about a friend with early-onset Alzheimer’s disease, said such patients should get to “live out their remaining years” rather than feel pushed to die early, per The Canadian Press. CBC reports that the illness would need to cause intolerable suffering, and that House committees will work out details.

Provinces would hold the final say over advance requests, and they already disagree. Quebec allows advance requests and tells its prosecutors not to charge clinicians who honour them, The Canadian Press reports; the BBC also notes Quebec’s rule. Alberta passed a law in March that bars advance consent and said on Wednesday it will not change course, according to The Canadian Press. Helen Long, chief executive of Dying With Dignity Canada, called it a “profoundly disappointing day” and warned that provincial choice “will create a patchwork” at best, leaving many people with no access, per The Canadian Press.

Critics on the other side object to bundling the two changes. Cardus, a Christian think tank that opposes MAID, and the disability-rights group Inclusion Canada welcomed the mental-illness exclusion but asked Parliament to split off advance requests for more study, The Canadian Press reports. Fraser declined, saying, “Democracy doesn’t demand unanimity.” Conservative MP Michael Cooper accused the minister of playing politics with life and death; Conservatives say they back the exclusion but want more study of advance requests, according to the same report.

The Commons fight over timing played out within hours. Conservative MP Tamara Jansen, whose private member’s bill C-218 would have excluded people with “mental disorders,” said Fraser wanted to sink her bill with a “phantom bill,” CBC reports. Fraser argued that her wording could reach degenerative brain diseases such as Alzheimer’s or Parkinson’s, which already qualify, and that it ignored advance requests. The House voted the bill down 187 to 141 at second reading, CBC says: Conservatives, the NDP, and Green MP Elizabeth May voted yes, while the Bloc Québécois and most Liberals voted no, with Liberal MPs Marilyn Gladu and Kent MacDonald crossing over to vote yes.

Courts may still decide the question. Dying With Dignity Canada leads a challenge arguing that the exclusion violates the Charter, The Canadian Press reports, and Fraser said the government will respect rulings from the Supreme Court of Canada. Michael Fenrick, a lawyer for Claire Brosseau, a plaintiff with treatment-resistant bipolar disorder, told the BBC he expects a long legal battle: “People will continue to suffer intolerably while the case goes through the courts.” The BBC adds that polls suggest most Canadians support assisted dying in general, but support drops for cases involving mental illness alone.

Open questions this desk will watch: the bill’s actual text and tabling date; whether it can pass both chambers before March 17, 2027; how many provinces opt in to advance requests; and how the Charter challenge proceeds. Readers in Canada who need support can call or text 988, the Suicide Crisis Helpline.