Delay of eligibility for medical assistance in dying for persons suffering solely from mental illness proposed by Ministers of Justice and Health
February 2, 2023 - Ottawa, Ontario - Government of Canada
Medical assistance in dying (MAID) is a complex and deeply personal issue. The Government of Canada is committed to ensuring our laws reflect Canadians’ needs, protect those who may be vulnerable, and support autonomy and freedom of choice.
Under Canada’s current MAID law, persons suffering solely from a mental illness who meet all eligibility criteria and for whom all applicable safeguards are met would be eligible for MAID as of March 17, 2023. However, today, the Honourable David Lametti, Minister of Justice and Attorney General of Canada, the Honourable Jean-Yves Duclos, Minister of Health, and the Honourable Carolyn Bennett, Minister of Mental Health and Addictions and Associate Minister of Health, introduced legislation to extend the temporary exclusion of eligibility for MAID where a person’s sole medical condition is a mental illness until March 17, 2024.
This proposed one-year extension would provide additional time to prepare for the safe and consistent assessment and provision of MAID where the person’s sole underlying medical condition is a mental illness and allow time to consider the Special Joint Committee on MAID’s final report, expected in February 2023.
In the meantime, the Government of Canada will continue to work closely with provinces, territories, and the healthcare community to finalize and disseminate key resources. The main purpose of this proposed extension is to allow more time to ensure MAID assessors and providers are ready to assess requests for MAID for persons suffering solely from a mental illness in a safe and consistent manner across Canada by the time the proposed extension is over.
“There is no doubt that medical assistance in dying is a very complex and deeply personal issue. We strongly believe that the proposed one-year extension, until March 17, 2024, of the temporary exclusion of eligibility for persons whose sole medical condition is a mental illness will provide sufficient time to ensure our health care system protects those who may be vulnerable and support autonomy and freedom of choice.”
The Honourable David Lametti, P.C., K.C., M.P.
Minister of Justice and Attorney General of Canada
“As MAID is a very personal and complex issue, the temporary extension would allow more time for regulators, clinicians, and others to better understand and implement guidelines and practices. This extension would play a crucial role in protecting the most vulnerable while supporting their autonomy, and ensuring assessors and providers are prepared and comfortable to support MAID for persons living with a mental illness, when it becomes available.”
The Honourable Jean-Yves Duclos
Minister of Health
“The safety and security of Canadians, including the most vulnerable, remains at the centre of our actions, alongside supporting individual autonomy. Canadians can rest assured we’re taking a careful and considered approach on the implementation of MAID for persons living with a mental illness.”
The Honourable Carolyn Bennett
Minister of Mental Health and Addictions and Associate Minister of Health
On March 17, 2021, the revised legislation on MAID (former Bill C-7) received Royal Assent and became law. Former Bill C-7 expanded eligibility to MAID to individuals whose death is not reasonably foreseeable and strengthened the safeguards for these applicants. With these changes, individuals whose sole medical condition is a mental illness, and who otherwise meet all eligibility criteria, are not eligible for MAID until March 17, 2023. This temporary exclusion was intended to provide the Government of Canada time to consider the Expert Panel on MAID and Mental Illness’ conclusions and recommendations, as well as the findings of the parliamentary Special Joint Committee on MAID.
On December 15, 2022, the Minister of Justice and Attorney General of Canada, the Minister of Health, and the Minister of Mental Health and Addictions and Associate Minister of Health announced the Government of Canada’s intention to introduce legislation in early 2023 to extend the temporary exclusion of eligibility for persons suffering solely from a mental illness beyond March 17, 2023. The introduction of Bill C-39 responds to this commitment.
On May 13, 2022, the Government of Canada tabled the Expert Panel on MAID and Mental Illness’ final report in Parliament. The report sets out 19 recommendations for establishing a MAID regime that addresses questions that may arise in some MAID requests, and particularly where the person requesting MAID’s natural death is not reasonably foreseeable. This includes questions of incurability, irreversibility, capacity, suicidality, and the impact of structural vulnerabilities (structural vulnerabilities being the effects of interactions between a person's sex, gender, socioeconomic status, race/ethnicity, sexuality, or institutional location, with one's position in society).
On June 22, 2022, the parliamentary Special Joint Committee on Medical Assistance in Dying released an interim report on the question of MAID and mental illness. The Special Joint Committee heard from various expert witnesses, including legal experts, palliative care providers, MAID practitioners, physicians, nurse practitioners, psychiatrists, and the chair of the independent Expert Panel on MAID and Mental Illness.
The parliamentary Special Joint Committee on MAID’s final report is expected by February 17, 2023, and may provide additional insight regarding MAID requests in complex circumstances, including for persons whose sole medical condition is a mental illness. The proposed extension would allow time to consider this final report.
In March 2023, MAID practice standards will be ready for uptake by health professional regulators and clinicians. The Government of Canada has appointed a Task Group of experts to develop these MAID practice standards, in collaboration with provincial and territorial governments, regulatory bodies, and clinicians across Canada.
The Government of Canada is also supporting the development of an accredited Canadian MAID curriculum to support clinician education and training. The curriculum will consist of seven modules, including a module on MAID and Mental Disorders. The launch of the modules will begin in the fall 2023, with the aim for all modules to be available by the end of 2023.
- Canada’s new medical assistance in dying law (former Bill C-7) (Justice Canada)
- Medical assistance in dying in Canada (Health Canada)
- Final Report of the Expert Panel on MAID and Mental Illness
- Medical Assistance in Dying and Mental Disorder as the Sole Underlying Condition: An Interim Report (Report of the Special Joint Committee on MAID)
- Government’s response to the First Report of the Special Joint Committee on MAID
For more information, media may contact:
Office of the Minister of Justice and Attorney General of Canada
Department of Justice Canada
Senior Communications Advisor and Press Secretary
Office of the Honourable Jean-Yves Duclos
Minister of Health
Senior Communications Advisor and Press Secretary
Office of the Honourable Carolyn Bennett
Minister of Mental Health and Addictions and Associate Minister of Health, Carolyn Bennett
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