Ottawa proposes delaying MAID expansion for patients with mental illness until 2027

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The Liberal government is seeking to delay access to medical assistance in dying for individuals whose sole underlying condition is mental illness until after the next election, introducing legislation on Thursday that would amount to a three-year pause.

Speaking after the bill was tabled, Health Minister Mark Holland and Justice Minister Arif Virani said the extension will allow for a special committee of MPs and senators to reconvene in two years to assess the state of readiness for the extension of MAID.

Mr. Holland said he communicated with all of his provincial counterparts on this timeline and their response was “very favourable.”

“They really do feel that they need more time,” he said.

This is the second time Ottawa is delaying plans to extend medical assistance in dying. Such provisions were set to take effect next month.

In 2019, the Superior Court of Quebec determined that criteria for MAID about “reasonable foreseeability” of natural death was unconstitutional. In 2021, federal legislation was passed that gave a road map for individuals whose death is not reasonably foreseeable. It included a prohibition on this procedure until March 17, 2023.

Ottawa then delayed that timeline to March of this year and reconvened the special joint committee to verify that there could be “a safe and adequate application” of the planned expansion.

The decision to table legislation for a second delay is taking place after a majority of members of the special committee released a report this week saying that Canada was not ready to proceed with MAID for individuals with a mental disorder.

Mr. Holland said the federal government agreed with that assessment.

Some critics, including Dying with Dignity Canada and three senators who wrote a dissenting report, see a further delay as an issue that affects constitutional rights.

Time is of the essence for the newly tabled bill because MAID for mental illness is set to take effect on March 17.

Michael Cooper, a Conservative MP who was part of the special committee, said in an interview that he is disappointed with the bill seeking a three-year delay, calling it inadequate.

“The responsible course for the Liberals to have taken in the face of the evidence heard by the committee from experts, and based upon calls from the vast majority of provinces and territories, is to put an indefinite pause on this radical and dangerous expansion of MAID.”

Earlier this week, a majority of provinces and all the territories sent a letter to Mr. Holland calling to “indefinitely delay” MAID for mental illness.

Health ministers from British Columbia, Ontario, Alberta, New Brunswick, Saskatchewan, Prince Edward Island, Nova Scotia, Nunavut, the Northwest Territories and Yukon said in the letter that expanding eligibility for MAID requires co-ordination between the levels of government to “ensure a consistent and safe approach across the country that includes appropriate safeguards.”

The letter also said that jurisdictions, health authorities, regulators and practitioners of medically assisted death need sufficient time to implement those safeguards and to address capacity concerns.

Alistair Macgregor, an NDP MP who was the vice-chair of the special committee, said Thursday that New Democrats welcome the decision to delay until March 17, 2027, and the requirement to reconvene the committee to review Canada’s readiness before that date.

The Conservatives will review the bill tabled Thursday, Mr. Cooper said, adding that a delay is better than moving ahead with the expansion of MAID in March. But he said the bill falls short of the indefinite pause the Official Opposition called for.

Mr. Holland said Thursday that a pause without a stipulated timeline would mean that “we will never get ready,” adding there is a “moral imperative” to get systems prepared.

“By setting out a timeline of three years, it’s an indication that the systems need to move toward readiness,” he said.

A dissenting report was filed by some members of the special committee: Senators Stan Kutcher, Marie-Françoise Mégie and Pamela Wallin.

The senators held a news conference on Thursday to detail their concerns about the majority committee’s report and about the approach taken by the government.

Ms. Wallin said she finds it “shocking” that on this particular issue, the government no longer subscribes to “the notion of choice and how important it is,” which leads her to believe there has been an “about-face” on the part of Ottawa.

In response to the dissenting senators’ concerns, Mr. Holland said provinces and territories said they are not ready to proceed, and the Canadian Mental Health Association also expressed concerns about readiness.

Mr. Virani said health care is delivered by the provinces and territories, which have indicated they are not prepared to proceed.

The federal government is not saying that MAID in this area is never going to happen, he said.

Helen Long, the CEO of Dying with Dignity Canada, said Thursday the government’s legislation results in a six-year delay of the expansion of MAID to those whose sole underlying condition is a mental disorder, and it is a “denial of constitutional rights for suffering people across Canada.”

“Dying With Dignity Canada is disheartened and shares the frustration of the continued exclusion, stigmatization and discrimination based on diagnosis – a clear breach of the Charter of Rights and Freedoms,” Ms. Long said.