In 2016, Medical Assistance in Dying (MAiD) was legalized in Canada. This allowed for doctors and nurse practitioners to use medication to cause a person’s death at their request. When the bill was first introduced, Prime Minister Justin Trudeau stated that the Liberal government was focused on, “respecting Canadians rights, defending their choices…while at the same time, protecting the most vulnerable in society.” At that time, MAiD was restricted to only those who were mentally competent and had a serious and incurable illness, disease, or disability whose death was “reasonably foreseeable.” The bill set out certain safeguards to ensure that the person requesting MAiD knew what was involved, and that they truly consented. According to a BBC poll, Canadians generally supported assisted suicide. MAiD has only evolved since, and this has led some to question whether the proposed safeguards are enough to protect patients when it comes to the proposed expansion of MAiD.
In 2019, a Quebec decision (Truchon v Attorney General of Canada) held that it was unconstitutional to limit access to MAiD to only those nearing the end of life. The Government of Canada, in response, decided to change the Canadian law from one that allowed people to have a peaceful death when facing a painful dying process, to one that allowed them to choose MAiD to relieve intolerable suffering, regardless of proximity to natural death. Bill C-7 was then introduced to permit MAiD for those whose death was not reasonably foreseeable. The government decided to prohibit MAiD for those solely with an underlying mental illness condition until 17 March 2023, when they would have expert recommendations for protocol for review.
People have differing opinions on the expansion of MAiD eligibility. There are groups that oppose the changes, emphasizing that there is a lack of social support for individuals affected by mental illness. An online campaign, “No Options, No Choice,” states that these Canadians are extremely vulnerable and should instead be provided with options to live before given options to die. However, there are many proponents for these changes. According to Dr. Dembo, a member of the twelve-person Independent Expert Panel on MAiD advising the federal government, “If those with mental illness were excluded, it would perpetuate stigma, implying that the suffering from mental illness is not as severe [and that they] lack decision making capacity.” She emphasized that the assessment process is extremely rigorous, and that, contrary to common conception, it is not “death on demand.” Perhaps the fear around changes to MAiD are unfounded.
On 15 December 2022, the government announced plans to temporarily delay MAiD eligibility for those suffering from mental illness until they had more time to consult with experts and review the final report. On 17 February 2023, the Committee on MAiD will table its final report consisting of recommended protocols, guidance, and safeguards that will apply to mental disorder related requests for MAiD. Striking a balance between protecting vulnerable persons while still allowing them to make informed choices for themselves will prove to be difficult, but it is comforting to know that consultation with experts and the community is occurring behind the scenes before any significant changes are made.