Minister of Justice Sean Fraser, then Housing Minister rises during Question Period in the House of Commons on Parliament Hill in Ottawa, on Oct. 16, 2023. (Screenshot from ParlVu)
The federal government will table legislation to indefinitely exclude people whose sole medical condition is a mental illness from receiving medical assistance in dying (MAID), Justice Minister Sean Fraser announced on Oct. 7.
Fraser said the decision reflected the recommendations of a special parliamentary committee on MAID, which recommended that people whose sole underlying medical condition is a mental illness remain excluded from eligibility.
“It also reflects the engagement that I’ve had, that my department has had over the course of my time in this particular position. While there is not a perfect consensus on this issue, we believe this is the correct approach at this particular time,” Fraser said.
The committee studying MAID expansion had concluded that the “evidentiary and systemic conditions necessary for safe and equitable implementation cannot presently be met.” It cited challenges in determining whether a mental illness is irremediable, a shortage of mental health services for Canadians, and concerns that the expansion could disproportionately affect women.
Fraser said the federal government will table legislation in the fall that would maintain the exclusion of people whose sole medical condition is a mental illness from MAID indefinitely.
Under the current law, the exclusion is set to expire on March 17, 2027, after being extended twice following concerns from provinces, territories, and health-care stakeholders that more time was needed to prepare the health-care system for the complex assessments and cases involved.
The justice minister also said Liberal MPs would vote later in the day against Conservative MP Tamara Jansen’s private member’s Bill C-218, which would prevent the expansion of MAID to people whose sole underlying medical condition is a mental disorder. Fraser said the government shared Jansen’s view on maintaining the exclusion but had concerns that the bill’s wording could “close off access to people who suffer from serious degenerative neurological disorders.”
Fraser said the legislation the government plans to introduce on MAID would permit advance requests for Canadians diagnosed with serious illnesses who may lose the capacity to consent in the future.
He said provinces would be able to decide whether to allow advance MAID requests. Quebec already permits advance requests under provincial legislation for people with serious and incurable illnesses, including neurodegenerative disorders such as Alzheimer’s disease.
When asked by reporters whether Canadians with a mental illness seeking MAID could take the issue to the Supreme Court, Fraser said that if such a case arose, “we would respect what decisions that they take.”
The justice minister was also asked whether the federal government would consider further restrictions on MAID, given that a bill to legalize assisted dying in England and Wales was recently defeated by UK lawmakers.
“At present, I don’t anticipate that there’s going to be further restrictions,” Fraser said.
The Conservative Party has opposed the expansion of MAID and called for stronger federal monitoring and public reporting, minimum national standards for oversight, updated guidance and training, and a review of the effectiveness and enforceability of existing MAID safeguards.
The Conservatives have also highlighted cases in which disabled Canadians and veterans were allegedly offered MAID without requesting it. Several veterans have provided testimony at parliamentary committees saying they were offered the procedure unprompted. Other concerns have been raised about whether MAID has been provided in cases where patients did not meet the eligibility requirements.
Jansen told reporters she was “extremely disappointed” that Liberals voted against Bill C-218 and characterized it as a “political game.” She said the Conservatives were willing to work with the government on the wording of her bill.
“We’ve said, ‘Hey, if you want to change it, we’re willing to do that.’ And now all of a sudden, that’s the reason why they can’t go forward with supporting C-218,” she said.
Advance Requests
Speaking alongside Jansen on Oct. 7 on Parliament Hill, Conservative MP Michael Cooper expressed his disapproval of the Liberals’ proposal to allow advance MAID requests for individuals with serious degenerative neurological disorders. He described Fraser’s latest announcement as “playing politics with life and death.”
“The minister has quite deliberately tried to tie in to—where there is clear consensus, where there is a clear path, which is to put an indefinite pause—an entirely new issue, which are advance requests,” Cooper said.
At a separate press conference on Oct. 7, Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, told reporters that extending MAID to people with dementia by advance consent creates “a really problematic situation.”
“Who makes the decision in the end? Some family member, some doctor who says, ‘Oh, I guess this was requested in the end.’ To me, it’s almost very eugenic,” he said.
The federal government legalized MAID in 2016 after Parliament passed Bill C-14, amending the Criminal Code in response to a Supreme Court of Canada ruling that found the existing prohibition on assisted dying unconstitutional. Parliament expanded MAID eligibility in 2021 through Bill C-7 to include people whose natural death is not “reasonably foreseeable.”
Since MAID was legalized in Canada, 76,475 people have received euthanasia, according to the latest available Health Canada data for 2024.