(Ottawa) The federal government is considering suspending its plan to expand the rules governing medical assistance in dying to include people whose only underlying condition is a mental disorder.
“We are evaluating our options,” Justice Minister Arif Virani said on Wednesday.
This would be the second time that the federal Liberals have suspended their expansion project. The first time, in February, the government decided to impose a one-year delay, in the face of concerns from the population and the political class.
This decision set a new deadline, March 2024, which now seems compromised. The cabinet will take into account the opinions of a joint parliamentary committee, as well as those of medical experts and other stakeholders, explained Minister Virani, who inherited the file in July during a reshuffle.
“We will evaluate all of this comprehensively to decide whether we move forward on March 17 or whether we take a pause,” he told The Canadian Press in an interview. Both options are “on the table,” he added.
In February, Mr. Virani’s predecessor, David Lametti, said the government could have moved forward with its timeline, but preferred to give health professionals more time to prepare for the change.
At the time, Mr. Lametti said an extension “would provide sufficient time to ensure our health care system protects vulnerable people and supports autonomy and freedom of choice.”
However, the CEO of Dying with Dignity Canada, an organization that has fought for better access to medical assistance in dying, says she is concerned that the government is “stringing people along and disappointing them” with another delay possible.
“There are people who have been waiting for years just to say, ‘Can I be evaluated?’ Not even: “Am I eligible?” But: “can I be evaluated? And what should I do next?” Helen Long said Friday. For these people, we are concerned about an announcement like this that throws them into crisis. »
Medical assistance in dying was legalized in Canada in 2016. Three years later, the Quebec Superior Court declared the initial criterion requiring that natural death be “reasonably foreseeable” unconstitutional.
The senators also argued that excluding people with mental illness was a violation of their rights. The government of Prime Minister Justin Trudeau finally agreed in 2021 to expand eligibility.
This decision resulted in a two-year “sunset clause,” which was set to expire last March, before the Liberals proposed extending it for another year, until next March.
A lively debate
A handful of European countries already allow adults whose only medical problem is a mental disorder to request medical assistance in dying. The question of whether Canada should follow suit has sparked heated debate.
Its supporters say expanding the scheme provides a choice for people who are suffering and have no other options; refusing them constitutes a violation of their rights.
However, some representatives of disability organizations believe that adequate mental health support is a better option.
Other organizations, like the Center for Addiction and Mental Health, note that there is no clear medical consensus on what constitutes “serious and irremediable” mental illness, or how to distinguish it from a desire of suicide.
According to Minister Virani, the first step will be to evaluate the recommendations of a special joint committee of deputies and senators tasked with studying the issue. The committee met again to study whether the system was ready for such an expansion.
Committee members adopted the report, but have until the end of January to present it to the House of Commons, said co-chair René Arseneault, Liberal MP from Quebec, in a statement.
“Canadians should follow the committee’s recommendations because we are very interested in having the system ready,” said Minister Virani. This will influence what we do on March 17 […] whether or not we move forward with mental illness as the sole underlying condition. »
Mme Long believes, however, that the federal government has done what is necessary to ensure the health care system is ready, including developing a national curriculum. The fact that Minister Virani made his comments before the committee submitted its report was “disappointing,” she said.
“It is important not to confuse those who do not support this option with (the question of): ‘Are we ready?’” she added. Those are two different things. »
The decision to seek medical assistance to end one’s life is a “fundamental personal choice”, he added. The government, he said, is “very actively listening” to voices that say Canada is not ready to expand its scope of action to mental illness.
The leader of the federal Conservatives, Pierre Poilievre, has already pledged to withdraw the enlargement plans if he forms the next government.
Some Liberal MPs also oppose this idea. Eight of them broke ranks in October. They supported a Conservative private member’s bill that would have amended the Criminal Code to expressly prohibit the use of a mental disorder as an eligibility criterion for medical assistance in dying.
Twenty-four elected New Democrats supported this bill; none objected. The bill was rejected by the majority of Liberal MPs and all Bloc Québécois MPs.