Ottawa considers suspending expansion of medical assistance in dying

The federal government is studying the possibility of suspending its initial plan to expand the rules governing medical assistance in dying to include patients whose only underlying condition is a mental disorder.

“We are evaluating our options,” Justice Minister Arif Virani said Thursday.

This would be the second time that the federal Liberals have suspended their project. The first time, in February, when the government decided to impose a one-year delay in the face of general concern among public opinion and the political world.

This decision set a new deadline, namely 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, Virani said.

“We will evaluate all of this comprehensively to decide whether we move forward on March 17 or pause,” he told The Canadian Press in interview.

Both options are “on the table,” he added.

In February, Mr. Virani’s predecessor, David Lametti, said the government could have moved ahead with its timetable, 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.”

Medical assistance in dying was legalized in Canada in 2016. Three years later, the Quebec Superior Court declared the original test requiring that natural death be reasonably foreseeable unconstitutional.

The senators also argued that excluding people with a qualifying mental disorder was a violation of their rights. Prime Minister Justin Trudeau’s government finally agreed to expand eligibility in 2021.

The move resulted in a two-year sunset clause that was set to expire last March, before the Liberals proposed delaying it for another year.

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 suicidality.

According to Mr. Virani, the first step will be to evaluate the recommendations of a special joint committee of deputies and senators charged with studying the issue. The committee was reconvened after the government imposed the original deadline.

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 Mr. Virani. This will influence what we do on March 17 […] whether we move forward with mental illness as the only underlying condition or not. »

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.

Federal Conservative Leader Pierre Poilievre has already pledged to withdraw expansion 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 a basis for choosing medical help to end a person’s life.

The bill was rejected, with the majority of Liberal and NDP MPs and all Bloc Québécois MPs opposing it.

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