The Trudeau government will consult healthcare professionals and provincial leaders this fall on legalizing early requests for state-sanctioned euthanasia, known as Medical Assistance in Dying (MAiD).
“What we’re saying very clearly is that this is an incredibly difficult issue, that we need to take the time to have a national conversation that includes our provincial and territorial colleagues, that where these lines are drawn and whether or not the system is ready is a very important step,” Health Minister Mark Holland told reporters on Monday.
As of October 30, Quebecers who remain mentally fit and face “serious and incurable diseases” like Alzheimer’s, may request the procedure in advance. Holland clarified that such requests contravene the Criminal Code.
Through a directive to prosecutors, the Government of Québec temporarily bypassed Ottawa to protect medical practitioners from facing criminal charges who perform MAiD on eligible patients.
When asked if he would challenge the directive, Minister Holland said he would not direct provincial prosecutions at this time.
“It's tricky because it's really a provincial competence,” he said in an interview with La Presse last week. “But after the pandemic, it was obvious that it was a huge problem and we need all provinces and the federal government to work together.”
That being said, Holland claims the issue raised by Québec is “legitimate” and “fair.”
The province’s commission on end-of-life care reported that 15 of 3,663 deaths since 2021 were non-compliant with provincial or federal laws. At the time, Ottawa permitted anyone 18 and older in “an advanced state of irreversible decline” to access MAID — not including the mentally ill.
The federal government intends to launch consultations with regional health care providers and provincial leaders next month. A final report will be tabled next spring.
To be eligible for the procedure, a person must be mentally sound and be assessed by two doctors or nurse practitioners.
A recent Leger poll found that two-thirds of Canadians (65%) believe people with an illness “that can affect their cognitive ability” should be able to make an early request for MAID. This proportion is higher among Quebecers (77%).
On February 2, 2022, Holland introduced Bill C-39, delaying the expansion of MAID to Canadians whose sole underlying condition is a mental disorder after extensive pushback.
Those persons could have accessed MAID as of March 17, 2023 but the federal government extended the temporary exclusion period until March 17, 2024. That too has been delayed, and remains before the House of Commons as of writing.
On January 29, Conservative and NDP MPs released a report urging Ottawa not to expand assisted-suicide legislation without sufficient provincial and expert consultations.
"Committee concludes that the medical system in Canada is not prepared for medical assistance in dying where mental disorder is the sole underlying medical condition,” the report reads.
Nearly half (47%) of Leger respondents endorsed pausing the policy in place of more comprehensive consultations. However, 37% disagreed with the delay.
“Minister, there are no legislative safeguards,” said Conservative MP Michael Cooper at a Commons health committee hearing at the time. “Well, you can say that,” replied Holland.
“You haven’t cited one. You haven’t cited any,” continued Cooper. “And you haven’t responded to 78% of Ontario psychiatrists who believe that whatever safeguards will be put in place will be insufficient,” he added.
“We’re talking about wrongful deaths when there has been an inappropriate application of MAID.”
Holland eventually adopted the committee recommendations.
Alex Dhaliwal
Calgary Based Journalist
Alex Dhaliwal is a Political Science graduate from the University of Calgary. He has actively written on relevant Canadian issues with several prominent interviews under his belt.