Canada delays euthanasia expansion for mental illness

On Thursday, the Canadian Senate passed Bill C-62, the Liberal government’s legislation that postpones the expansion of euthanasia, also known as medical assistance in dying, until March of 2027. Larry Worthen, the executive director of the Christian Medical and Dental Association of Canada, said that the earlier March 2024 expansion would have been shameful.

“If this had passed, [there] would have been a three-month waiting period for someone with mental illness to get euthanasia. The average wait time in Canada to see a psychiatrist is six months,” he said. “So, if this had passed, it would have been an absolute scandal that we would be killing people who are not able to get proper healthcare.”

Euthanasia has been legal in Canada since 2016, initially restricted to those whose “natural death has become reasonably foreseeable.” In Canada, assisted suicide is primarily performed by a doctor or nurse practitioner who administer a drug to the person. In some cases the medical practitioner will prescribe the drug so the person can swallow it to cause their own death at a later time. The country now has some of the most permissive assisted euthanasia legislation in the world.

Canada’s most recent data from the Fourth Annual Report on Medical Assistance in Dying found that 13,241 people died by euthanasia in 2022. That number accounted for 4.1 percent of Canada’s total deaths and was a 31 percent increase from 2021.

In 2021, lawmakers removed the “reasonably foreseeable” death requirement, making individuals with chronic health conditions or disabilities eligible for the medical assistance in dying program. They also said the program would include individuals solely seeking assistance due to mental illness, but that expansion was contingent upon a two-year study by a parliamentary joint committee composed of 15 members of parliament and senators.

While lawmakers initially slated the expansion to take effect in March 2023, they later delayed it until March 17, 2024. Former Justice Minister David Lametti said that this delay aimed to “provide time to help provincial and territorial partners and the medical and nursing communities to prepare” for the program’s expansion

Now, a year later, after receiving a large backlash from doctors, psychiatrists, and advocates, the federal government introduced legislation again—this time to push the expansion to 2027. This comes after the Special Joint Committee on Medical Assistance in Dying released a January report stating that “the medical system in Canada is not prepared.”

When the bill to delay the mental illness expansion was introduced to the House of Commons in February, members of the Liberal, Conservative, New Democratic, and Green parties voted in favor, while the Bloc Québécois party voted against it in preference of a one-year timeline.

Although the Conservative party voted in favor of the delay, it has been vocal in urging the Liberals to completely abandon the expansion. Last year, Conservative Member of Parliament Ed Fast introduced a bill to eliminate the mental illness clause. While the measure garnered support from New Democratic party and Green party members, as well as some Liberals, it was defeated in Parliament in October.

“Our steadfast commitment should be to allow our most vulnerable to live with dignity. Assisted death for the mentally ill is not healthcare, especially when the mental health community has been unable to agree on whether irremediability can ever be determined when elevating mental illness,” Fast said at a news conference on Tuesday.

Blaise Alleyne is the eastern strategic initiatives director for the Canadian Centre for Bio-Ethical Reform, an educational pro-life organization. He expressed gratitude for the delay and said that the extended timeline would make euthanasia a contentious issue for the upcoming election.

“I’m glad that it’s being delayed till 2027, but that’s because this should have never passed,” he said. “2027 means it can be an issue for the next election because many Canadians have been really disturbed to see how far assisted suicide has been expanding.”

The next federal election is set to happen no later than October 2025. Polls show growing support for the Conservative party. A 2023 Angus Reid Institute poll showed that only 3 in 10 Canadians say they support euthanasia expansion for mental illness. Conservatives could use this issue as leverage to defeat the Liberals, who continue to voice support for euthanasia.

Worthen of the Christian Medical and Dental Association of Canada said that the Liberal government’s decision to delay rather than scrap the clause reflects its ideological commitment to bodily autonomy.

“There’s an ideological commitment here to follow autonomy at the exclusion of all other ethical principles,” Worthen said. “It’s not backed by any sense of altruism.”

Alleyne referenced Dr. Sonu Gaind, chief of psychiatry at Sunnybrook Health Sciences Centre in Toronto, who has emphasized that predicting an individual’s recovery from a mental health disorder is only accurate around 47 percent of the time, suggesting that more often than not, predictions are unreliable. “That means you’d be more accurate to flip a coin and guess whether or not someone was going to recover from a mental health illness or not,” Alleyne said.

Nicole Scheidl is the executive director of Canadian Physicians for Life, an organization that works to advance life-affirming medical practice. She said that expanding euthanasia for those with mental illness gives powers to medical professionals in situations they can’t necessarily predict.

“Most psychiatrists do not think this is a good idea. The vast majority of them say, ‘We can’t tell the difference,’” she said. “‘We can’t tell if someone’s going to get better or not, and so you’re asking us to play God and just decide whether someone’s life is worth living or not at the most vulnerable and challenged time in their life.’”