Federal government to introduce bill restricting MAID for mental illness

The federal government is set to introduce changes to Canada’s medical assistance in dying law Tuesday to bar people suffering solely from a mental illness from accessing MAID, and to allow for advance directives.

The government put the legislation on notice last week and Justice Minister Sean Fraser and Heath Minister Marjorie Michel are set to answer questions Tuesday about the proposed changes.

The amendments are being tabled almost three weeks after Fraser said the government would not be extending access to assisted dying to people whose sole underlying condition is a mental illness.

The government has repeatedly pushed back the date when mental illness could become a qualifying factor for an assisted death and asked a special parliamentary committee to study the issue.

The committee’s conclusion, reported in June, said the government should indefinitely exclude people suffering solely from a mental illness from accessing MAID.

Following that report’s release, Fraser’s office reviewed the evidence the committee considered and sought additional opinions on the deeply divisive issue.

“When I hear that there is a lack of consensus within the medical community about the irremediable nature of certain mental illnesses, that gives me real cause for concern,” Fraser said on Oct. 7.

He said he’s also heard concerns about a lack of access to mental health care and worries that people who can’t get help might turn to MAID instead.

Fraser also said the government would be using the new bill to decriminalize advance requests, allowing those at risk of losing their capacity to consent to an assisted death to do so ahead of time.

A news release from the Department of Justice says “rigorous safeguards” will be put in place for advance requests that follow a diagnosis of an incurable illness.

Advance requests are documents that allow a person who suffers from a degenerative condition, such as dementia or ALS, to ask that an assisted death be carried out once they no longer have the capacity to consent.

The strict eligibility rules for MAID require that a qualifying patient be suffering from a grievous and irremediable medical condition and be able to consent at the time of the procedure.

Advocates have argued that requirement means people who know they are going to lose their capacity to consent must choose to end their lives earlier than they would want.

Some critics have asked Fraser not to put both mental illness and advance requests into the same bill in order to give the government more time to consult. He has indicated no plans to do so.

Fraser has said the legal change on advance requests will only affect the Criminal Code and it will be up to provinces to decide whether to provide advance requests through their own health systems.

The proposed bill will need to pass the House of Commons and the Senate before March 17 — the date on which the law states people with a mental illness as their sole underlying condition would become eligible for MAID.