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Should those with mental illness be eligible for MAID (medical assistance in dying)?

Advocacy groups and politicians differ over whether mental illness should be included in expansion of the assisted dying law. The issue is up for review this spring.
Expanding the law for medical assistance in dying (MAID) to include those with mental illness is pitting politicians against citizens and advocacy groups. Photo: Dying With Dignity /Facebook

The Trudeau government has put vulnerable people at risk with its flawed plan to include people suffering from mental illness in the medical assistance in dying (MAID) law, says St. Albert-Edmonton MP Michael Cooper.

While the Liberals announced in December they want to delay expansion of the existing law beyond a March 2023 target date, Cooper says the government has not begun to address the many safety concerns of allowing people with mental disorders to have medically assisted deaths.

“What is clear is that it cannot be done safely based upon what experts, including leading psychiatrists, are telling them,” said Cooper. “The government's policy is an absolute mess.

“It has from Day One been driven by ideology as opposed to taking an evidence-based approach."

While Cooper stopped short of saying the law expansion should be abandoned altogether, he said “meaningful study” needs to take place before proceeding.

Cooper slammed the Liberals for ignoring warnings about the flawed legislation from the Conservatives and the psychiatric profession, then waiting until the 11th-hour to announce the expansion delay right after the House of Commons broke for a six-week winter break.

This shows the “reckless and ideological” approach the government is taking to the issue, he added.

“Their dangerously rushed approach has ignored the voices of the most vulnerable,” a statement issued by Cooper and three other Conservative MPs reads.

Justice Minister David Lametti and Minister for Mental Health and Addictions Carolyn Bennett announced last week legislation to extend the March deadline will be introduced. But they did not cite any specific date for pushing ahead or specify a new date for expanding MAID to include applications from mentally ill people.

Lametti argued the delay was justified because more time is needed to develop standards for assisted-dying requests from people whose only condition is a mental illness. Provinces and medical professionals also need more time to prepare for the change, Lametti said.

In a statement, Dying with Dignity Canada denounced the delay, saying the current exclusion of those with a mental disorder from making an end-of-life request is discriminatory and unconstitutional. Bradley Peter, an Edmonton region spokesman for the group, says barriers that prolong suffering should be avoided.

“It’s definitely disappointing,” Peter said in response to the delay. He noted an expert panel on MAID and mental illness had already made a series of recommendations to deal with expansion of the law.

“And it’s been suggested that many of those recommendations could actually be implemented sooner rather than later,” Peter added.

The government first passed MAID legislation in 2016. The law was amended in 2021 to remove a restriction that medically-assisted dying was only available to those whose deaths were “reasonably foreseeable.”

According to, MAID's current legislation allows a capable adult suffering from a grievous and irremediable medical condition to voluntarily request medicine that will bring about their death.

Under pressure from critics who say the exclusion of the mentally ill is unconstitutional, the government had set a two-year time limit to include requests from people with mental disorders.

Donna Wilson, a nursing professor at the University of Alberta who has done research on end-of-life care, says she views the existing MAID as a compassionate law but isn't surprised by the delay to include requests from the mentally ill.

“Mental illness isn’t one illness,” said Wilson, adding, “There are about 100 of them.”

Deciding who should qualify for a MAID request--and when--is a hugely complex issue that will require considerable time to sort out, Wilson believes.

“They are going to have to decide, who do they say ‘yes’ to and who do they say ‘no’ to,” said Wilson. “What do you do with someone who could live 10 years, 20 years, 30 years?”

Wilson thinks the law will eventually apply to people with mental disorders. But it “may be six months to a year or longer,” before it happens, she predicted.