Ottawa Delays MAID Expansion by Three Years Amid Health-Care Readiness Concerns

Federal Health Minister Mark Holland makes an announcement in Calgary on Dec. 21, 2023. (The Canadian Press/Todd Korol)

The federal government has announced it will postpone for three years its expansion of the medical assistance in dying (MAID) regime that would include individuals whose sole underlying condition is a mental illness.

Health Minister Mark Holland introduced legislation on Feb. 1 that would postpone the change until March 17, 2027, just over six weeks before the expansion was scheduled to take effect. Parliament must now move quickly to pass the bill before the expansion automatically takes effect.

Justice Minister Arif Virani told reporters at a Feb. 1 press conference on Parliament Hill that the pause is meant to “ensure the [health-care] system readiness, which is what the health-care system is indicating is required and what Canadians are asking.”

Canada’s MAID regulations are among the most permissive in the world, leading to an increase in its utilization by individuals facing severe vulnerabilities. In recent years, the use of MAID surged significantly.

In 2022, the instances of MAID-related deaths climbed by 31.2 percent, representing over 4 percent of all deaths in the country, according to Statistics Canada. This translates to 13,241 individuals choosing MAID in 2022, a significant rise from 10,029 deaths in 2021 and 7,446 in 2020.

In January, ministers responsible for health and mental health from British Columbia, Alberta, Saskatchewan, Ontario, New Brunswick, and the three territories collectively addressed a letter to Mr. Holland and Mr. Virani, expressing concerns that Canada’s health-care infrastructure is not adequately prepared to manage the proposed expansion of MAID. They urged for an “indefinite pause” on broadening the program, advocating for enhanced cooperative efforts among governmental tiers.

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A parliamentary committee also concluded this week after extensive deliberation that the country was unprepared to implement the proposed MAID expansion.

Central to their concerns was the challenge of ensuring clear differentiation between individuals experiencing suicidal ideation and those seeking assisted dying under the criteria of mental illness alone.

The bill introduced by Mr. Holland not only mandates a three-year delay to the expansion but also stipulates the formation of a new joint parliamentary committee. This body is tasked with re-evaluating the issue within the next two years, with the obligation to present any recommendations to both houses of Parliament.

Addressing the media, Mr. Holland cited his interactions with provincial and territorial health ministers in October as a pivotal factor in this decision. He said the reaction from his provincial counterparts to news of the delay was overwhelmingly positive.

“Their response was very favourable,” he said. “They really do feel that they need more time.”

The Opposition Conservatives have been calling to scrap the expansion altogether, but have said they would still support a delay.

The Canadian Press contributed to this report.