Ottawa is for the second time postponing a planned expansion of the medical assistance in dying (MAID) regime, which had been due to take effect March 17. Health Minister Mark Holland said the government is pausing the MAID expansion that would include Canadians whose only medical condition is mental illness.
“It’s clear from the conversations we’ve had that the system is not ready,” Mr. Holland said Jan. 29 outside the House of Commons in response to a reporter’s question on MAID.
The government still intends to expand eligibility to include those suffering solely from mental illness, but within a longer time frame, he added.
Here’s a timeline of the changes MAID has undergone since it was first introduced.
2015: In the Supreme Court of Canada ruling Carter v. Canada, a Canadian referred to as “T” in court documents challenged the Criminal Code prohibition against physician-assisted dying. T had a fatal disease, and the court concluded that the prohibition did not apply to physician-assisted death for “a competent adult” who “clearly consents” to the procedure and “has a grievous and irremediable medical condition (including an illness, disease, or disability) that causes enduring suffering that is intolerable to the individual.”
2016: Prompted by the 2015 Supreme Court decision, Parliament amended the Criminal Code via Bill C-14, which came into force in June 2016, exempting doctors and nurse practitioners from criminal offences for providing or helping to provide MAID.
2019: A ruling by the Supreme Court of Quebec declared unconstitutional the “reasonable foreseeability of natural death” eligibility criterion in the federal MAID legislation. The court said the criterion violates the Canadian Charter of Rights and Freedoms, which “protects against deprivations of life, liberty and security of the person” and “guarantees the right to the equal protection and equal benefit of the law without discrimination.”
2021: In response to the Quebec ruling, the feds introduced Bill C-7, which came into effect in March 2021, amending the Criminal Code to expand MAID to those over age 18 who are “capable to make decisions with respect to their health and eligible for health services funded by the federal government, a province or a territory,” the Justice Department said. “They must make a voluntary request for MAID that is not the result of external pressure and must give informed consent, after having been informed of the means available to relieve their suffering,” the department noted. The bill excluded scenarios where mental illness was the only medical condition. The exclusion was set to expire March 17, 2023.
August 2022: A military veteran filed multiple complaints with Veterans Affairs Canada (VAC) before receiving an apology after he was offered MAID during a call with a VAC service agent, Global News reported. The veteran had asked for treatment for a traumatic brain injury and post-traumatic stress disorder.
As well, media reports showed that a number of individuals have decided to resort to MAID after failing to get support for their disability.
October 2022: The House veterans affairs committee heard from a witness that a VAC agent told a veteran on the phone: “I know I can do it [MAID] for you. We did it before, and we are now supporting the surviving wife and two children.”
December 2022: On Dec. 1, 2022, the same committee heard from CAF veteran and former paralympian Christine Gauthier, a paraplegic who had been trying to get a new platform lift installed in her home for five years. She said she was offered the same advice about getting MAID. “I was told that if I was that desperate, they could give me medical assistance in dying now.” She was the sixth veteran who had alleged having been offered unprompted MAID by VAC.
December 2022: The government announced Dec. 15, 2022, that it intended to delay the March 17, 2023, eligibility date for those whose sole medical condition is mental illness, saying it would introduce the required legislation for this in early 2023.
December 2022: A VAC spokesperson said on Dec. 20, 2022, that the VAC employee who allegedly suggested veterans consider MAID was no longer employed by the department.
February 2023: Bill C-39 was introduced, extending the eligibility date to March 17, 2024. “By extending the prohibition on MAID where mental illness is the sole underlying medical condition for one year, Bill C-39 seeks to ensure the safe provision of MAID in these circumstances,” the Justice Department said.
October 2023: Conservative MP Ed Fast’s Bill C-314, which would prevent MAID for those suffering only from mental illness, was defeated at second reading. The legislation would have amended the Criminal Code “to provide that a mental disorder is not a grievous and irremediable medical condition for which a person could receive medical assistance in dying.”
October 2023: The government released the Fourth Annual Report on MAID in Canada, covering the year 2022, showing that the number of medically assisted deaths increased by 31.2 percent in 2022, to 13,241, and that the procedure accounted for 4.1 percent of all deaths in the country that year. There were 463 cases—3.5 percent of the total MAID deaths in 2022—where the person’s natural death was not reasonably foreseeable, the report said.
January 2024: Ottawa said it will again extend the deadline for expanding MAID to those whose only medical condition is mental illness.
Health and mental health ministers from British Columbia, Alberta, Saskatchewan, Ontario, New Brunswick, and all three territories sent a joint letter to Mr. Holland and federal Justice Minister Arif Virani stating Canada’s health systems aren’t ready to handle MAID expansion. They asked the ministers to “indefinitely pause” the expansion to allow further collaboration between the levels of government.
Matthew Horwood and The Canadian Press contributed to this report.
