Pausing Expansion of MAID for Mental Illness as Sole Condition: Health Justice Responds
Canada recently paused the legal expansion of Medical Assistance in Dying (MAiD) to people whose sole underlying condition is a mental illness that was due to come into effect on March 17, 2023. The expansion will be delayed until March 17, 2024.
In a previous post, we described how the law has changed to expand access to MAiD and why we’re having the wrong conversation about autonomy when it comes to mental health-related needs. Providing one choice is not real choice – respecting autonomy means providing a spectrum of choices that meet an individual’s needs and wishes. People must have the choice to live with dignity for there to be any meaningful choice to die with dignity.
On December 15, 2022 the Minister of Justice and Attorney General of Canada, the Minister of Health, and the Minister of Mental Health and Addictions and Associate Minister of Health announced the Government of Canada’s intention to introduce legislation in early 2023 to extend the temporary exclusion of eligibility for persons suffering solely from a mental illness beyond March 17, 2023.
On January 30, 2023 Health Justice wrote a letter to the Minister of Justice and Attorney General of Canada, the Minister of Health, and the Minister of Mental Health and Addictions to express our concern about inadequate safeguards with respect to involuntary patients. We identified oversights in the Final Report of the Expert Panel on MAiD and Mental Illness released in May 2022 that fail to take into account the laws applying to involuntary patients who have their freedom and health care consent rights taken away. This is particularly true in BC, a jurisdiction which uses a unique legal model for involuntary treatment and has the highest hospitalization rate for mental illness and substance use in the country. Canada was poised to expand access to MAiD to people whose sole underlying condition is a mental illness without sufficient clarity or guidance to ensure that safeguards are in place to protect involuntary patients from influence, coercion, or pressure in relation to choices surrounding MAiD.
On March 9, 2023 legislation came into force that delayed the expansion of MAiD in circumstances where a person's sole underlying condition is a mental illness for a period of one-year, until March 17, 2024. While this delay would provide more time to create guidance and safeguards, it is vital that guidance and safeguards take into account the unique situation of involuntary patients who have been deprived of their freedom and their right to make choices regarding the very condition they may be seeking MAiD in relation to.
Read Health Justice’s full letter to the federal Ministers regarding inadequate safeguards with MAiD for involuntary patients.