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As deadline looms, Liberals say Canada not ready to expand assisted dying eligibility

OTTAWA — The federal government is hitting pause on its plans to make medical assistance in dying available to people whose only medical condition is a mental illness — and Health Minister Mark Holland is offering no clues about a new timeline.
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Federal Health Minister Mark Holland listens to a question from a reporter during a news conference, Tuesday, December 12, 2023 in Ottawa. Some lawyers are pushing their national advocacy organization to withdraw its support of expanding medical assistance in dying to those suffering solely from a mental disorder. THE CANADIAN PRESS/Adrian Wyld

OTTAWA — The federal government is hitting pause on its plans to make medical assistance in dying available to people whose only medical condition is a mental illness — and Health Minister Mark Holland is offering no clues about a new timeline.

The country is not yet ready to take such a significant step, Holland acknowledged Monday, concurring with a findings of a joint parliamentary committee that released its final report earlier in the day. 

That committee, which reconvened last year to explore whether medical professionals were prepared, concluded that fundamental issues around the controversial expansion have not yet been resolved. 

While practitioners of assisted death, medical professionals and regulators have done plenty of prepatory work, the committee heard "significant testimony" from stakeholders that the system was not yet ready. 

"Many practitioners remain concerned, particularly regarding the challenges of assessing irremediability," the report read. 

Significant questions also remain about how assessors would be able to tell the difference between someone requesting an assisted death and someone who is experiencing suicidal thoughts. 

Senators and MPs on the committee also heard "conflicting" testimony, said the report, which also recommended that the committee resume its work a full year before the next deadline.

The government will soon introduce legislation detailing its plans, Holland said. That will have to happen before the expansion is scheduled to take effect March 17. 

"We need more time," he said. "We'll be in a position in the coming days to talk about how much time we believe is required." 

The Liberals already legislated a one-year delay last year, saying at the time that medical providers and provinces needed more time to prepare.

The government is very aware of the coming deadline, said Justice Minister Arif Virani. 

The Liberals still maintain that someone who has experienced "decades" of torment and has exhausted all their treatment options should be afforded the option of an assisted death, Holland said.

But the government needs to ensure it is "limited to those circumstances and that we have proper controls," he added.

Holland also pointed to concerns expressed by the governments of Saskatchewan, Alberta and Manitoba about the planned expansion and the risks it could pose to those who are mentally ill. 

The Liberals have been under growing opposition pressure to hit the brakes on the expansion plans. The federal New Democrats want more mental health supports in place first. 

 The federal Conservatives, meanwhile, are calling for it to be scrapped altogether. 

In a dissenting report, Conservative MPs and senators on the committee said that it would be "reckless and dangerous" for the Liberals to allow the scheduled change to take place in March. 

"Canada is not ready for this, and frankly, there is no evidence that Canada will ever be ready," several MPs said in a statement. 

“Justin Trudeau must immediately and permanently halt the expansion of (medical assistance in dying) to those with mental illness."

Dying with Dignity, a national advocacy organization for end-of-life care, called on the government to present its plan with all due haste. 

The necessary training and practice standards have been developed and after three years of preparations by providers, the country is indeed ready to move ahead, the group said in a statement.

Depriving those with mental illness the chance to be assessed for an assisted death amounts to a breach of their rights, it continued. 

Three independent senators echoed that point in a dissenting opinion from the committee's findings.

"Canadians with mental disorders should receive appropriate health care on a case-by-case basis," read the statement by senators Stan Kutcher, Marie-Francoise Megie and Pamela Wallin. 

"It also stigmatizes individuals with mental disorders, promoting the myth that individuals with mental disorders are incapable of making informed decisions about their end-of-life choices."

This report by The Canadian Press was first published Jan. 29, 2024.

Stephanie Taylor, The Canadian Press