Provinces ask Ottawa for indefinite pause on expansion of assisted dying eligibility
Most provinces and territories are asking the federal government to hold off “indefinitely” on a controversial plan to expand eligibility for assisted dying.
Health and mental-health ministers from all three territories, along with Alberta, Saskatchewan, Ontario, New Brunswick and British Columbia, are pleading with their federal counterparts for more time.
A parliamentary committee urged much the same in its final report Monday, warning that the health system is not ready to allow medical assistance in dying for people whose only condition is a mental illness.
The expansion was due to take place in mid-March. But there’s simply too much work to be done, the ministers warned in a letter to Health Minister Mark Holland and Justice Minister Arif Virani.
“It is critical that all jurisdictions, health authorities, regulators and practitioners have sufficient time to implement these safeguards and to address capacity concerns that are expected to result from the expansion,” says the letter.
The federal government said Monday it is seeking another pause on extending medical assistance in dying to those suffering solely from mental illnesses. ‘It’s clear from the conversations we’ve had that the system is not ready,’ Health Minister Mark Holland said.
“We encourage you … to indefinitely pause the implementation of the expanded (medical assistance in dying) eligibility criteria to enable further collaboration between provinces, territories, and the federal government.”
Both Holland and Virani agreed with the committee’s conclusions Monday, but refused to say when they would share details of a new timeline.
Ministers from Nova Scotia and P.E.I. said their provinces are better prepared for the changes. They still signed on to support their colleagues.
The federal Conservatives are calling on the Liberals to cancel plans for the expansion altogether. The New Democrats want to see more mental-health supports in place first.
Speaking to reporters on his way into the Liberals’ weekly cabinet meeting Tuesday morning, Holland said that new legislation is coming but refused to elaborate.
The federal government updated its assisted dying law in 2021 to expand eligibility to include people suffering solely from mental illness.
That legislation included a two-year clock to allow practitioners and systems to get ready, meaning the change was scheduled to take effect in March 2023.
Last year, the government passed a bill to add another year to that timeline.
The federal government has announced it’s hitting the brakes on expanding medical assistance in dying to those suffering solely from mental health issues, saying Canada’s health system is not ready.
If the government opts to pause the expansion indefinitely, it could leave the door open to a constitutional challenge, said Shelley Birenbaum, chair of the end-of-life working group at The Canadian Bar Association.
“I think that it’s a grave injustice to those whose suffering is so great that they wish to access MAID as a response,” said Birenbaum, a Toronto-based health lawyer.
She said that even if the minister tables legislation that sets a new deadline to expand the eligibility, she doesn’t know who would trust the government to meet it.
She said she also doesn’t believe a parliamentary committee is the appropriate body to determine clinical readiness.
“Why would laypeople sitting on a committee, who are not experts in any of these fields, be able to assess readiness?” she said.
The Current19:33Growing number of Canadians getting MAID
A growing number of Canadians are choosing medically-assisted death. Last year, more than 13,000 Canadians used the program — a 31 per cent increase over the year prior. Matt Galloway discusses why more Canadians are choosing medically-assisted death, with Dr. Michel Bureau, the head of Quebec’s commission on end-of-life care; and Dr. James Downar, a physician who heads the University of Ottawa’s palliative care division, and the co-author of a recent study for the Canadian Medical Association Journal that looked at who gets MAID and why.
Lawyers are expected to debate a resolution that calls for the bar association to withdraw its position on the policy next week.
In the meantime, Birenbaum said the working group plans to continue to advocate in favour of opening up eligibility to people whose only underlying condition is mental illness.
Holland acknowledged Tuesday that some provincial officials may simply oppose expanding assisted-dying eligibility on ideological grounds.
The Alberta government, for example, says it is calling for an indefinite delay because it does not believe that offering a medically assisted death to someone with a mental disorder is a role for the health-care system.
Proponents of the expansion argue that people with mental illness deserve to be treated the same way under the law as those suffering from debilitating physical conditions. They say it would violate patients’ rights to exclude them.
Holland said the government believes in eventually making the change for that reason but wants to ensure that most provinces and territories are ready.
