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Justice Minister Sean Fraser announced on October 7 that the federal government will table legislation this fall to maintain the exclusion of medical assistance in dying for people whose sole underlying condition is mental illness on an indefinite basis. The decision follows a special joint parliamentary committee report from June that recommended the government amend the Criminal Code to bar such access after hearing divergent expert views on whether mental illness can be deemed irremediable. Fraser said there is no perfect consensus on the issue but that the government believes this is the correct approach at this time given continuing gaps in mental health services.
The exclusion for mental illness was introduced in the 2021 amendments to Canada’s MAID legislation and has been delayed three times with the most recent extension pushing implementation to March 2027. According to a Reuters report a recent Angus Reid poll showed that while support for assisted dying in terminal illness cases approaches 80 percent it falls to 43 percent when mental illness is the only factor. The parliamentary committee had concluded that conditions for safe and equitable implementation could not yet be met.
Fraser’s statement also outlined plans to permit advance requests for MAID from patients diagnosed with serious progressive illnesses who may lose the capacity to consent in the future. The minister noted that provinces and territories would retain responsibility for deciding whether to offer advance requests with Quebec already permitting them in cases such as Alzheimer’s while Alberta has passed legislation prohibiting the practice. This element of the forthcoming bill responds to calls for greater flexibility in end-of-life planning for those facing neurodegenerative decline.
Canada legalized medical assistance in dying in 2016 initially limiting it to cases where natural death was reasonably foreseeable before the 2021 changes expanded eligibility to include intolerable suffering from grievous and irremediable medical conditions. Health Canada monitoring has tracked a steady rise in MAID cases since legalization with the program now among the most utilized in the world according to comparative international assessments. The latest policy shift settles a decade of debate that included multiple court challenges and intense public discussion over safeguards.
The announcement arrived on the same day the House of Commons was scheduled to vote on a Conservative private member’s bill that would have similarly blocked the mental illness expansion. Fraser indicated the government had reviewed a broad range of perspectives before settling on the indefinite pause and the new measures on advance consent. Officials have stressed that existing MAID access for patients with physical illnesses remains unchanged under the planned legislation.
