Canada indefinitely suspends expansion of medically assisted dying to people whose sole condition is mental illness

Canada has indefinitely suspended plans to expand medically assisted dying to people whose sole condition is mental illness. Justice Minister Sean Fraser announced the reversal on Wednesday.

The expansion was set to take effect in March 2027, but a parliamentary committee earlier this year recommended that Canada indefinitely exclude persons whose sole underlying medical condition is a mental illness from eligibility for medical assistance in dying. Fraser said the government will introduce new legislation in the coming weeks to formalize that indefinite bar.

Fraser cited the lack of medical consensus on the irremediable nature of certain mental illnesses as a central reason for the decision. “When I hear that there is a lack of consensus in the medical community about the irremediable nature of certain mental illnesses, that gives me real cause for concern,” he said. Fraser acknowledged that the Supreme Court could weigh in on the issue in the future, telling reporters, “while there is not a perfect consensus on this issue, we believe this is the correct approach at this particular time.”

Advocates call decision ‘profoundly disappointing’

The advocacy group Dying with Dignity Canada called the government’s decision “profoundly disappointing.” Helen Long, the group’s CEO, said that while a very small number of individuals with severe and persistent mental illness would be eligible, “their suffering is no less real than those who live with physical illnesses.” A federal court case challenging the government’s earlier decision to delay access to MAID for people with mental illness remains before the courts. Claire Brosseau, who has treatment-resistant bipolar 1 disorder, is part of the case and told the BBC earlier this year that assisted dying would offer her “a safe death.” Her lawyer, Michael Fenrick, said he anticipates a lengthy legal battle. “People will continue to suffer intolerably while the case goes through the courts,” he said.

Legislation also addresses advance requests

The proposed law will also address advance requests, allowing patients with progressing or incurable illnesses to consent to assisted dying before losing the capacity to do so. Advance requests are not currently legal under federal law but are allowed in Quebec for those with serious and incurable illnesses. The final decision on advance requests will be left to individual provinces. Alberta has already said it will not permit them. Fraser said the bill attempts to ensure that “the doctors who provide the services will not be treated as criminals for doing so.”

A decade of incremental expansion

Canada’s MAID laws were drawn up after a 2015 Supreme Court decision, and medically assisted dying became legal in 2016 for people with terminal illnesses. In 2019, a Quebec judge ruled that restricting access to those with a reasonably foreseeable death was unconstitutional, forcing federal lawmakers to amend and expand the existing laws. In 2021, the law was expanded to people with incurable conditions whose death was not imminent, and lawmakers placed a temporary exclusion on mental illness as a sole condition. That exclusion was renewed in 2023 and 2024. According to the latest government figures, 95.6% of MAID deaths involve people whose natural death was considered reasonably foreseeable. The Liberal legislation also aims to ward off a private member’s bill that would amend the criminal code section covering MAID so that “a mental disorder is not a grievous and irremediable medical condition.”