Provinces ask Ottawa for indefinite pause on expansion of assisted dying eligibility

Most provinces and territories are asking the federal government to "indefinitely" hold off on a controversial plan to expand eligibility for assisted dying.

The Liberal government is facing pressure to explain what such a delay could look like. Eligibility for assisted death was due to be expanded to those who only have a mental illnessin mid-March.

Health and mental-health ministers from all three territories, along with Alberta, Saskatchewan, Ontario, New Brunswick and British Columbia, are prodding 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 committee, which heard from 21 expert witnesses and received hundreds more briefs, concluded it heard "significant testimony" indicating the system was not ready.

It found that critical questions remained unanswered, such as how to tell if patients requesting an assisted death are suicidal or whether it is possible for them to get better.

WATCH |Government wants to wait on expanding medical assistance in dying

Health minister seeks pause on MAID expansion, says system is 'not ready'

8 months ago

Duration 1:47

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.

There's simply too much work to be done, provincial and territorial 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," the letter read.

"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."

Ministers from Nova Scotia and P.E.I. said their provinces are better prepared for the changes. They stillsigned on to support their colleagues.

Reacting to the committee report on Monday, both Holland and Virani said they agreed with its conclusions and the system needs more time.

But just how much is still in question, and ministers are staying mum until new legislation is tabled.

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.

NDP MP Alistair MacGregor, who sat on the parliamentary committee that probed the issue, says while New Democrats haven't seen what the Liberals are proposing for a delay, he would be "hesitant" to attach a timeline to it.

The Liberals already legislated a one-year delay to the expansion last yearand that "obviously wasn't enough," he said.

MacGregor said Holland must listen to the call for an indefinite pause coming from provinces, since they are ultimately responsible for overseeing its system.

WATCH | Health minister seeks pause on MAID expansion, says system is 'not ready'

Government wants to wait on expanding medical assistance in dying

8 months ago

Duration 2:26

The federal government has announced its hitting the brakes on expanding medical assistance in dying to those suffering solely from mental health issues, saying Canadas health system is not ready.

Holland told reporters on Tuesday that the government must listen to what the provinces are saying, but also what medical professionals report about the readiness of the system.

He acknowledged that for some provinces, ideology may be at play.

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 belongs in the health-care system at all.

Still, provincial ministers from across the political spectrum are raising concerns, Holland noted.

"I've talked with health ministers from New Democratic governments, health ministers from a Liberal government, a health minister from Quebec all of whom say their system isn't ready," he said.

"So it's not just conservative health ministers that are saying this."

Quebec passed a law last year that excludes adults in that province from accessing a medically assisted death solely for a mental disorder.

The federal government updated its assisted dying law in 2021 to expand eligibility to include people suffering solely from mental illness.

The law, which passed in March 2021, included a two-year clock on the coming-into-force of the provision to allow practitioners and health-care systems to get ready.

Last year, the government passed a bill to add another year to that timeline with support from across the political aisle.

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.

Even if the minister tables legislation that sets a new deadline to expand the eligibility, she said she doesn't know who would trust the government to meet it.

She also said shedoesn'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.

LISTEN |Growing number of Canadians getting MAID

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 Ottawas 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.

There has been recent debate within the bar association over whether it should maintain its position that excluding people with a mental illness would violate their rights. Birenbaum said she will continue to advocate for that position until the association chooses to change it.

MPs and senators heard a variety of legal opinions during hearings last fall.

Some argued that excluding people who only have a mental illness violates their rights, while others said such patients are vulnerable and would be at greater risk if assisted death becomes an option.

Dying With Dignity Canada and other proponents of the expansion say excluding those with mental illness perpetrates a belief that they cannot make decisions for themselves.