Paul Tuns:

The unanimous support of all Conservatives, Green, and NDP MPs, joined by a handful of Liberals, was not enough to save Bill C-314, the Mental Health Protection Act, from being defeated in the House of Commons, on Oct. 18, in a vote of 167-150.

The private member’s bill was introduced by Conservative MP Ed Fast (Abbottsford) in March to turn the temporary one-year reprieve of euthanasia and physician-assisted suicide for people suffering solely from mental illness into a permanent exclusion.

Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, said the narrow vote “indicated that Canada’s parliament is divided on the issue of euthanasia for mental illness.”

Every sitting Conservative, Green, and NDP MP supported C-314, and they were joined by one independent (Kevin Vuong, Spadina-Fort York) and eight Liberal MPs: Chad Collins (Hamilton East—Stoney Creek), Julie Dzerowicz (Davenport), Emmanuella Lambropoulos (St. Laurent), Joël Lightbound (Louis-Hébert), Wayne Long (Saint John—Rothesay), Ken McDonald (Avalon), John McKay (Scarborough—Guildwood), and Marcus Powlowski (Thunder Bay-Rainy River).

All 30 sitting Bloc MPs and 137 Liberals voted together to defeat C-314.

Schadenberg told The Interim “we are pleased and surprised that every NDP MP supported Bill C-314.” He said, “this was clearly a decision based on the fact that Canada lacks access to timely and effective treatment for mental illness, therefore permitting euthanasia for mental health is a dangerous decision.” He said the thinking is that there is “no freedom of choice when treatment is not accessible.”

On March 17, 2021, Parliament passed Bill C-7 which expanded Canada’s euthanasia law by removing the “terminal illness” requirement, removing the 10-day reflection period when someone is deemed to be “terminally ill,” adding a 90-day waiting period for someone who is approved for euthanasia but not “terminally ill,” permitting euthanasia for someone who is incompetent but previously approved for euthanasia (through advanced directives), and permitted euthanasia for someone with mental illness alone, albeit with a temporary moratorium that was extended to 2023.

Euthanasia for mental illness alone will become officially legal on March 17, 2024.

Bill C-314 would have protected people from euthanasia who are living with mental illness, by expressly forbidding mental illness as a criterion for so-called Medical Assistance in Dying.

On Oct. 5, the House of Commons held a debate for one hour on C-314.

Ed Fast stated, “The mental health community has raised significant concerns” about expanding euthanasia to people suffering solely from mental illness. He noted that, “the heads of seven Canadian psychiatry schools implored decision-makers to hold off on expanding assisted suicide to the mentally ill” and the Canadian Psychiatric Association “does not support the expansion of MAID due to the many ethical and clinical concerns that have not been resolved.” The CPA, Fast noted, argues “that mental illness is often highly treatable and that patients should be provided with the treatment they need to manage their symptoms and lead fulfilling lives.”

Fast reported that some psychiatry experts have said that “the issues of suicidal ideation, irremediability and competency have not been resolved, ensuring that Canadians will needlessly die because we have rushed ahead with expanding MAID.”

Fast concluded his remarks saying, “With so much uncertainty, surely we should err on the side of life, not death.”

NDP MP Don Davies (Vancouver Kingsway) rose to speak in favour of C-314. Davies said that it “would remove this eligibility at least until we have satisfactory answers and guardrails to ensure that we can extend this profoundly permanent step with confidence.” He added, “In my view, we do not have that necessary confidence today, and I think the majority of Canadians and health professionals, and the data, concur.”

Davies noted the “chronic underfunding” of mental health services – “Canada spends the lowest proportion of funds on mental health among all G7 countries” — and Canadians’ worries about accessing needed mental health services.

The NDP MP also raised concerns by experts about the treatment of people with mental illness and the lack of consensus or legal protocols to determine when a patient’s situation is irremediable. Davies concluded, “Adequate time, in my view, is needed to facilitate a comprehensive national conversation about acceptable safeguards and the availability of medically assisted dying for those suffering from psychological or mental health conditions alone, so that we minimize negative impacts on people living with mental health problems and illnesses when they are most vulnerable, and on their caregivers and health professionals.”

Liberal MP Kevin Lamoureux, the Parliamentary Secretary to the Leader of the Government in the House of Commons, spoke on behalf of the Liberals, during which he rehearsed the legislative history of euthanasia in Canada since the Carter decision in December 2014. He said the issue has been debated and studied extensively, but that the government would defer to “stakeholders” and “experts” on the issue, failing to note that they are far from unanimous.

Bloc Quebecois MP Gabriel Ste. Marie (Joliette), said, “The Bloc Québécois is of the opinion that it is wrong to draw false analogies between the different problems in society and the specific issue of access to medical assistance in dying when a mental disorder is the sole underlying medical condition.”

Ste. Marie stated, “When it comes to interpreting the expression ‘grievous and irremediable medical condition,’ the criteria of incurability, irreversibility and enduring and intolerable suffering, which are currently contained in the Criminal Code, must be duly established.”

Ste. Marie’s colleague, Monique Pauze (BQ, Repentigny), condemned the Conservative Party for raising the issue. “What I want to speak out against today is what I see as the official opposition’s blatant politicization of this issue,” she said. “It is the whole message surrounding the introduction of this bill in the House that I want to condemn,” adding, “I would like to be able to say that some members just do not understand, but I cannot even use that explanation as an excuse for their behaviour.”

The Society of Canadian Psychiatry noted in a brief released on Oct. 13 that there is no consensus on when mental illness is irremediable.

In a last-minute plea on the day before the vote on C-314, Fast said: “The government refused to listen to mental health experts, to veterans, to disabled people and to indigenous Canadians. It did not listen to the family whose mother begged for help, but instead was euthanized before her kids could even say goodbye.”

In March 2023, 40 specialists in psychiatry, palliative care, and disability rights signed an open letter in response to the report issued by the Special Joint Committee on Medical Assistance in Dying of the Senate and House of Commons. In a section on expanding euthanasia to people whose sole condition is mental illness, the signees argue the report’s “recommendations regarding MAID for sole mental illness conditions (MAID MD-SUMC) are deeply flawed and selectively ignore evidence while preferentially accepting personal opinions of witnesses ideologically favouring expansion.”

The letter also states the “recommendations place Canadians who would recover from mental illness at risk of avoidable premature death, and if enacted will be responsible for facilitating state provided deaths to marginalized and suicidal Canadians who would have recovered.”

The experts concluded, “the Committee is condoning a form of eugenics through expanding MAID in Canada.”

The Canadian Association for Suicide Prevention and the Society of Canadian Psychiatry supported C-314.

Campaign Life Coalition also supported C-314. Campaigns manager David Cooke said in a communication to supporters encouraging them to urge their MPs to vote for C-314, stated: If Bill C-314 does not pass this week, our friends, neighbours, and family members who struggle with  depression, anxiety, panic, PTSD, or other troubling thoughts and behaviours will be ‘eligible’ for a pseudo ‘right to die.’ There will be nothing anyone can do to stop them from visiting a death doctor and receiving their so-called ‘right’.” “There are no additional legislative safeguards around MAiD for mental illness,” said Julia Beazley, director of the Evangelical Fellowship of Canada’s Centre for Faith and Public Life.” This is deeply concerning given the immense complexity of mental health.” Beazley said, “It’s especially troubling to imagine a severely depressed 18-year-old being eligible for euthanasia. That could be the reality in Canada this coming March if nothing changes.”

Conservative MP Branden Leslie (Portage-Lisgar) tweeted, “I was disgusted today when Liberals voted against protecting those suffering from mental illness from the out-of-control culture of death promoting euthanasia, known by its Orwellian name of ‘medical assistance in dying.’ I will always stand up for protecting the vulnerable and the sanctity of life.”

Conservative leader Pierre Poilievre said if the Conservatives form government they would ban euthanasia for those suffering solely from mental illness.

The government announced that the Special Joint Committee on MAiD will meet to discuss concerns surrounding euthanizing people with mental illness. Schadenberg said, “notice that the government will continue with their plans to kill people with mental illness, they are only suggesting that how it is done may need further discussion.” He said he does not expect “any substantive suggestions” will come out of the process because “the committee is stacked with hardcore pro-euthanasia members.”