Paul Tuns:

Federal Justice Minister David Lametti introduced bill C-39, to delay for one year its decision to allow people who suffer solely from mental illness to seek euthanasia. This came after a public backlash to Canada’s euthanasia regime, following news stories of numerous cases of people accessing so-called Medical Assistance in Dying for social reasons, and concerns from mental health experts that protocols had not been developed outlining eligibility for MAiD that would protect patients with suicidal ideation. The bill was introduced Feb. 2, six weeks before Canada’s MAiD regime was scheduled to include those suffering solely from mental illness.

Meanwhile, Conservative MP Ed Fast (Abbottsford) introduced C-314, a bill that would outlaw euthanasia for patients whose sole condition was mental illness.

C-314 would declare that “a mental disorder is not a grievous and irremediable medical condition” and therefore would not qualify for euthanasia. Fast noted that there is no agreement among psychiatrists about when or if mental illnesses are irremediable. Under the current law, patients who are not dying but have a “grievous and irremediable condition” – and it may be considered irremediable because the patient refuses treatment – are eligible to be medically killed.

Fast said when he tabled his bill in the House of Commons on Feb. 10, “Issues of irremediability, competency and suicidality are not anywhere close enough to being resolved to justify this major policy shift in favour of death.”

He that when the Trudeau government passed C-14 legalizing euthanasia in 2016, MAiD “was expressly limited to capable adults who have an irremediable disease that causes enduring and intolerable suffering that cannot be alleviated, and when their natural death is reasonably foreseeable.” He said the government and euthanasia advocates “assured Canadians that this would not lead to a slippery slope on which the scope of MAID would continually be expanded to include other Canadians.” Yet “Not surprisingly, in the intervening seven years, the government has expanded the scope of MAID by de facto extending its scope to those who are not dying, but who are living with disabilities.”

Fast said that the government expanded euthanasia to include the mentally ill in 2021 although it was not scheduled to take effect until March 2023. He also said the government “signaled its intention to extend this right to mature minor children,” adding, “Clearly, we are on the slippery slope many of us had warned about, and Canadians have a right to ask who is next.”

Fast worried that euthanasia will be extended to include the “drug addicted, the indigent, the homeless, or needy veterans,” asking, “Where does it end?”

C-314, Fast said, was necessary “to reverse this momentum and repeal the government’s decision to extend MAID to the mentally ill.” Fast assured the House of Commons, “My bill does not, in any way, reverse the rest of Canada’s MAID regime. Instead, it arrests Canada’s slide down the slippery slope of assisted suicide, which so many of us had predicted would happen.”

The Preamble to C-314 states, “Parliament considers that vulnerable Canadians should receive suicide prevention counselling rather than access medical assistance in dying” and worries “Canada’s medical assistance in dying regime risks normalizing assisted dying as a solution for those suffering from a mental disorder.”

The federal government has repeatedly vowed to increase health care transfers to the provinces to fund mental health services, but provincial health ministers say that the funding comes up short to meet the growing demand for psychiatric services in Canada.

Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, told The Interim that “we are very pleased by Bill C-314 and it should be promoted and supported in every way.”

Campaign Life Coalition national president Jeff Gunnarson agrees. He told The Interim “CLC and its supporters are thrilled that an elected representative is standing up to the Trudeau government’s relentless expansion of euthanasia and saying ‘enough is enough’.” CLC is encouraging its supporters to contact their MPs to urge them to vote for C-314.

Gunnarson said it may be necessary to support the government’s delay first, but that “our goal is not to delay the killing of patients with mental illness but to stop it, and eventually to end all euthanasia.”

Lametti introduced Bill C-39 which would delay eligibility for MAiD for people suffering solely from mental illness for one year. If C-39 does not pass, the start date for euthanizing patients with mental illness will be March 17. “It is clear more time is needed to get this right,” Justice Minister David Lametti said in a news conference, indicating that the delay was due to Covid, not the public backlash against Canada’s liberal euthanasia law.

In late 2022, the heads of Canada’s psychiatric departments of Canada’s medical schools said that MAiD would result in patients being killed before they were given a chance to recover, noting that the government had not created guidelines to assess eligibility. The Canadian Association of MAiD Assessors (CAMA) said that they had received no guidance from the government about how to proceed on the issue of mental illness but vowed to permit their physicians to approve euthanasia requests for patients with mental illness even in the absence of any protocols for doing so.

CAMA originally said such protocols would not be ready until Fall 2023, but suggest they might be available sooner. The Globe and Mail reported that once they are in place it would take “time for regulatory bodies and hospitals to adopt them.”

The euthanasia advocacy group Dying with Dignity criticized C-39, saying that it needlessly prevents patients from accessing euthanasia.

Conservative House Leader Andrew Scheer said the Conservatives will support the government’s delay bill and urged the Liberals to expedite the bill to ensure its passage. Scheer spoke in the House of Commons on Feb. 9, saying, “Conservatives feel very strongly that mental illness should not be the sole factor when considering medical assistance in dying.” He said the delay was necessary “to establish more of a timeline for the government to get this right, for parliamentarians to come together and get this part of the regime right.”

Speaking in favour of C-39, Conservative Justice Critic Rob Moore (Fundy Royal) said the delay was “an admission of a process that was far too rushed.” He noted that “Just two years ago” Justice Minister David Lametti appeared before the justice committee to say the government was not proceeding with mental illness as a criterion for MAiD eligibility but after the Senate amended C-7 to include mental illness, Lametti was “confident there was a consensus” on how to proceed.Conservative MP Michael Cooper (St. Albert-Edmonton) spoke in favour of the delay even those C-39 was “legislation that imposes a new arbitrary deadline of March 2024 in place of the Liberal government’s arbitrary deadline of March 2023 whereby persons with a sole underlying mental health disorder would be eligible for MAID.” He said he supported C-39, “only because it is better than the alternative, namely that in one short month from now, on March 17, MAiD would be available to persons with a sole underlying mental health disorder.” He said, extending euthanasia to the mentally ill, “would be an absolute disaster and certainly result in vulnerable persons prematurely ending their lives, when otherwise, they could have gone on to recover and lead healthy and happy lives.”Cooper said, “rather than imposing a new arbitrary deadline that is not grounded on science and evidence, what the Liberal government should be doing is abandoning this radical, reckless and dangerous expansion of MAiD altogether.” He said that is why he “wholeheartedly support(s) Bill C-314.”The House gave unanimous consent to C-39 on Feb. 13. The Senate is scheduled to consider C-39 on March 8.

Dr. Ramona Coehlo, a family physician and outspoken critic of euthanasia, said, “Delaying the expansion for MAID for mental illness is only the tip of the iceberg of what the Canadian government must do.” Noting that she serves a predominantly low-income clientele, Coelho said her patients have trouble accessing social services and that, “Canada has not done its part to ensure them a quality of life that should rightfully be theirs.”

The extension afforded by C-39 would also allow both the government and Parliament to consider the final report of the select parliamentary committee reviewing the Medical Assistance in Dying Law, which was filed in mid-February. When euthanasia was legalized in 2016, a mandatory review was made part of the law and many MPs thought it would be conducted before any expansion of MAiD. The government expanded eligibility of euthanasia in 2021 in response to a Quebec court decision deeming that a patient’s death be imminent was unconstitutional. The government is now considering whether to permit adolescents – so called mature minors — to be euthanized.

Dying with Dignity said it opposes expanding euthanasia to only mature minors but supports such a law as a step to inevitably expanding euthanasia for children and infants. In 2021 and again in 2022, the Quebec College of Surgeons and Physicians urged governments to permit newborns to be euthanized.