Canada is set to join Belgium and the Netherlands as one of the world’s most liberal countries for assisted suicide. After March 17, 2023, Canada will allow medical assistance in dying (MAiD) for individuals whose sole underlying medical condition is mental illness.
In March 2021, Bill C-7 was passed as an amendment to the Criminal Code striking down the requirement that a person’s death must be “reasonably foreseeable” or “incurable” to access MAiD, expanding access to those living with disabilities and chronic illness. The bill includes a sunset clause that temporarily restricts MAiD access for those with psychiatric disorders for 24 months. Once the bill’s clause expires, it will be legal for practitioners to provide assisted suicide for qualified individuals whose sole underlying medical condition is mental illness.
The continued expansion of MAiD and the issues it surfaces are not without controversy. Many of the concerns flagged following the passage of Bill C-7 are again coming to a head as the sunset clause on mental illness winds down.
Groups vocally opposed call Bill C-7 eugenicist and highlight a lack of existing social supports for impacted individuals. Others argue that limiting access to MAiD based on specific diagnoses does nothing to address core underlying issues; denying groups access to MAiD based on their diagnosis is paternalistic and a violation of charter rights.
Bill C-7 is an amendment to the Criminal Code, not a change in health policy. Provincial health policy, funding and education measures, and the development of specific protocols with regards to implementing these expansions will still need to be fleshed out separately.
On May 13, an expert panel tabled a report on recommended protocols to apply to requests for MAiD by persons who have a mental illness. The report does not address whether those with mental illness should be eligible for MAiD, but issues guidance and protocols. Questions on the inclusion and implementation remain.
Parliament’s Special Joint Committee on Medical Assistance in Dying continues to hold hearings in the leadup to its own interim report on MAiD and mental illness, which is expected to be tabled this fall. The next meeting of the committee is to be held today (May 25).
We asked a group of experts whether they thought MAiD should be permitted in instances where the sole underlying condition is mental illness and what they think will be important going forward.
‘There has to be more than lip service paid to improve mental-health care, economic and social support for those with mental illness.’
‘Changing access to include mental illnesses is not evidence of a slippery slope – it brings the current legislation in line with the Supreme Court criteria where Canada’s MAiD journey began.’

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This may not be the appropriate place to be asking about this topic but I was wondering why (death) takes so long and why do you use so many different medications? I had to have my elderly cat euthanized at the Veterinary cinic last month and, after her catheter was secured, the lethal drug was injected and my cat passed quickly and painlessly – one heartbeat pumped the medicine out and within 2 seconds she was ‘gone’, peacefully. Why does it take so long for humans to pass w/MAiD?
I have autism and have suffered numerous bouts of depression over the past several years. In February 2017 when I was 29, I very nearly committed suicide in the night by hanging myself from the baseball field fence with my sister’s dog’s leash. The day after, we had a meeting with my autism psychiatrist and in the days that followed, my very scared, distraught mother told me several times, “If you kill yourself, my life will be over.”
I fear that if MAID is extended to people suffering solely from mental illness, that it will encompass people like myself from 5-and-a-half years ago. What if some depressed autistic young adult gets granted an assisted death that will devastate their entire family and all who knew them when they had so much to live for and could have made many more fruitful accomplishments if they had sought counselling or psychiatric help?
You could argue that a person in such a situation will be offered counselling or psychiatric service by the MAID team, but there’s no guarantee that the person will accept those services even upon considering them and even if their whole family screams “NO! DON’T DO THIS! OUR LIVES WILL BE OVER IF YOU KILLED YOURSELF OR GOT AN ASSISTED DEATH!” the patient (who could have accomplished more in their life like how I have done since my own crisis) might still be granted an assisted death despite their family’s tearful pleas against it.
Well said, David! Your voice about your own experience is valuable in this discussion,
“No! Don’t do this! It will hurt me! You keep on suffering so I don’t have to, you hear me!?!”
Agreed. I feel for those I will leave behind. but there is no point to my life anymore. If they really cared they would actually provide assistance to people insterad of letting us suffer for years and face a future of nothing but continued pain. I just turned 55 and I just submitted my MAID application. I can’t wait for this crap to be over.
Well said!
When I first failed at committing suicide, a lot of friends and family were telling me that. But then, vanished, forgetting I’m still in pain.
Its been 7 years I’m extremely depressed with suicidal tendencies. People say: why don’t you get help? Depression makes you not give a fuck about yourself. If I can’t get up to take a shower, eat, or get some fresh air; What makes you think I’m capable of seeking help?
Do not get me wrong. I’ve tried asking for help from time to time. But I’m a black “male.” Doctors treat you like a number and society look at you with shame.
Like “Shut up! Be a man”
In the summer of 2021, I hit an ultimate low, and because of covid there was no one to reach out to. I ended up spending 9days in a psych ward with legit crazy people. I was so depressed and suicidal that I wanted to stay there until I got better. But, they wanted me to leave. So the doctor gave antidepressants for the first time, but they turned me into a zombie. Unable to do every day functions. After that I was homeless for 2months, sleeping in my car.
I am more than willing to do MAID. Society does not care about mental illness. Everytime I’m doing good, something happens, and I always lose more than I gain. Depression has put me in a position where I feel like I’m in hell. A burden to everyone around me, especially to myself.
I totally agree with MAID and I am registered. I am a recent widower with a heart condition. I have no biological children and I am the last leaf on this family tree. I do not wish to be a burden. I only wish to pass wuth dignity on my time table. Am I mentally ill or merely a pragmatic individual?
I’m basically in the same boat at 65. Mind me asking where you found the application form for MAiD? Thank you!
Come hell or high water I’m doing it whether the government approves or not. Someone will assist me. Even if it’s a Dr. Jack Kevorkian-type in the back of a van. I want assisted suicide as someone who has a mental illness that has no cure and the state doesn’t provide proper support to those who are mentally ill. I want assisted suicide because I don’t want to traumatize someone who finds my body. Nor the police, fire, and ambulance workers that show up to take away my body. I’ve thought about this a long time. It’s not an impulse decision. I want assisted suicide because I don’t want to end up on the street because I can’t function normally in society. It’s my decision and one I have a right to have control over. I’m mentally ill. Not stupid.
“Sole”? This word shows that the writer has no idea what living with an illness like schizophrenia is.
I see the validity of some of the arguments that those opposed to MAiD in this case make, but none of them strike me as sufficient to prevent an individual from having the right to make their own decision here. Drs. Crawford and Stainton would have us wait until any academic debate about whether (and when) a patient’s condition is irredeemable is settled. Dr. Vrakas can’t support it until all inequality, stigmatization and inequality for people with mental illnesses is overcome. I don’t think anyone could seriously disagree that we need further research to better understand the causes and course of mental illnesses, that our system is woefully under-resourced to make adequate care universally accessible for patients with these conditions, or that greater advocacy work is needed to reduce stigmatization and discrimination. I’m left wondering, though, how much our striving towards any of those goals at some indefinite point in the future would matter to a patient whose suffering is intolerable right now, in 2022, and who has not been helped by any of the treatments that are currently available to them. Dr. Schuklenk has it right: how would denying such patient access to MAiD, if they believe they need it, make them, as autonomous individuals, better off? Providing MAiD doesn’t free us from the moral obligation to improve the care we provide to those with serious mental illnesses, but neither does the current inadequacy of that care justify withholding MAiD as an option.
Agree wholeheartedly – they’d try anyway, but in a horrific way. How can we end pets’ suffering and turn a cold shoulder on people who suffer unbearably?
There is another group that suffer from disabling diseases that are not medically recognized such as complex disseminated persistent Lyme because there is no good test. This happened because the long-term disability insurance industry red-flagged some diseases as being too expensive to treat. These patients are given inferior diagnoses, have been told that they suffer from medically unexplained symptoms and told to seek psychiatric help. Many of these medically abandoned patients have ended their lives or applied for MAiD. If there isn’t a test for a disease then it doesn’t exist. Modern medicine has lost its way and is no longer searching for the root cause of inflammation and disease. Historically infection has usually been found to be the cause root cause but there are few medical sleuths with microbiological training. Specialists work in silos and infectious disease doctors have abandoned their medical colleagues who have to live with the patients and inferior diagnoses. In medicine the dead shall speak to the living but autopsies are seldom done and when they do search for causes in diseases such as myalgic encephalitis they don’t know what they are looking for and they are searching in the wrong places. Shareholder preferences control things and shareholders are not interested in cures, vaccines or new antibiotics. The paradigm of modern medicine is to name it and treat it which gives the pharmaceutical industry lifelong annuities. MS was once known as faker’s disease. Pandemics disable people — the history lesson that policymakers ignore. How about some cures?
Miriam Toews writes beautifully about this in her heartbreaking book “All My Puny Sorrows.” Worth the read for anyone concerned with this topic.
As individuals we must come to terms with the inevitability of death and as older adults to insist that our voices are heard when discussing their end-of-life care, with more control over what we want than others may think.
Chambers LW, Smith M. New MAiD legislation calls for the wise words of a pioneer. Healthy Debate May 12, 2021 New MAiD legislation calls for the wise words of a pioneer – Healthy Debate
We live in an ageist society where myths like “Most older persons suffer from mental illness can’t be treated” or “Cognition inevitably declines in old age”. Becca Levy (see “Breaking the Age Code” published in 2022) recommends the ABC method be used to overcome this. For example, with MAID these are: Awareness — identifying where negative and positive images are found in MAID decisions, Blame: understanding that MAID decisions can be the result, at least in part, of the negative age beliefs, and Challenge: we need to take action to ensure MAID decision-making arising from ageism is not harmful.