More than 90 disability rights and mental health groups urge feds to stop MAID expansion

A collective of more than 90 disability rights and mental health organizations are calling on the federal government to take medical assistance in dying specifically for mental illness “off the table” in a letter addressed to Prime Minister Mark Carney, Health Minister Marjorie Michel, and Justice Minister Sean Fraser.  

The groups want the government “to put a permanent stop to the expansion of MAID [medical assistance in dying] to people whose sole underlying condition is mental illness, instead of continuing to punt it down the road,” said Krista Carr, CEO of Inclusion Canada, which advocates on behalf of individuals with intellectual disabilities.

“From our perspective, [it] leaves people in fear that it's coming—[it] might not be coming today, but it could be coming later on.”

Carr, whose group led the charge on the letter, said that because Ottawa has already twice delayed expanding MAID, “we're just asking for it to be taken off the table altogether.”

If the government does not introduce legislation to repeal or delay MAID specifically for mental illness, it will become legal in March 2027. 

MAID for those whose deaths are reasonably foreseeable—known as track one—became legal in Canada in 2016. A second track was added for those with a grievous and irremediable medical condition, but whose deaths are not reasonably foreseeable—including individuals with disabilities—in 2020. Each track was developed in response to separate court decisions declaring that Canada’s stance on MAID contravened the Charter of Rights and Freedoms. 

When MAID was expanded in 2020, a clause was included in the legislation saying track two would not be available to those whose only condition is a mental illness until 2023. But under then-prime minister Justin Trudeau, that 2023 implementation date was delayed twice. 

Whether Carney’s (Nepean, Ont.) government goes ahead with the current 2027 date is up in the air. When questioned by reporters in the West Block on May 6, Fraser (Central Nova, N.S.) said his government is waiting for a report from a joint committee that studied the issue this spring “before we develop our final position.”

The Globe and Mail reported on May 5 that cabinet is “prepared to table” a bill that would pause the expansion if the committee recommends it, which the government is expecting to happen. The reporting was based on anonymous sources. 

The Special Joint Committee on Medical Assistance in Dying features 12 MPs and five Senators tasked with conducting a “comprehensive review relating to the eligibility of persons” whose sole medical condition is a mental illness. Seven meetings were held between late March and early May, and the committee is now preparing its report. 

Committee co-chair and Liberal MP Marcus Powlowski (Thunder Bay-Rainy River, Ont.) told The Hill Times in an interview in April for a previous article that the committee is meant to advise as to whether MAID for mental illness should go ahead, but that the decision is ultimately up to Parliament.  

Carr told The Hill Times on May 26 that her group wanted to get their letter to the government before too much progress had been made on the committee’s report. 

Anti-MAID expansion groups want feds to focus on improving access to services

In the letter to Carney, Fraser, and Michel (Papineau, Que.), Inclusion Canada and other signatories—including the Canadian Mental Health Association, Indigenous Disability Canada, the Schizophrenia Society of Canada, and the Autism Alliance of Canada—write: “We urge you not to legalize MAID for mental illness. … Mental health-related disability is still the fastest growing disability in Canada. Mental health care remains underfunded. Wait times for psychiatric treatment are still unreasonably long. … The majority of people with a mental illness continue to have unmet needs for therapies and services.” 

Schizophrenia Society of Canada CEO Chris Summerville said his organization signed the letter because allowing MAID for the sole condition of mental illness “runs so contrary to the recovery philosophy,” which guides his society’s work.

Recovery is “learning to live beyond the limitations of a mental illness with meaning, purpose, hope, and social inclusion. … So, it does not mean cure, and there are people, even with schizophrenia, with a more severe mental illness, that do go into remission, [but] not necessarily a cure,” Summerville said.  

He said the focus should not be on expanding MAID, but on support for early intervention and recovery. 

Pointing to a report released last month from the Canadian Psychological Association, which discusses the lack of publicly funded access to psychologists, Summerville said there's been a public conversation about improving the availability of mental health care for 30 years.

“It’s ridiculous, and you'd think Canada, being one of the wealthiest countries in the world, would have a far better mental health system than we do.” 

The report states more than 5 million adults did not get mental health services when needed in the past 12 months due to cost.

Inclusion Canada has also focused its advocacy on the need for more mental health, social, and financial support for people with disabilities. 

Individuals with disabilities already have access to the broader track two MAID, which the group also opposes. 

Its concerns stem from the lack of publicly funded support for people with disabilities as well as the stories they hear from those who are either considering or who have applied for MAID. 

“Even though they do not want to die, they're in horrible situations, and they are making a lasting attempt to find someone who can help them,” Carr said, adding that her organization has been tracking the communications it receives from individuals interacting with the MAID system. 

Inclusion Canada is also concerned about stories from individuals with disabilities who say MAID is being suggested to them by doctors who are treating them for other conditions that would be temporary such as a bruised hip or pneumonia, according to Carr. 

As to whether it plans to publish or share that information, Carr said she is having those conversations with other groups and is looking at how to co-ordinate their data. 

Inclusion Canada filed a Charter challenge in the Ontario Superior Court of Justice in 2024, asking the court to strike down MAID’s broader second track for those whose deaths are not reasonably foreseeable. 

The case is unlikely to be heard until 2027. An outcome is not expected before MAID for mental illness would be legal, and Carr acknowledged Ottawa would have to intervene to stop an expanded MAID system. 

Mental illness exclusion is discriminatory, says Dying With Dignity Canada chair

There is another Charter challenge in that same Ontario court, also launched in 2024, led by Dying With Dignity Canada, which supports both MAID tracks. The organization is calling on the Ontario Superior Court of Justice to uphold Ottawa’s original plan to allow MAID when mental illness is the sole condition. 

Daphne Gilbert, chair of Dying With Dignity Canada's board of directors, said the government has not yet responded to the challenge in the court. 

Also a plaintiff in this challenge is Claire Brosseau, who wants to apply for MAID for mental illness. In a statement last month, she described her reasons: “I have been diagnosed with a severe form of bipolar I disorder and post-traumatic stress disorder, among other mental disorders.”

Noting she has tried various treatments over 30 years, “my mental illness just continues to get worse. I have reached the limit of my ability to live like this— in a state of unrelenting suffering.” 

Brosseau is now applying for an emergency motion in the Ontario Superior Court of Justice to access track two MAID even though her mental-health conditions aren’t eligible under the current system. 

“She can no longer wait … it's going to be at least a couple of years now before the [original] case is heard, and she's suffering intolerably,” said Gilbert, who is also a law professor at the University of Ottawa. Gilbert's research specialties include MAID. 

Dying with Dignity Canada's position is that “it is discriminatory not to include people with a mental illness as a grievous and irremediable condition in the MAID regime. That category of people, if they have capacity to make legal decisions, should have the same rights as everybody else in terms of how they choose to end their life,” Gilbert told The Hill Times. 

When the organization launched its original Charter challenge in August 2024—following the Trudeau government’s second announced delay for expanding MAID in February 2024—it “still believed and hoped” the government would move ahead, said Gilbert. 

She said now “it is clear” to her the government will not lift the exclusion though a decision has not been announced. Gilbert said her belief is based on media reporting and her observations of how the joint committee study was conducted. 

Gilbert appeared at the committee on April 21 as an individual. She said she was the only one of 10 witnesses who appeared that evening, and was supportive of expanding MAID. 

“They did not invite a single person with lived experience who was wanting MAID. They didn't invite Claire Brosseau, for example, who made herself available to the committee,” Gilbert said. 

Canadian Senators Group Senator Gigi Osler (Manitoba), who participated in the April 28 meeting, also remarked that evening about the absence of witnesses with lived mental-health experience who supported expanding MAID. 

Both Inclusion Canada and Dying With Dignity Canada are moving ahead with their advocacy on MAID, albeit from different positions. 

Carr said her group will continue to be vocal on their opposition through conversations with MPs, social media, and traditional media. It will also continue its Charter challenge. 

Gilbert said her group continues to work on educating the public about MAID, and is developing a new platform to counter misinformation. 

tsanci@hilltimes.com

The Hill Times

Editor's Note: This article was was updated on June 1, to correct Daphne Gilbert's title. She is chair of Dying With Dignity Canada.