The Special Joint Committee on Medical Assistance in Dying (AMAD) met on March 24, 2026, to study the readiness of Canada's MAID framework for cases where mental illness is the sole underlying medical condition. Appearing as witnesses were Dr. K. Sonu Gaind, Dr. Mona Gupta, Professor Jocelyn Downie, and Professor Trudo Lemmens, all speaking as individuals.
Dr. K. Sonu Gaind argued that Canada is not ready to provide MAID solely for mental illness, citing evidence that assessors cannot reliably predict irremediability or separate suicidality from MAID requests, and that suicide risk factors such as feeling a burden, loneliness, and marginalization already drive many track 2 cases. He noted that international bodies like the International Association for Suicide Prevention and the American Psychiatric Association oppose psychiatric euthanasia, and he warned that expanding MAID would disproportionately harm marginalized individuals and women. He recommended an indefinite pause until evidence, not constructed consensus, demonstrates safety, and he disagreed with Dr. Gupta's reassurances, calling them unsupported by data.
Dr. Mona Gupta testified that clinical readiness has been achieved, pointing to consensus among psychiatrists that mental disorders can be grievous and irremediable, new Canadian Psychiatric Association guidelines on assessing irremediability and suicide risk, and training programs from CAMAP and Université Laval. She argued that excluding mental illness is discriminatory, as other countries with similar regimes do not do so, and that the complexities attributed to mental illness already exist in physical conditions. She recommended lifting the exclusion, stating that assessors are prepared and that the law's eligibility criteria and procedural safeguards are sufficient.
Professor Jocelyn Downie asserted that a blanket ban on MAID for mental illness breaches sections 7 and 15 of the Charter, as confirmed by the Carter, E.F., and Truchon decisions, and that any further extension of the exclusion cannot be demonstrably justified. She stated that clinical and regulatory readiness have been met, citing training programs, practice guidance, and the readiness of provincial regulatory colleges, and that Health Canada data show socio-economic vulnerabilities are not drivers of MAID. She recommended allowing access, warning that continued exclusion will cause people to die by suicide or suffer needlessly, and she disagreed with claims that the MDRC reports indicate systemic problems, noting the committee does not make findings of non-compliance.
Professor Trudo Lemmens argued that MAID for mental illness is not constitutionally required and would create significant risks of premature death, citing troubling cases from the Ontario MAID death review committee where unaddressed suicidality, psychosis, and substance use did not prevent MAID provision. He warned that permissive clinicians act as a "pole of attraction" for suicidal people, that gender disparities are evident in jurisdictions allowing psychiatric euthanasia, and that Canada's emphasis on access over protection exacerbates dangers. He recommended against expansion, urging Parliament to strengthen guardrails and prioritize suicide prevention, and he disagreed with Professor Downie's interpretation of Carter, arguing the Supreme Court did not intend to include mental illness.
The meeting included procedural debate when Senator Wallin raised a point of order about a witness's intervention on personal privilege and the chair's use of prerogative to intervene, seeking clarification on committee rules and time allocation.
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