This special joint committee meeting examined the eligibility of persons whose sole underlying medical condition is a mental illness to receive medical assistance in dying (MAID). Witnesses included Margaret McKinnon, Lilian Thorpe, Gordon Gubitz, Stefanie Green, Eliana Close, Allison Crawford, Douglas Grant, Jitender Sareen, Sandip Singh Gandham, Melissa Prokopy, and Kevin Young.
Margaret McKinnon, a clinical psychologist and person with lived experience of depression and PTSD, testified that she would have sought MAID during a past period of severe illness and now feels unsafe with the proposed expansion. She appealed to the committee to consider Canadians who would feel at risk and to acknowledge that not all Canadians have equal access to gold-standard mental health treatments due to economic, geographic, and cultural inequities.
Lilian Thorpe, a geriatric psychiatrist, described her clinical experience with track 2 MAID patients, noting that her primary goal is to improve quality of life so patients no longer wish to die. She expressed that MAID for mental disorders presents even greater challenges, including difficulty predicting long-term outcomes, particularly for young people, though she hoped a peaceful death might be available for a minority of older patients with truly refractory illness.
Gordon Gubitz and Stefanie Green, representing the Canadian Association of MAID Assessors and Providers (CAMAP), stated that clinicians are ready for the expansion, citing the Canadian MAID curriculum, national guidance documents, and a decade of experience assessing patients with comorbid mental illness. They disagreed with claims of unpreparedness, arguing that practitioners who are not ready should not be involved, and that the curriculum has addressed ableism. Green noted that CAMAP does not advocate for changes in law.
Eliana Close, a senior research fellow from Australia, described Canada’s MAID regulatory ecosystem as robust, with comprehensive monitoring, retrospective oversight of over 90% of cases, and important "coal face" regulation at the clinical level. She argued that additional legislative safeguards are not warranted, but that more transparency in provincial oversight and reinforced accountability networks would be beneficial.
Allison Crawford, chief medical officer of the 9-8-8 Suicide Crisis Helpline, recommended against expansion, citing that up to 7% of crisis line interactions reference MAID and that 74% of those callers endorsed recent suicidal thoughts. She stated there is no credible evidence that suicidal intent can be reliably distinguished from a MAID request when mental disorder is the sole condition, and that recent Canadian Psychiatric Association guidance is aspirational and lacks operational frameworks.
Douglas Grant, registrar of the College of Physicians and Surgeons of Nova Scotia, said his college will be ready if the law changes, as it is their legal duty to keep pace with medical progress. He expressed confidence in physicians’ ability to assess informed consent and decisional capacity, and noted that in Nova Scotia, only three of roughly 4,000 complaints have involved MAID, all resolved through education. He urged the committee to examine readiness on its own merits, not as a proxy for other objections.
Jitender Sareen, head of psychiatry at the University of Manitoba, urged an indefinite pause on expansion, arguing that prognosis in mental disorders is often uncertain, there is no international standard for irremediability, and there is no reliable way to distinguish a MAID request from suicidality. He noted that most international professional associations and Canadian lived-experience groups oppose expansion, and that Quebec and Alberta have moved to exclude mental illness as a sole condition.
Sandip Singh Gandham, a family physician and MAID assessor, acknowledged the real suffering of those with severe mental illness but concluded that the risks of proceeding currently outweigh the benefits. He cited the uncertainty of irremediability, the difficulty of distinguishing autonomous wishes from symptoms of illness, and the risk that MAID could become a response to remediable social failures rather than truly irremediable suffering.
Melissa Prokopy and Kevin Young, representing the Ontario Hospital Association, highlighted significant barriers to mental health care access and equity, noting that 41% of adults with diagnosed mental disorders report unmet or partially met needs. They argued that more time is needed to develop clinical consensus and ensure system capacity, and that additional consultations with Indigenous peoples and other groups should occur before any decision to expand.
The meeting included procedural debate and a brief suspension for a House vote, but no motions or votes on the substance of the review were taken.
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