Medical Assistance in Dying

This meeting of the Special Joint Committee on Medical Assistance in Dying was held to study eligibility for MAID for those whose sole condition is mental illness. Appearing were Professor Brian Mishara, Director of the Centre for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices at Université du Québec à Montréal, and Dr. Sanjeev Sockalingam, Senior Vice-President of Education and Chief Medical Officer at the Centre for Addiction and Mental Health (CAMH), followed by Roderick McCormick, Professor at Thompson Rivers University, and Neil Belanger, Chief Executive Officer of Indigenous Disability Canada.

Professor Mishara argued that MAID for mental illness is impossible to determine because no one can accurately predict whether a patient will respond to future treatments, diagnoses are often unreliable and change over time, and there is no discernible difference between the reasoning behind MAID requests and suicide justifications. He cited data from the Netherlands showing a sharp increase in deaths after media coverage of cases, with most requests coming from depressed women living alone under 24, and warned that offering MAID for mental illness communicates that death is a viable alternative to treatment, undermining suicide prevention.

Dr. Sockalingam stated that CAMH remains concerned about expanding MAID to those whose sole condition is mental illness because there are no established criteria or evidence to objectively determine irremediability, and the Canadian Psychiatric Association's guidance only offers a process, not evidence-based criteria. He noted that a new review found no evidence to reliably distinguish between a MAID request and suicide intent, and that Canada's underfunded mental health system leaves many without adequate care, so CAMH recommends delaying the expansion indefinitely until evidence-informed criteria exist and the system is properly resourced.

Roderick McCormick testified that expanding MAID for mental illness contradicts his 40 years of work in indigenous suicide prevention and life promotion, as many clients who recovered from suicidal thoughts realized their desire to die was a temporary problem. He argued that the government is abdicating its responsibility by offering death instead of providing the range of mental health services needed, particularly for indigenous peoples who face high rates of trauma, poverty and limited access to care, and that MAID's emphasis on individual autonomy is culturally biased against collective indigenous values.

Neil Belanger stated that Indigenous Disability Canada works with individuals who have requested or been approved for track 2 MAID due to inadequate housing, discrimination, racism in health care, and lack of disability supports, not because of their mental illness itself. He noted that the United Nations Committee on the Rights of Persons with Disabilities recommended Canada repeal track 2 MAID, including for mental illness, and that Canada has not responded, and he argued that offering MAID when basic needs are unmet constitutes coercion, urging the committee to recommend repeal and instead provide adequate services so people can have dignified lives.

A procedural point of order was raised regarding a senator's line of questioning about committee structure, and another member corrected the record that a person with lived experience had previously appeared.