Nurses in Ontario will be receiving new guidance on how to approach medically assisted deaths in anticipation of legal changes set to take effect next March, when patients with the sole condition of mental illness can access the procedure.
The College of Nurses of Ontario, which regulates nursing in the country’s most populous province, said its current MAID guidance was published in April, 2021, and it was updated last year.
“Since its publication, the political and legislative context for MAID has evolved in Canada, particularly around the topic of mental disorder as a sole underlying condition for MAID,” said Maria Feldman, a spokeswoman for the college.
Ms. Feldman did not specify when the new changes will be released but said the college’s mandate to protect the public will be top of mind. “The updated guidance will reinforce and strengthen nurses’ accountabilities related to medical assistance in dying.”
MAID has been a polarizing issue. The former Trudeau government introduced a law in June, 2016, that allowed Canadian patients whose deaths were deemed “reasonably foreseeable” to seek the help of medical professionals to end their lives.
In 2021, the law was updated to allow patients with incurable conditions, such as multiple sclerosis, to seek to end their lives. Patients no longer needed to demonstrate that their deaths were reasonably foreseeable to access the procedure.
At the same time, it was determined that patients living with mental illness would not be immediately eligible for MAID. Instead, an initial two-year temporary exclusion was put in place to allow for more time to study how MAID could be delivered to such patients.
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On March 17, 2027, Canada is set to begin permitting MAID for patients with mental illness. The federal government could delay this timeline, as it has already done twice, but it would need to introduce a bill to do so. In 2024, the federal government cited provincial concerns about readiness and cited that more time was needed.
The Office of the Chief Coroner for Ontario said this February that 13 MAID cases have been referred to both the College of Nurses of Ontario and the Ontario College of Physicians and Surgeons. There is no breakdown of how many cases were referred to each body. This week, both colleges declined to provide further details, citing confidentiality provisions.
In recent months, several MAID cases have landed in court and generated growing calls for changes, including from an Ontario mother of a 26-year-old who struggled with mental illness and other medical conditions and who was approved to die by MAID in British Columbia.
Alberta Premier Danielle Smith cited this case at a news conference last month when her government tabled legislation seeking to shut down MAID for mental illness in advance of the law taking effect. The bill also proposes rescinding the procedure for patients with incurable conditions. It also looks to bar physicians from referring patients to doctors located outside of Alberta.
This week, the Archbishop of Toronto called on Prime Minister Mark Carney to bar the expansion of MAID for patients with mental illness. Mr. Carney, a practising Catholic, has not publicly shared his personal views about the procedure.
Over the past month, a joint parliamentary committee has been studying how the federal government should proceed in allowing patients with mental illness to access MAID. The committee must submit its report to Parliament by early October.
Audrey Champoux, the deputy director of communications to Mr. Carney, shared a statement Thursday that said the government looks forward to the committee’s findings and said the “safety and well-being of all Canadians, especially those who are vulnerable, is our government’s top priority.”