Justice Minister Sean Fraser says he will detail 'the path forward' for MAID in Canada.Adrian Wyld/The Canadian Press
The Liberal government will vote against a Conservative private member’s bill seeking to restrict access to medical assistance in dying for those whose sole condition is a mental disorder and lay out its own position on next steps for Canada’s MAID regime.
A Liberal Research Bureau briefing note sent to the party’s MPs and viewed by The Globe and Mail says the government will oppose Conservative MP Tamara Jansen’s bill when it comes up for a vote on Wednesday afternoon.
But Justice Minister Sean Fraser said on Tuesday that ahead of the vote, he’ll disclose “the path forward” for MAID in Canada.
He is up against a clock.
On March 17, 2027, those whose sole underlying condition is a mental illness will have access to medical assistance to end their lives - unless the government legislates differently.
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Earlier this year, a joint House of Commons and Senate committee studying the issue recommended the government should not allow for the expansion of access and “indefinitely exclude persons whose sole underlying medical condition is a mental illness from eligibility for medical assistance in dying.”
The conclusion, however, was not unanimous. Three senators on the committee criticized the hearing process as flawed and said the government should not accept the recommendation and instead refer the issue to the Supreme Court.
Mr. Fraser spent the summer doing his own consultations on the issues following the committee’s findings.
“I feel confident that we’ve heard a range of different views in the development of the policy process, and we’ll be able to share next steps [Wednesday],” he told reporters.
Ms. Jansen’s bill, C-218, is up for a vote at second reading on Wednesday.
It seeks to amend the Criminal Code section covering MAID to read “a mental disorder is not a grievous and irremediable medical condition.”
The Liberal briefing note on the bill says the government’s position is that use of the phrase “mental disorder” is too broad, and, among other things, could restrict access to MAID for those already eligible, such as people with neurocognitive ailments.
The MAID provisions in the Criminal Code use the term “mental illness,” which the government has previously explained as a term meant to capture conditions that fall within the domain of psychiatry.
Though the briefing note said government – meaning cabinet – will vote against the private member’s bill, it is expected to be a free vote for backbench Liberal MPs.
When a similar bill came before the House of Commons in 2023, eight Liberal MPs voted in favour. But the bill failed to move ahead.
MAID first became legal in Canada in June, 2016, for Canadians whose deaths were deemed “reasonably foreseeable.”
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In 2021, the law was updated after a Quebec court decision allowed patients with incurable conditions to seek to end their lives. At that time, it was determined that people whose sole underlying medical condition is mental illness would not be immediately eligible.
A two-year temporary exclusion was then put in place to allow more time to study the delivery of MAID in this area.
The federal government has since twice delayed implementation, citing concerns over the readiness of the provinces and health care system to deliver access to that cohort, among other things.
The current postponement expires on March 17, 2027.
The issue is contentious.
The advocacy group Dying With Dignity Canada has spent more than two years suing Ottawa for barring access. The case remains before the courts.
Opinion: The MAID committee got it right on mental illness. But Parliament must go further
But other organizations, including disability advocates and some medical professionals, have argued against expansion for reasons that include the difficulty of determining if a mental illness is truly incurable.
MAID for mental illness is not the only part of the system on the government’s radar.
It has also been grappling with whether to amend the Criminal Code to allow advance directives – the ability of people who are not eligible for MAID to say they would like to access it in the future, if they meet the criteria then.
Quebec has allowed advance directives since 2024.
The federal government has not challenged Quebec, but it has also not amended the part of the law requiring patients to have capacity to consent immediately before MAID is provided.
Ottawa conducted national consultations on advance directives last year but has yet to signal a direction.