Construction workers build scaffolding on Parliament Hill in Ottawa in March, 2025. A majority of committee members pressed the government to limit access to the procedure.Sean Kilpatrick/The Canadian Press
Patients whose sole condition is mental illness should not be eligible for medical assistance in dying, a majority of members of a special parliamentary committee said in a report released Wednesday that recommends the federal government not expand access to the procedure.
The report of the 17-member joint House of Commons and Senate committee says that over the course of its work, it heard about “significant complexities and risks, grave concerns and deep divisions that continue to accompany this issue.”
While the committee considered a range of avenues for how the government could proceed with MAID eligibility, the report said, ultimately it settled on a single recommendation:
“That the Government of Canada amend the Criminal Code to indefinitely exclude persons whose sole underlying medical condition is a mental illness from eligibility for medical assistance in dying.”
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The committee report marks the latest development in the long-running national debate over whether Canadian law should allow for patients with mental illness to access MAID. Twice before, the federal government has delayed a timeline for implementing access.
It has been an emotional and polarizing conversation. Some see the issue as a matter of Charter rights for patients living in suffering. Others believe expanding access would risk making MAID the default choice for people with mental illness when their health could instead improve with additional support.
The committee also heard questions about the readiness of the health care system to provide oversight of patient eligibility, and a divergence of views on treatments for mental illness.
Although the committee was expected to recommend against expanding MAID, it was unclear before Wednesday whether it would call for a complete halt or merely another delay. Its report is the first parliamentary study to conclude there should be no access at all.
Now, it is up to Prime Minister Mark Carney’s government to decide how to proceed.
Under current law, patients whose sole underlying condition is mental illness will be able to access MAID beginning in March, 2027. To change that timeline, new legislation will be required.
In May, The Globe reported that, according to three sources, the Carney government was prepared to follow the committee’s recommendation and table legislation to put the expansion on pause.
Liberal MP Marcus Powlowski, a physician who also co-chairs the committee, said the choice to recommend against expanding MAID access should not be understood as ignoring those who are suffering.
Factors that contribute to mental illness, such as housing, social supports and access to mental-health services, are all under the control of government, he wrote in his contribution to the report.
“A government offering death as an alternative to addressing these issues is not a humane and compassionate government; it is the opposite.”
The committee’s recommendation was not unanimous.
Senators Rosemary Moodie, Pamela Wallin, Kristopher Wells and Flordeliz Osler issued a dissenting report and called the committee process “fundamentally flawed, highly irregular, biased, and lacking the evidentiary rigour required to inform policy on such a consequential issue of societal importance.”
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They claimed that more than two-thirds of the 44 witnesses invited to testify were opposed to extending MAID eligibility. Concerns about witness selection were ignored by the committee’s co-chairs, they alleged.
The senators said the federal government should disregard the majority recommendation and refer the question of MAID eligibility for patients with mental illness to the Supreme Court of Canada.
The Bloc Québécois also disagreed with the majority of the committee.
The release of Wednesday’s report comes a decade after MAID first became legal in Canada, on June 17, 2016, for patients whose deaths were deemed to be “reasonably foreseeable.”
The law was updated in 2021 and extended to patients with incurable conditions after a court challenge in Quebec.
At that time, Ottawa put a two-year temporary exclusion in place to allow more time to study MAID for those with mental illness. Since then, the federal government has moved the implementation timeline twice.
A spokesperson for Justice Minister Sean Fraser thanked the committee for its work and said the government will review the report and evidence.
“MAID is a deeply personal and complex choice that touches people at different times in their lives, and our government is committed to getting this right,” Jeanne Joannie Fogue Mgamgne said in a e-mail.
The Conservatives, who have long called for a halt to the expansion of MAID, said they hope the Liberals will take up Conservative MP Tamara Jansen’s private member’s bill, which would permanently exclude MAID for mental illness.
Ms. Jansen said the issues core to her party’s opposition are that clinicians can’t reliably determine when a mental illness is irremediable, and that they cannot reliably distinguish a request for MAID from suicidality in the context of mental illness.
“The evidence is clear. It has always been. Moving forward with this expansion is reckless and dangerous,” Ms. Jansen said at a news conference Wednesday.
Disability rights organization Inclusion Canada said the majority recommendation was the right one and urged the government to move swiftly to change the law.
“Today’s recommendation recognizes what many have argued from the beginning: the challenges associated with MAID for mental illness are not temporary implementation issues,” Inclusion Canada’s chief executive officer Krista Carr said in a statement.
“They raise fundamental questions about safety, equality, vulnerability, and how we respond to suffering.”
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Helen Long, the CEO of Dying With Dignity Canada, said her organization is disappointed with the recommendation for an indefinite exclusion.
“We believe that excluding people whose sole underlying condition is a mental illness from assisted dying legislation is a breach of Section 15(1) of the Canadian Charter of Rights and Freedoms,” she said.
Claire Brosseau, who has lived with bipolar disorder for 35 years, questioned whether members of the committee think they’ve left patients with mental illness better off.
The 49-year-old Torontonian, who has launched two legal actions over being denied MAID, had sought to testify before the committee, but was not called as a witness. She argues there is a distinction between individuals who are in an acute mental-health crisis and those, like herself, who grapple with enduring, treatment-resistant mental illness.
“The committee has made it clear that their perception of people living with mental illnesses cannot be changed, because they refuse to sit in a room and listen to people like me,” Ms. Brosseau said.
“They believe our perspective isn’t relevant and that I’m not a reliable witness to my own life.”