Parliamentary committee on MAID expected to oppose expanding access to patients with mental illness, sources say

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A joint House of Commons and Senate committee studying medical assistance in dying is poised to recommend against expanding MAID access to include patients whose only condition is mental illness.

The special committee reviewing MAID is scheduled to table its report late Wednesday afternoon after being tasked last year with undertaking a renewed study of the possible expansion of access to the procedure.

The potential expansion has been delayed twice since 2021 and is currently set to take effect in March of next year. It has emerged as one of the most contentious policy debates since MAID was legalized a decade ago.

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Three sources have told The Globe and Mail that Liberal and Conservative MPs, who combined constitute a majority of the 17-member committee, are aligned in opposition to expanding access to MAID for patients whose sole underlying condition is mental illness.

The sources declined to specify whether the committee’s main recommendation will be to further delay the expansion, or to cancel it permanently. The Globe is not identifying the sources because they are not permitted to speak publicly about the committee’s recommendations in advance.

In May, The Globe reported that the Carney government is, according to three other sources, prepared to follow the committee’s expected recommendation and table legislation to put the expansion on pause. It is not clear whether the Liberal government would support a total cancellation of the expansion.

The Carney Liberals hold a slim majority in the House of Commons and would be able to pass legislation to pause, or outright cancel, the expansion without requiring opposition support.

They would also have the backing of the Conservatives, who have long opposed the mental health expansion, and potentially the New Democrats as well; the NDP previously voted in favour of a private member’s bill to cancel the expansion of MAID when it was before the last Parliament.

But, the legislation would also have to pass through the Senate, where it is less obvious there is broad support for putting off an expansion. At least one of the senators on the special committee is expected to file a dissenting report on Wednesday.

Kristopher Wells, an independent senator from Alberta and a member of the special committee, opposes another extension delaying MAID for patients with mental illness, calling wider access to the procedure a matter of “compassion for individuals who are intolerably suffering.

He wants the Carney government to refer the matter to the highest court.

“The most prudent thing to do is to send a reference to the Supreme Court of Canada so that they can examine the existing evidence and make a ruling once and for all,” he said.

During the committee hearing process, Mr. Wells raised concerns about how the majority of witnesses who testified before senators and MPs were against expanding MAID for patients with mental illness.

“I was really shocked and disappointed by the committee process, and how unbalanced and biased it was in its construction,” he said.

“It certainly has never been my experience participating in a parliamentary committee to see the inequity, the imbalance in the perspectives of the witnesses.”

He also noted how individuals with lived experience, such as Claire Brosseau, a 49-year-old based in Toronto who has lived with bipolar disorder for 35 years, did not get the opportunity to testify.

Ms. Brosseau has two pending legal actions related to her desire to access MAID, including an application before the Ontario Superior Court seeking emergency access to the procedure.

Among those who have asked the government to halt the expansion are the heads of psychiatry departments at 13 Canadian medical schools.

In a letter addressed to the parliamentary committee, they argued that there is no accurate way to determine when a mental disorder is incurable, no way to distinguish between suicidality and a MAID request, and no way to adequately protect vulnerable patients.

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Conservative MP Andrew Lawton, who is on the special committee, cited his own personal experience with mental illness in saying he doesn’t think MAID should be expanded.

“I’m on record, and have been for quite a long time, in believing that MAID should never be made available for people with mental illness,” he said.

“I say that as someone who is himself a suicide survivor and might not be here had the expansion that’s set to come into law been on the books 15 years ago.”

MAID became legal in Canada a decade ago, on June 17, 2016. The law allowed Canadian patients whose deaths were deemed “reasonably foreseeable” to seek the help of medical professionals to die.

In 2021, access was broadened after a Quebec court decision to allow patients with incurable conditions such as multiple sclerosis to seek to end their lives. At that time, it was determined patients whose sole underlying medical condition is mental illness would not be immediately eligible. Instead, a two-year temporary exclusion was put in place to allow more time to study the delivery of MAID for that population.

Since then, the federal government has delayed implementing MAID for mental illness twice.

The last bill to delay implementation sailed through the House of Commons with only the Bloc and a single Liberal MP voting against.

Justice Minister Sean Fraser said Tuesday the government does not want to presuppose the outcome of the special joint committee’s report.

“I will be reviewing the recommendations, but importantly to me, I’m also going to be reviewing the witness testimony upon which those recommendations were based,” he said at an unrelated news conference.

“If I’m satisfied that the committee has had an opportunity to reach thoughtful conclusions based on the advice of those who are most experienced, most knowledgeable with the issues, then there’s a good chance we may align with the recommendations.”