6. Media Lines / Questions and Answers (MLQA)

Issue: Medical Assistance in Dying – Extension of exclusion of eligibility for persons suffering solely from a mental illness (Bill C-39, January 2023).

Key Messages

Questions & Answers

Delay of March 17, 2023 Date of Eligibility for Mental Illness

  1. Why is the federal government proposing to extend the temporary exclusion of eligibility?

    Allowing eligibility for MAID to persons whose sole medical condition is a mental illness is complex. We need to get this right to protect those who may be vulnerable, and to also support autonomy and freedom of choice.

    Through Bill C-39, the Government of Canada proposes to extend the temporary exclusion of eligibility for MAID for persons whose sole medical condition is a mental illness until March 17, 2024. This extension would allow more time for:

    • consideration of any recommendations arising from the Special Joint Committee on MAID’s final report expected in February 2023, alongside the recommendations of the Expert Panel on MAID and Mental Illness; and

    • dissemination and uptake of key resources, such as MAID practice standards and MAID education and training curriculum, by the medical, nursing, and health provider communities.

  2. Will this proposed extension provide sufficient time to achieve the Government’s objectives?

    We believe that a one-year extension, until March 17, 2024, would provide sufficient time to ensure health system readiness, to disseminate and promote uptake of key resources by the medical and nursing communities, and to fully consider any recommendations arising from the Special Joint Committee on MAID’s final report. It is imperative that MAID assessors and providers be ready to assess requests for MAID for persons suffering solely from a mental illness in a safe and consistent manner across Canada by the time the proposed extension is over.

    The Government of Canada, provinces and territories, and their medical and nursing communities have made important progress in preparing for March 2023. A number of activities are already underway that address the recommendations of the Expert Panel on MAID and Mental Illness, including the development of MAID practice standards and a Canadian MAID curriculum.

  3. Parliament delayed eligibility for two years (until March 17, 2023) following the coming-into-force of the new MAID law. Why do you still need more time?

    The COVID-19 pandemic caused delays in key studies relating to MAID and mental illness and required those responsible for the health system to focus their efforts on pandemic response. The Expert Panel on MAID and Mental Illness started its work in August 2021. Its final report was tabled in Parliament in May 2022. The parliamentary Special Joint Committee on MAID was not able to begin its work until April 2022. The Committee’s final report is expected by February 17, 2023 and will need to be carefully considered.

    The Government of Canada, provinces and territories, and their medical and nursing communities have made important progress in preparing for March 2023, including on the development of MAID practice standards and a Canadian MAID curriculum.

    However, the Government of Canada recognizes that more time is needed to consider the final report of the Special Joint Committee on MAID and to ensure that dissemination and uptake of key resources by the medical and nursing communities has been completed.

  4. What is the public reaction to the current plan to allow MAID for persons whose sole medical condition is a mental illness on March 17, 2023?

    MAID is a complex and deeply personal issue. The Government of Canada recognizes and respects the diverse views on whether MAID should be permitted for persons suffering solely from a mental illness. We remain committed to ensuring that our laws protect those who may be vulnerable, and supporting autonomy and freedom of choice.

    We have heard diverse views from Canadians and experts about whether the health care system will be ready to accommodate MAID requests for persons whose sole medical condition is a mental illness by March 17, 2023.

  5. What has the Government done to prepare for the March 17, 2023 eligibility date?

    Health Canada, provinces and territories, and other stakeholders have made significant progress to prepare for eligibility for MAID for persons whose sole medical condition is a mental illness.

    The Government of Canada has appointed a Task Group of experts to develop MAID practice standards, in collaboration with provincial and territorial governments, regulatory bodies, and clinicians across Canada. These standards will be ready for health professional regulators and clinicians by March 2023.

    The Government of Canada is also supporting the development of an accredited Canadian MAID curriculum to support clinician education and training, and to address various topics related to the assessment and provision of MAID, including mental disorders and other complex chronic conditions. The curriculum will consist of seven modules. A rolling launch of modules will begin in the fall 2023, including a module on MAID and Mental Disorders, with the aim for all modules to be available by the end of 2023.

    A number of activities are underway that address the recommendations of the Expert Panel on MAID and Mental Illness including:

    • enhanced data collection through the federal MAID monitoring system to provide more robust reporting on MAID in Canada;
    • engagement with Indigenous peoples using a distinctions-based approach to learn about their views and experiences with MAID;
    • discussions with provinces and territories on additional oversight and quality assurance processes; and

    • research to facilitate gathering of critical qualitative information related to the circumstances and experiences of people who seek MAID.

  6. Why did the Government wait so long to propose an extension of the temporary exclusion of eligibility for persons suffering solely from a mental illness?

    The Government of Canada has been actively preparing for eligibility for MAID for persons whose sole medical condition is a mental illness, in collaboration with provincial and territorial partners. The Expert Panel on MAID and Mental Illness released its final report in May 2022, and the parliamentary Special Joint Committee on MAID released an interim report on MAID and Mental Illness as the Sole Underlying Condition in June 2022. The Special Joint Committee’s final report, which may provide further insight or recommendations on MAID and mental illness, is expected in February 2023. The Special Joint Committee’s final report was originally expected in October 2022, but was extended to February 2023 at the Committee’s request.

    These reports are all critically important to fully understanding the challenges and considered approaches to assessing and providing MAID in circumstances where mental illness is the sole underlying condition. More time will be beneficial for the consideration, implementation and dissemination of the guidance that has been and will be provided through these reports.

  7. What are the provinces and territories saying regarding the approaching March 17, 2023 date of eligibility for persons whose sole medical condition is a mental illness?

    Provincial and territorial governments and their stakeholders, such as health professional organizations, regulatory bodies, and clinicians, have been actively planning for eligibility for MAID for persons whose sole medical condition is a mental illness.

    For example, many provincial and territorial medical regulatory bodies have developed guidelines and standards for MAID, and some regional health authorities and care coordination services are configuring health professional resources to facilitate consultations and make referrals to necessary services or clinicians.

    However, some provinces and territories have indicated that more time is needed to implement and support uptake of necessary resources. The proposed extension would ensure that all provinces and territories have the tools and information they need to provide MAID in a safe and consistent manner.

  8. Many say that former Bill C-7 was a “slippery slope”, and that its effects will inevitably widen the scope of eligibility in Canada. How do you respond to this?

    Canada’s MAID regime is set out in Canada’s Criminal Code, which applies equally in all provinces and territories across Canada. While provinces and territories can, in certain contexts, limit the scope of application of the law within their jurisdiction – meaning they can prohibit something that is allowed under federal law – they cannot widen the scope of application within their jurisdiction. This means that they cannot allow something that is prohibited under the federal Criminal Code.

    As reported in the Third Federal Annual Report on MAID in Canada, growth in MAID provision has increased each year as a result of awareness and acceptance of the practice. Increases have been similar over the past three years. The most recently reported number, for 2021, was 3.3% of all deaths in Canada occurred through MAID. Other countries with MAID regimes similar to Canada’s report a proportion of approximately 5% of all deaths occurring through MAID.

    Any further changes to widen the scope of application of MAID in Canada would need to be federally legislated. This means that a bill would need to be introduced, studied and debated by Parliament. The federal government cannot broaden Canada’s MAID regime (criminal law) without introducing legislation that is then passed by Parliament.

    For more information on Canada’s legislative process, please visit: https://www.justice.gc.ca/eng/laws-lois/index.html

Independent Reviews

  1. Can you comment on what might be included in the Special Joint Committee on MAID’s final report, expected in February 2023?

    Parliament’s Special Joint Committee on Medical Assistance in Dying was established to undertake a review of the provisions of Canada’s MAID law and its application, as well as other outstanding important questions related to MAID – such as eligibility of mature minors, advance requests, mental illness, palliative care and the protection of Canadians with disabilities. The Committee’s final report may provide insight and recommendations on any of these issues.

    On June 22, 2022, the Committee released an interim report on MAID and Mental Disorder as the Sole Underlying Condition. This interim report did not include recommendations, but urged the federal government to work with provinces and territories to ensure that the recommendations of the Expert Panel on MAID and Mental Illness are implemented before eligibility for MAID is expanded to persons whose sole medical condition is a mental illness.

    The Government of Canada tabled its response to the interim report in October 2022, which outlined progress that had been made toward implementing the recommendations of the Expert Panel on MAID and Mental Illness.

  2. Will the federal government consider a further expansion of Canada’s MAID regime based on the Special Joint Committee’s final report?

    The Government of Canada is focussed on working with its partners to support the safe and consistent assessment and provision of MAID in circumstances where a person’s sole underlying condition is a mental illness, while protecting those who may be vulnerable.

  3. What were the key conclusions of the Expert Panel on Mental Illness?

    A key conclusion of the Panel was that the challenges people tend to associate with MAID eligibility for persons with mental disorder (e.g., irremediability, decision-making capacity, suicidality and structural vulnerability) are neither unique to requests for MAID from persons with a mental disorder, nor applicable to every requester who has a mental disorder.

    The Panel also concluded that the safeguards currently provided in Canada’s MAID law are sufficient, and that new legal safeguards are not required to ensure that requests for MAID from individuals with a mental disorder are handled safely and appropriately. They noted that the legal framework for MAID already sets a very high bar for eligibility. The key consideration for the Panel was ensuring that practitioners have additional guidance on how to operationalize the existing eligibility criteria and safeguards in the context of mental disorder and other complex MAID requests.

    The central recommendation of the Panel was for federal, provincial and territorial governments to facilitate collaboration among regulatory bodies on the development of MAID practice standards. This process is well underway.

    Most of the remaining recommendations provide guidance on the interpretation of the MAID eligibility criteria, application of the legislated safeguards, and the assessment process; others focus on measures to improve the functioning of Canada’s MAID regime more broadly.

Procedural Safeguards

  1. Are the current procedural safeguards sufficient to protect people who might be more vulnerable?

    Canada’s MAID law includes a two-track approach to procedural safeguards that medical practitioners must follow, based on whether or not a person’s natural death is reasonably foreseeable. Since March 2021, new and enhanced safeguards apply to persons whose natural death is not reasonably foreseeable. These safeguards seek to address the diverse sources of suffering and vulnerability that could potentially lead a person who is not nearing death to ask for MAID.

    The following procedural safeguards apply to eligible persons’ whose natural death is not reasonably foreseeable:

    • The request for MAID must be made in writing: a written request must be signed by one independent witness, and it must be made after the person is informed that they have a “grievous and irremediable medical condition” (a paid professional personal or health care worker can be an independent witness).
    • Two independent doctors or nurse practitioners must provide an assessment and confirm that all of the eligibility requirements are met.
      • If neither of the two practitioners who assesses eligibility has expertise in the medical condition that is causing the person’s suffering, they must consult with a practitioner who has such expertise.
    • The person must be informed that they can withdraw their request at any time, in any manner.
    • The person must be informed of available and appropriate means to relieve their suffering, including counselling services, mental health and disability support services, community services, and palliative care, and must be offered consultations with professionals who provide those services.
    • The person and the practitioners must have discussed reasonable and available means to relieve the person’s suffering, and agree that the person has seriously considered those means.
    • The eligibility assessments must take at least 90 days, but this period can be shortened if the person is about to lose the capacity to make health care decisions, as long as both assessments have been completed.

    • Immediately before MAID is provided, the practitioner must give the person an opportunity to withdraw their request and ensure that they give express consent.

  2. Will the federal government put more procedural safeguards in place for persons suffering solely from mental illness?

    The Government of Canada, provinces and territories, and other stakeholders have made significant progress to prepare for eligibility for MAID for persons suffering solely from mental illness.

    The Government of Canada has appointed a Task Group of experts to develop MAID practice standards, in collaboration with provincial and territorial governments, regulatory bodies, and clinicians across Canada. These standards will be ready for health professional regulators and clinicians in March 2023. While the Government of Canada cannot mandate these standards across Canada, it is expected that the provinces and territories will either adopt these standards in their entirety, adapt them as necessary to fit their particular context, or integrate elements of the standards within their existing standards.

    Next steps will be considered after the review of the Special Joint Committee’s final report is complete.

Eligibility

  1. Is the federal government considering removing eligibility for persons suffering solely from a mental illness?

    No, the Government of Canada is not considering removing eligibility for persons suffering solely from a mental illness.

    The proposed extension of the temporary exclusion of eligibility for persons suffering solely from a mental illness would allow more time to disseminate and ensure uptake of key resources by the medical, nursing, and health provider communities, and consider any recommendations arising from the Special Joint Committee on MAID’s final report.

    The Government of Canada remains committed to ensuring that our laws reflect Canadians’ needs, protect those who may be vulnerable, and support autonomy and freedom of choice.

  2. Can you respond to criticism that depressed children and teenagers will have greater capacity to end their own lives under Canada’s new MAID law?

    Canada’s law does not permit for MAID to be administered to persons under 18 years of age under any circumstance. Specifically, for a person to be eligible for MAID in Canada, they must meet all of the following eligibility criteria:

    • be 18 years of age or older and have decision-making capacity;
    • be eligible for publicly funded health care services;
    • make a voluntary request that is not the result of external pressure;
    • give informed consent to receive MAID, meaning that the person has consented to receiving MAID after they have received all information needed to make this decision;
    • have a serious and incurable illness, disease or disability (currently, this excludes a mental illness until March 17, 2023);
    • be in an advanced state of irreversible decline in capability; and

    • have enduring and intolerable physical or psychological suffering that cannot be alleviated under conditions the person considers acceptable.

    On February 2, 2023, the Government of Canada introduced legislation to extend the temporary exclusion of eligibility for persons suffering solely from a mental illness until March 17, 2024. This proposed extension would not alter the minimum eligibility age (18+) for MAID in Canada.

  3. Is allowing eligibility for persons whose sole medical condition is a mental illness responsive to results from public consultations and ongoing engagement?

    In January and February 2020, the Government of Canada engaged with provinces, territories, Canadians, Indigenous groups, key stakeholders, experts, and practitioners to receive their feedback on expanding Canada’s MAID framework.

    Over 300,000 Canadians participated in the online public consultations. Ministers Lametti, Hajdu and Qualtrough, and their Parliamentary Secretaries, also met with stakeholders, experts, practitioners, disability rights organizations, and Indigenous groups to consult them directly on revising Canada’s federal MAID legislation.

    The federal government also continues to engage with the provinces and territories, both at the ministerial level through discussions at federal, provincial, and territorial tables, and at the officials’ level through an established Federal-Provincial-Territorial working group on medical assistance in dying.

    On MAID in general, most participants focused on the person’s right to choose when to die, no matter what the situation, and argued that it is important to honour the wishes of the patient and grant them dignity in dying.

    Engagement also revealed mixed opinions on the question of eligibility for persons suffering from mental illness. Some online consultation participants felt that people with mental illness should be eligible for MAID in certain situations, such as circumstances where mental illness is irreversible and untreatable, or where mental illness causes serious and irreversible physical suffering. During roundtable discussions, some experts and persons with lived experience of serious mental illness felt that denying people with mental illness access to MAID would be discriminatory.

    Regardless of their opinion on this question, most agreed that more needed to be done to improve availability of mental health supports and treatments. We are committed to responding to this call in collaboration with provinces and territories.

  4. Is excluding eligibility for persons whose sole medical condition is mental illness discriminatory and unconstitutional?

    The temporary exclusion of eligibility for persons suffering solely from mental illness was based on the inherent risks and complexity associated with allowing MAID in circumstances where the sole medical condition is a mental illness, and the need for more time to explore how to safely provide access to these individuals.

    The exclusion is not based on the assumption that individuals who suffer from mental illness lack decision-making capacity, or on a failure to appreciate the severity of their suffering.

Health and Social Supports

  1. Are some Canadians receiving MAID for reasons solely related to lack of support services?

    Lack of access to social supports or to health services would never, on its own, make a person eligible for MAID.

    MAID is a deeply personal and complex choice and the law recognizes personal autonomy to choose MAID and to receive it when specific criteria and safeguards are fully satisfied. It also provides robust protections for those who may be vulnerable.

    MAID is intended for adults who freely choose to pursue a medically assisted death in situations where they have a grievous and irremediable medical condition (as defined in the legal framework for MAID) and whose illness is associated state of irreversible decline causes them enduring physical or psychological suffering that cannot be relieved under conditions they consider acceptable. They must be found eligible by two independent practitioners, and be aware of and have been offered supports that both practitioners agree have been seriously considered.

    For more information on the robust eligibility criteria and safeguards in place for accessing MAID in Canada, please consult: https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html

    Working to improve access to health care services remains a priority for the Government of Canada. All jurisdictions in Canada have a broad range of policies, programs and initiatives aimed at providing support to persons with disabilities and promoting their inclusion and full participation in Canadian society. While the federal government provides financial support to provinces and territories, the responsibility for matters related to the administration and delivery of health care services falls within provincial and territorial jurisdiction. This includes setting their own priorities, administering their health care budgets and managing their own resources.

  2. What is the Government doing to improve mental health and suicide prevention efforts?

    On mental health:

    Supporting the mental health and well-being of everyone in Canada is a priority for the Government of Canada.

    Through Budget 2021, the Government Canada is providing $100 million to support projects that promote mental health and prevent mental illness in populations disproportionately impacted by the COVID-19 pandemic, including youth, older adults, First Nations, Inuit and Métis, and Black and other racialized Canadians. The Government of Canada is also providing $50 million to support projects that address post-traumatic stress disorder (PTSD) and trauma in health care workers, front-line and other essential workers and others affected by the pandemic.

    Budget 2022 provided $140 million over two years to Health Canada to continue to provide virtual mental health and substance use supports via the Wellness Together Canada portal.

    Through Budget 2021, the Government is investing $45 million to develop national standards for mental health and substance use services, in collaboration with provinces and territories, health organizations, and key stakeholders. National standards will help to ensure that Canadians receive high quality, (e.g., safe, effective, patient-centred, equitable, and culturally sensitive) evidence-based mental health and substance use services.

    The Public Health Agency of Canada (PHAC) is also providing more than $14.8 million over 36 months to Kids Help Phone to provide crisis support to children and youth during the pandemic. The 2020 Fall Economic Statement included the announcement of a $50 million investment to bolster the capacity of distress centres across the country, which have been experiencing a surge in demand for crisis support during the COVID-19 pandemic. This includes investments of $2 million to Centre for Addiction and Mental Health (CAMH) to support distress centre resources and $1,825,000 for 14 distress centres across the country.

    Through Budget 2019, PHAC is investing $21 million over five years, with $4.2 million per year ongoing, in CAMH to operate Talk Suicide Canada. Talk Suicide Canada currently provides people across Canada with suicide prevention crisis support from trained responders via phone (24/7) at 1-833-456-4566 and text (evenings) to 45645. For residents of Quebec, call 1-866-277-3553 or visit suicide.ca for support by text and online chat.

    The Government of Canada is also currently investing $5 billion over ten years to improve Canadians’ access to mental health and substance use services. The investment is being provided directly to provinces and territories via negotiated bilateral agreements to help them expand access to community-based mental health and addiction services.

    Mental health remains a priority for the Government, and we will continue to invest in it and work with provinces, territories and key stakeholders to support the needs of individuals and communities across the country, now and in the future.

    On suicide prevention:

    The Government of Canada recognizes the importance for all Canadians to have access to critical mental health resources and suicide prevention services.

    Through Budget 2019, the federal government is investing $25 million to develop a pan-Canadian suicide prevention service. Talk Suicide Canada currently provides suicide crisis support in English and French to people across Canada over the phone (1-833-456-4566), 24 hours a day, seven days a week and by text (45645) in the evenings.

    In addition, the Government has invested $57.5 million to support crisis services during the pandemic, including $2 million to develop resources for distress centres that are tailored to meet the needs of diverse populations such as older adults, youth, LGBTQ2+ populations, persons with disabilities as well as Inuit, First Nations and Métis communities.

    The Government of Canada welcomes the Canadian Radio-television and Telecommunications Commission determination to adopt 9-8-8 as the number to call or text for Canadians in need of immediate mental health crisis and suicide prevention support on November 30, 2023.

    In preparation, the Government has announced that the Centre for Addiction and Mental Health will lead the coordination of 9-8-8 service delivery, building on its experience delivering Talk Suicide Canada, and is committed to ensuring 9-8-8 has the capacity to meet demand, connecting people to quality and effective crisis support when they need it the most.

    The Government of Canada is also leading the development of the National Suicide Prevention Action Plan, formerly M-174, aimed at reducing suicide rates and improving mental well-being based on best practices and innovations in suicide prevention and life promotion.

  3. What is the Government of Canada’s response to Indigenous groups raising concerns about mental health and alarming suicide rates of Indigenous youth and adults?

    The Government of Canada recognizes the unique characteristics, needs and challenges facing First Nations, Métis and Inuit, as well as urban Indigenous people. This is why Indigenous groups and individuals were invited to participate in roundtables held by Ministers Lametti, Hajdu and Qualtrough, as well as Parliamentary Secretaries Virani and Fisher, in January and February 2020. These roundtables were focused on receiving specific feedback from Indigenous practitioners and community leaders, and informed the development of Canada’s current MAID law (former Bill C-7).

    Improving mental wellness for First Nations, Inuit and Métis is a key priority for the Government of Canada. We recognize that Indigenous populations in Canada are at a higher risk of experiencing mental health issues. We have to address the root causes of these issues – including intergenerational trauma, the effects of colonization, the residential school system, climate change, poverty, and lack of access to stable housing.

    The Government of Canada is developing and implementing a comprehensive, evidence-based plan for mental health care as well as advancing a strategy to address substance use issues in Canada, including the overdose crisis. In addition, we are working closely on distinctions based approaches to a Mental Health and Wellness Strategy, including culturally appropriate services for addictions and trauma, suicide prevention and life promotion, and the building of treatment centres.

    The Government of Canada is also supporting a variety of initiatives including the Hope for Wellness Helpline, the implementation of the National Inuit Suicide Prevention Strategy, the National Aboriginal Youth Suicide Prevention Strategy, and the Youth Hope Fund. The Hope for Wellness Helpline provides immediate, culturally safe, telephone crisis intervention support for First Nations and Inuit, 24 hours a day, seven days a week in English and French, and upon request in Cree, Ojibway, and Inuktitut.

  4. How do you respond to criticism that Canada’s MAID legislation is going against suicide prevention efforts?

    Protecting vulnerable persons, including those suffering from mental illness or in crisis, remains a priority for the Government of Canada. It is important to note that international evidence does not indicate that there is a direct causal relationship between the availability of MAID and an increase in suicide rates.

Persons with Disabilities

  1. Advocates for persons with disabilities are saying that the revised MAID law violates the equality rights and dignity of persons with disabilities, contrary to the Charter of Rights and Freedoms. In addition, the United Nations Special Rapporteur on the rights of persons with disabilities has said that it could violate the Convention on the Rights of Persons with Disabilities. How is the federal government responding to these changes?

    The Government of Canada fully respects the equality rights of Canadians with disabilities and has taken concrete measures to recognize and uphold them. As an example, we have acceded to the Optional Protocol to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), which means that Canadians will have additional recourse to make a complaint to the UN Committee on the Rights of Persons with Disabilities, if they believe their rights under the Convention have been violated.

    The preamble of MAID legislation passed on March 17, 2021, recognizes the importance of both equality and autonomy rights, and acknowledges Canada’s obligations as a signatory to the UNCRPD. The Government of Canada believes the amendments are consistent with its human rights obligations. The expansion of eligibility for MAID is based on respect for the autonomy of all persons with a serious and incurable illness, disease or disability to choose MAID as a response to intolerable suffering that cannot be alleviated by means acceptable to them.

    The Government of Canada is committed to protecting those who may be vulnerable, and supporting the autonomy and freedom of choice of Canadians. That is why Canada’s MAID law includes a two-track approach to procedural safeguards, including new safeguards for persons whose natural death is not reasonably foreseeable. These safeguards seek to address the diverse sources of suffering and vulnerability that could potentially lead a person who is not nearing death to ask for MAID.

    The Government of Canada has heard the concerns raised by the disability community and appreciates that other important outstanding issues related to MAID must still be explored. As required by MAID legislation, the Special Joint Parliamentary Committee on MAID (AMAD) has been considering areas such as the eligibility of mature minors, advance requests, mental illness, palliative care and the protection of Canadians with disabilities as part of its review of MAID.

    Some members of the disability community have appeared before AMAD to express concerns about persons with disabilities seeking MAID out of despair as an alternative to lack of social supports. The Government has heard these concerns and provided a response to AMAD’s interim report on October 20, 2022. AMAD is continuing its work and is expected to table its final report on February 17, 2023.

    The Government believes that persons with disabilities should not have to seek MAID due to a lack of disability supports. As such, the Government released the Disability Inclusion Action Plan on October 7, 2022 and has committed to introducing a new Canada Disability Benefit. Bill C-22, the Canada Disability Benefit Act, is currently being considered by Parliament.

Other Issues

  1. What has the Government done to respond to Veterans Affairs officials recommending MAID to veterans in need of care and support?

    Note: Enquiries on this issue should be referred to VAC for response at the departmental level.

    Providing advice on MAID is not a Veterans Affairs Canada (VAC) service. VAC employees have no role or mandate to recommend or raise it. Considerations for MAID are the subject of discussions between a patient and their primary care providers to determine appropriateness in each individual context. There are limited circumstances in which MAID may be appropriately discussed with VAC such as how it might impact eligibility for VAC services and benefits.

    Preliminary findings of VAC’s investigation into this issue indicate that this is not a widespread or systemic issue. Veterans Affairs Canada can confirm that the employee is no longer employed in the Department. For privacy reasons we cannot provide any further details.

    This situation is not a reflection of the work of hundreds of case managers and Veteran service agents who interact with the utmost care, compassion and respect with Veterans every single day.

    We know that Veterans, their families, and stakeholders are upset by this news, and we understand why.

    We want Veterans and their family members to know that we are here for them. VAC employees are trained to deal with Veterans in crisis. We cannot reiterate enough that Veterans dealing with mental health concerns should reach out so we can get them the help they need. They can also contact the VAC Assistance Service at 1-800- 268-7708 for free, 24/7 confidential assistance.

    If someone is aware of a Veteran in distress, they should contact us at 1-866-522-2122 so we can help find programs to help support them and get them back into a safe space.

    All Canadians in a crisis situation should access urgent health care needs through emergency services such as 9-1-1.

Background

Canada’s MAID law was revised in March 2021 and expanded eligibility to persons whose death is not reasonably foreseeable. The revised law also included a temporary exclusion of eligibility for persons whose sole medical condition is a mental illness until March 17, 2023.

Media coverage on MAID and MAID-related issues in Canada has increased since Bill C-7 received Royal Assent in March 2021, in particular as it relates to the legislation temporarily excluding eligibility for MAID for persons whose sole medical condition is a mental illness. Coverage typically increases following policy updates by the federal government (e.g., legislation introduction, parliamentary report publications), litigation decisions, and individual stories concerning MAID as heard during testimonies at AMAD.

Recent media coverage (news outlets and podcasts) have drawn specific attention to the debate of extending MAID to persons whose sole underlying medical condition is a mental illness. Stories have mainly focussed on voices opposing MAID, including for persons suffering from mental illness, and have shed light on systemic gaps and barriers impacting vulnerable Canadians.

On December 15, 2022, the Government of Canada announced its intention to introduce legislation in early 2023 to extend the temporary exclusion of eligibility for persons suffering solely from a mental illness beyond March 17, 2023.

On February 2, 2023, the Government of Canada introduced Bill C-39, which proposes to extend the temporary exclusion of eligibility for persons suffering solely from a mental illness by one year, until March 17, 2024.