2. Opening Remarks

Bill C-62, An Act to amend An Act to amend the Criminal Code (medical assistance in dying), No. 2

Senate Committee of the Whole

Minister’s Opening Remarks

February 2024

I am pleased to be here to speak to Bill C-62, which proposes to extend the MAID mental illness exclusion until March 17, 2027. Three years is the amount of time that we have determined is reasonable based on the provinces and territories’ requests for more time to get their health care systems ready for the expansion.

I want to start off by acknowledging that mental illness can cause the same level of suffering as physical illness, and that the fact that a person has a mental illness does not mean that they do not have decision-making capacity.

The mental illness exclusion is not based on harmful assumptions or stereotypes about people living with mental illness. It is based on the complexities associated with assessing requests for MAID of persons whose sole underlying medical condition is a mental illness. We have heard concerns about difficulties distinguishing between suicidality and a valid request for MAID. Specifically we have heard that suicidal thoughts may be a symptom of the mental illness that has led the person to request MAID. We have also heard that there are concerns about how to determine that a mental illness is irremediable, given that the course that a mental illness may take is often less predictable than that of physical illness. Finally, we have heard that some believe that the Criminal Code safeguards are simply not enough.

I want to be abundantly clear that our Government believes, as a matter of social policy, that eligibility for MAID should be expanded to include mental illness. However, we believe that this needs to be done in a prudent and measured way. This three-year extension would allow more time to further delve into some of these complexities. The uptake and implementation of the Model Practice Standard for MAID and the accredited MAID curriculum may also increase knowledge in these areas, and lead to greater comfort among practitioners and society alike. However, time is needed for these resources to become embedded within provincial and territorial healthcare systems.

We recognize that there are experts who believe that we are ready for the expansion, those who believe we are not ready, and those who oppose the expansion altogether. We cannot convince everyone to support this expansion. Nor can we ignore the concerns that have been raised. We want to take the time to address some of these concerns to ensure that MAID can be safely provided in these complex circumstances.

I want to conclude by touching on the Charter, which has animated much of the debate on this issue. The Supreme Court of Canada has been clear, and I agree, that there are competing interests on either side of this complex issue. There is autonomy of individuals who seek MAID on the one hand, and the need to protect those who may be vulnerable and at risk in a permissive regime on the other. The Supreme Court has acknowledged the difficult task that Parliament faces in balancing these competing interests. It also suggested that the Courts should give a high degree of deference to the particular balance Parliament’s response struck.

I believe that the Charter does not dictate a particular answer to this very difficult question. Both permitting and prohibiting MAID in these circumstances fall within a range of reasonable alternatives open to the federal government under the Charter.

The response that we have put forward, that we believe best balances these competing interests, is that eligibility for MAID for mental illness should be expanded, but it should not be expanded until our health care systems are ready. This is why we are asking for more time.

Thank you.