Canadian Govt advised to abandon plans to euthanise people with mental illness

People should not be allowed to ask for help to die on the grounds of mental illness alone, a Canadian parliamentary committee has concluded.

Canada is scheduled to expand Medical Assistance in Dying (MAID) legislation to include people with mental health conditions who do not have any physical illnesses from March 2027.

But a group of senators and MPs commissioned to study the proposal now recommend that Canada’s criminal code be amended “to indefinitely exclude” people in this category from seeking MAID.

Complexities and risks

In the course of its investigation, the Special Joint Committee on Medical Assistance in Dying heard from scores of witnesses, including clinicians, researchers, academics, professional bodies and those living with a mental illness.

Some psychiatrists, the Committee reported, found it inherently incoherent for the medical discipline to claim it can “both prevent suicide in one patient and help finalize suicide in another with the same suffering”.

The report noted that a “recurring theme across the testimony was the pressing need for increased and more equitable access to adequate mental health services”. Some witnesses warned that expanding MAID may lead to a ‘suicide contagion effect’ and risked undermining suicide prevention efforts.

Given “the significant complexities and risks, grave concerns and deep divisions that continue to accompany this issue”, the Committee called on the Government to protect “persons whose sole underlying medical condition is a mental illness” from being exposed to MAID.

Saved lives

Speaking to the BBC, expert witness Dr Sonu Gaind — a professor in medicine at the University of Toronto — said the scheduled expansion “would have started providing death to suicidal people struggling with mental illness who could have gotten better”.

He added: “Assessors cannot predict when a mental illness won’t improve, in fact flipping a coin would be more accurate.”

Conservative Leader Pierre Poilievre stated that thousands of lives “will be saved” if the Committee’s recommendation is adopted. The Government has until 11 July to respond to the report.

Inadequate proposals

Plans to legalise assisted suicide recently returned to Westminster. Lauren Edwards’ decision to resurrect Kim Leadbeater’s controversial Bill means it is set to be debated again in the House of Commons on Friday 11 September.

By using identical legislation, Edwards could invoke the Parliament Acts. This would mean that if the Bill is voted through the House of Commons in an unchanged manner it could become law without the approval of the House of Lords – where the Leadbeater Bill stalled.

Last year, the Royal College of Psychiatrists (RCPsych) announced that it could not support the Bill “as it stands”. RCPsych President Dr Lade Smith explained: “The Bill, as proposed, does not honour this role, or require other clinicians involved in the process to consider whether someone’s decision to die might change with better support.”

Dr Annabel Price, who examined the Leadbeater Bill for RCPsych, said: “A significant part of our engagement on this Bill to date has been to point out that people with terminal physical illnesses are more likely to have depression.

“Terminal illness is a risk factor for suicide, and unmet needs can make a person’s life feel unbearable. But we know that if a person’s situation is improved or their symptoms treated, then their wish to end their life sooner often changes.”