Canada is Killing Itself. Euthanasia (MAiD) for mental illness is already happening in Canada.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Elaina Plott Calabro wrote an exposé on Canada's euthanasia law that was published in the September edition of the Atlantic titled - Canada is Killing Itself. The article is too long to comment on in one article, so I have written a series of articles covering the important points.

One of the topics that Calabro tackles in are article is the question of further expansions of euthanasia in Canada. Calabro first tackles the topics euthanasia by advance request and euthanasia for children "mature minors" and writes:

Despite all of the questions surrounding Track 2, Canada is proceeding with the expansion of MAID to additional categories of patients while gauging public interest in even more. As early as 2016, the federal government had agreed to launch exploratory investigations into the possible future provision of MAID for people whose sole underlying medical condition is a mental disorder, as well as to “mature minors,” people younger than 18 who are “deemed to have requisite decision-making capacity.” The government also pledged to consider “advance requests”—that is, allowing people to consent now to receive MAID at some specified future point when their illness renders them incapable of making or affirming the decision to die. Meanwhile, the Quebec College of Physicians has raised the possibility of legalizing euthanasia for infants born with “severe malformations,” a rare practice currently legal only in the Netherlands, the first country to adopt it since Nazi Germany did so in 1939.

On February 15, 2023 a Canadian government committee recommended the extension of euthanasia for people who request it in advance and to children. During the committee meetings the Québec College of Physicians urged the committee to support euthanasia for newborns with disabilities (infanticide).

Calabro then focusses on euthanasia for mental illness alone, which is currently scheduled to go into practise in March 2027. 

As part of Track 2 legislation in 2021, lawmakers extended eligibility—to take effect at some point in the future—to Canadians suffering from mental illness alone. This, despite the submissions of many of the nation’s top psychiatric and mental-health organizations that no evidence-based standard exists for determining whether a psychiatric condition is irremediable. A number of experts also shared concerns about whether it was possible to credibly distinguish between suicidal ideation and a desire for MAID.

After several contentious delays, MAID for mental illness is now set to take effect in 2027; authorities have been tasked in the meantime with figuring out how MAID should actually be applied in such cases. The debate has produced thousands of pages of special reports and parliamentary testimony. What all sides do agree on is that, in practice, mental disorders are already a regular feature of Canada’s MAID regime. At one hearing, Mona Gupta, a psychiatrist and the chair of an expert panel charged with recommending protocols and safeguards for psychiatric MAID, noted pointedly that “people with mental disorders are requesting and accessing MAID now.” They include patients whose requests are “largely motivated by their mental disorder but who happen to have another qualifying condition,” as well as those with “long histories of suicidality” or questionable decision-making capacity. They may also be poor and homeless and have little interaction with the health-care system. But whatever the case, Gupta said, when it comes to navigating the complex intersection of MAID and mental illness, “assessors and health-care providers already do this.”

Alan Nichols

The argument was meant to assuage concerns about clinical readiness. For critics, however, it only reinforced a belief that, in some cases, physical conditions are simply being used to bear the legal weight of a different, ineligible basis for MAID, including mental disorders. In one of Canada’s more controversial cases, a 61-year-old man named Alan Nichols, who had a history of depression and other conditions, applied for MAID in 2019 while on suicide watch at a British Columbia hospital. A few weeks later, he was euthanized on the basis of “hearing loss.”

It is important to not that euthanasia for mental illness is already happening in Canada, but the person is required to have another medical condition. As Mona Gupta stated:

“people with mental disorders are requesting and accessing MAID now.” They include patients whose requests are “largely motivated by their mental disorder but who happen to have another qualifying condition,” as well as those with “long histories of suicidality” or questionable decision-making capacity. They may also be poor and homeless and have little interaction with the health-care system. But whatever the case, Gupta said, when it comes to navigating the complex intersection of MAID and mental illness, “assessors and health-care providers already do this.”

The Euthanasia Prevention Coalition is urging the Canadian government to do a complete review of the euthanasia law, which was promised but has never been done (Link).

The Euthanasia Prevention Coalition is also asking our supporters to sign and share the petition in support of Bill C-218, the bill that will prevent euthanasia for mental illness alone (Link).