Important insight into decision to reject euthanasia for mental illness.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The report of the Special Joint Committee on Medical Assistance in Dying (AMAD): Mental Disorder as the Sole Underlying Medical Condition: A Complex and Challenging Conversation Among Canadians was released on June 17, 2026, which is also the 10th Anniversary of the legalization of euthanasia in Canada.

The AMAD Committee decided that Canada should not implement euthanasia for mental disorders as the sole underlying medical condition on March 17, 2027. The report concluded:

That the Government of Canada amend the Criminal Code to indefinitely exclude persons whose sole underlying medical condition is a mental illness from eligibility for medical assistance in dying.

It is great news that the AMAD Committee decided that Canada should not implement euthanasia for mental illness, but the battle is not over.

Possibly the most interesting parts of the AMAD Committee report were the supplemental reports from the members of the Committee. 

Dr Marcus Powlowski MP

The supplemental report (starting at page 63 of the report) from AMAD Committee Chair, Marcus Powlowski, (Liberal MP from Thunder Bay - Rainy River) and a physician is most interesting. Powlowski's arguements may influence Canada's future euthanasia debates.

Powlowski first examined Canada's Charter of Rights and Freedoms (Charter) with regard to not permitting euthanasia for mental illness alone. he writes:

Unfortunately, the discourse about whether to allow MAiD for mental illness seems to have been largely reduced to the somewhat simplistic question of whether not allowing it is a violation of the Charter. The argument being if we allow MAiD for physical illness, but do not allow it for those with mental illness, we discriminate against those with mental illness (under s.15) and inappropriately restrict their liberty or threaten their security (s.7)...

Powlowski explains his position on Canada's Charter:

I think the courts ought to conclude, as did our committee, that not allowing MAiD for mental illness, until such time as some fundamental concerns are addressed, is a reasonable limitation under s.1. These fundamental concerns are the difficulty/perhaps even impossibility of determining irremediability of mental suffering (a core requirement under the law), and the lack of ability to distinguish suicidality from rational decision making in someone with a mental illness (I will return to this issue, and explain why it is so important, at the end of this submission). Numerous witnesses cited these concerns as reasons why we should decline to expand MAiD to this population.

The Supreme Court of Canada Carter decision did not obligate the government to permit euthanasia for mental illness alone, but even when interpreted in that manner, I agree with Powlowski that not permitting euthanasia for mental illness is a reasonable limitation.

Powlowski then deals with the question of "readiness" to expand euthanasia to people with a mental illness alone.

In addition, although some, perhaps a majority, of MAiD providers assured us of their readiness to provide MAiD for mental illness, and the adequacy of existing safeguards, we also heard disturbing stories of questionable conduct by some MAiD providers. Given what we heard it is hard not to conclude that some providers take an exceedingly expansive interpretation of what constitutes "serious and incurable illness, disease or disability", what constitutes an "advanced state of irreversible decline in capability"; and what constitutes "enduring physical or psychological suffering that is intolerable". Furthermore, we heard stories of doctors with a seemingly cavalier attitude towards ending a life. 

Although we were assured that mechanisms, such as Colleges of Physicians and Surgeons, would provide adequate safeguards, we were presented with scant, if any, evidence to indicate that such bodies have, as of yet, seriously pursued allegations of misconduct by MAiD providers. This does not mean that colleges have not received complaints or looked into them. As the president of the Nova Scotia College of Physicians and Surgeons pointed out- colleges only publish the reports of hearings when there has been a finding of wrong doing. That being said the paucity of any prosecutions of providers, combined with the suggestion by a number of witnesses that in fact there seems to be a lacunae of law enforcement when it came to MAiD ought to give rise to concern. Several witnesses suggested the criminal system, the medical colleges, and at times government Ministry's responsible for MAiD provision (BC), all allegedly treat enforcement as someone else's responsibility. Given the lack of evidence to the contrary it is frankly difficult to believe that the system is ready to expand.

This may be the most important comment by Powlowski. As the chair of the committee he recognizes that Canada's euthanasia law lacks effective oversight and is saying that expansion to people with mental illness alone would not be safe.

Further to that, his comments are important to the argument by the Euthanasia Prevention Coalition (EPC) that Parliament needs to completely review the law. The evidence suggests that the law lacks oversight, but further to that, the original law required a complete review and that has not happened.

Powlowski then argues that since Canada's law requires a person to have an irremediable medical condition, that the law would need to be amended to approve euthanasia for mental illness alone. He wrote:

But perhaps we will never be ready for MAiD for mental illness as the law is currently written. Numerous very experienced psychiatrists told us of seemingly irremediable cases where for some reason patients, after prolonged periods of seemingly irremediable suffering, the person eventually got better and started to enjoy life again. Furthermore, what evidence there is seems to suggest psychiatrists can not accurately predict who will not get better. 

Perhaps the simplest solution to the legal question is to recognize the requirement of irremediability as being dispositive of the issue. The law as written requires irremediability. If there is really no way to accurately determine irremediability it would seem we would need to change the law if we want to allow for MAiD for mental illness.

Jocelyne Downie

Powlowski suggests that based on irremediability that many euthanasia deaths for physical illness also do not qualify within the law. He writes:

We did, I would acknowledge, hear the argument that perhaps with some physical illness irremediability is not certain either (the argument was most forcibly made by Professor Downie- a law professor not a medical clinician). To the extent that there are such cases I would suggest it would be more appropriate to question whether MAiD is appropriate in any such case where there is uncertainty over the medical prognosis - rather than to accept the conclusion of those practitioners who suggested they were "comfortable" with making a decision about irremediability even if there was inherently some inability to come to that conclusion with reasonable certainty. 

Powlowski then answers the question about the role of parliament and the role of the courts. He writes:

I would suggest the elected legislature is totally justified in drawing a line, in deciding that we are unwilling to support the state enabling physicians to taking the life of someone who, perhaps, would have gotten better. The decision of whether we do so is a moral decision and very much a reflection of what we value as a society. As such it is a decision more appropriately made by those of us who are elected by the members of society, and who are ultimately accountable to the people- at the poll box, rather than the unelected courts.

This is important since Claire Brosseau and the euthanasia lobby are seeking an emergency court decision that would approve Brosseau for death by lethal poison based on mental illness alone. The euthanasia lobby want the court to legislate from the bench by approving that Brosseau be killed. 

EPC is intervening in the Brosseau court case concerning euthanasia for mental illness alone.

Powlowski made many more important comments but his closing argument is important:

In recommending that we not extend MAiD to those with mental illness we are not suggesting embarking on a new path of prohibiting suicide, or further trying to limit people's autonomy. We are suggesting the state decline to provide assistance to people with mental illness ending their lives and decline to allow medical professionals to actively do it for them.

EPC opposes killing people but we are not limiting a persons autonomy but rather we oppose the state giving doctors and nurse practitioners the right in law to kill people. When a doctor or a nurse pracitioner kills you, it is not about autonomy, it is about someone else killing you.

The EPC presentation to the AMAD Committee on May 5 urged Parliament to do a complete review of the euthanasia law, which was actually part of the original euthanasia law that was implemented in June 2016. I stated:

...Parliament needs to examine how the current law has led to outcomes like the death of Kiano Vafaeian (26) died by MAiD in Vancouver on December 30, 2025. Parliament needs to completely review the euthanasia law.

More broadly, Canada’s assisted dying law is vague. While Health Canada provides guidance, the legal framework allows for wide interpretation and it lacks effective oversight.

Because of time constraints, I will highlight one key issue.

Sections 241 (3) and 241 (3.1) of Canada's Criminal Code states that medical practitioners or nurse practitioners are required only to be “of the opinion” that the eligibility criteria are met. That, in practice, makes accountability extremely difficult, even impossible to prosecute a medical or nurse practitioner in Canada, even when the MAiD death is clearly wrong or deeply disturbing.

The MDRC reports and cases that have already been submitted to you speak to that reality.

Canada should not be considering the expansion of the euthanasia law to include people with mental illness alone but rather Parliament needs to fully review the law.

In April 2026, Canada surpassed 100,000 euthanasia deaths since legalization. Many of these deaths have been controversial and were outside the intent of the law.

EPC urges the government to consider the many stories associated with our euthanasia law that have been publicized world-wide and recognize that the law needs to be reviewed.

We look forward to presenting to the AMAD Committee when they provide a complete review of Canada's euthanasia law.