For a second year in a row, Canada’s federal government is going to delay opening euthanasia to people whose only condition is a mental illness. The expansion in eligibility was due to begin on March 17. But a report from a joint parliamentary committee has declared that the country is ill-prepared for this change.

A majority of the members of the committee argued that euthanasia for mental illness should not be made available until the federal and provincial health and justice ministers believe that “based on recommendations from their respective departments and in consultation with their provincial and territorial counterparts and with Indigenous peoples, that it can be safely and adequately provided.”

“The system needs to be ready,” acknowledged Mark Holland, the federal health minister. “We need to get it right.”

Canada’s debate has attracted world-wide attention. Even the editorial board of the Washington Post, a bellwether for progressive thinking, urged the Canadians to put on the brakes. “They need to remember that no procedural protections are perfect — and building them for psychiatric euthanasia is a profound challenge.”

Stakeholders in discussions over euthanasia for mental illness have expressed a number of intractable reservations. These include:

• Whether safeguards established by the medical system can protect the most vulnerable.
• Whether it is possible to predict the long-term prognosis for a mentally ill person.
• Whether it is possible to distinguish between suicidality and a “reasonable wish to die”.
• Whether providing – or denying – medical assistance in dying is compatible with Canada’s Charter of  Rights
• Whether there are enough psychiatrists available to give a second opinion on a mentally ill person’s condition.

Supporters of MAID were exasperated by another year of delay. “For the people across the country who live with treatment-resistant mental disorders who have patiently waited for this change in Canada’s MAID law, Dying With Dignity Canada is disheartened and shares the frustration of the continued exclusion, stigmatization and discrimination based on diagnosis – a clear breach of the Charter of Rights and Freedoms,” said Helen Long, of DWDC.  

Euthanasia in Canada is increasing faster than in any other country in the world, according to an analysis by the Investigative Journalism Bureau and the Toronto Star. “Assisted deaths accounted for four per cent of all deaths in Canada in 2022 — up from one per cent in 2017, the first full year the legislation was in place. The number of MAID deaths quadrupled during that time. In 2022, the total number hit 13,000 nationwide —a 31 per cent jump from the previous year.”