TORONTO – The federal Liberals face a difficult choice at the start of 2024: they can allow a clause to come into force so that eligibility for medical assistance in dying extends to adults whose only reason for requesting it is a mental disorder, or they can do what they did in 2023 and postpone that decision further, even indefinitely.

As the CBC reports, federal Justice Minister Arif Virani says the government is evaluating its options ahead of the March deadline for making this decision. The first step, he says, will be to see what members of the House and senators recommend after committee hearings that examined the issue last fall.

Medical assistance in dying (in plainer words: assisted suicide) has been legal in Canada since 2016, and five years later Parliament approved expanding the eligibility criteria to include those suffering from a mental disorder as the only condition.

Senator Stan Kutcher, a Nova Scotia psychiatrist, had supported the expansion, which was due to take effect in March 2023 before being delayed for a year due to concerns about the consequences. Last fall, a joint committee of parliamentarians was tasked with examining the question of whether Canada’s health care system was ready for such an expansion: now the federal Liberals must now choose whether or not to proceed with the expansion of the rules.

Justice Minister Arif Virani told the Canadian Press last month that he would carefully review what the commission recommends, opening the door to a new suspension of the plan to broaden the rules. Kutcher, who was part of the commission that looked into the matter, says he believes the courts have ruled that Canadians should have access to medical assistance in dying on a case-by-case basis, and that he expects Canada’s attorney general to “complie to the Charter”.

But what do the Provinces think about it? As the CBC explains, while New Brunswick says it is working to ensure it is ready and a spokesperson for Ontario’s Ministry of Health expressed no concerns, Quebec passed a law in June that bars access to death medically assisted exclusively for a mental disorder. A spokesperson for the Government of Saskatchewan said it was “concerned” about the planned expansion and “cannot commit” to implementing it “without carefully considering the risk this may pose to people suffering from mental illness”. In short, the topic is very divisive. A big deal for the federal government. 

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