No more MAiD delays

Further delays to the eligibility for medical assistance in dying, or MAiD, in circumstances where the sole underlying condition is a mental illness are deeply concerning and should not be prolonged. That’s the gist of a letter to Justice Minister David Lametti and Health Minister Jean-Yves Duclos from the Canadian Bar Association’s End of Life Working Group.

The CBA’s commitment to clarifying the law about end-of-life decision-making goes back nearly a decade. “The CBA supports MAiD for persons with mental illnesses and mature minors, and supports advance requests for MAiD, with appropriate safeguards.” It has made recommendations to that effect consistently over the years.

The letter reiterates the Working Group’s belief that denying MAiD in circumstances where the sole underlying condition is a mental illness is likely unconstitutional. “People living with mental illness are entitled to autonomy and self-determination about their health, without discrimination, and to recognition that their suffering is no less real than that of individuals affected by a physical illness,” it explains.

What’s more, forcing persons whose sole underlying condition is a mental illness to challenge the constitutionality of their exclusion from the MAiD “imposes an unreasonable burden that is inconsistent with the fundamental principle of equal access to justice.”

The letter quotes data from Dying With Dignity Canada showing more than one-third of the calls they field are related to psychiatric disorders, “several among them confirming that the delay in the implementation of MAiD has further increased their suffering and desperation.”

This is concerning because of the risk that such persons might pursue other options than MAiD, including taking their own lives in ways that are “dangerous and undignified.”

That is one reason why the CBA Working Group urges the government to “commit the time and resources necessary to ensure no further delay to the eligibility for medical assistance in dying in circumstances where the sole underlying medical condition is a mental illness,” which must be available by March 2024.

As well, the government, along with its provincial and territorial partners, “must ensure the collaboration of regulatory authorities, medical practitioners and nurse practitioners to establish standards and safeguards for assessing MAiD requests.”

The suffering of individuals with a mental illness is just as real and serious as the suffering of individuals with a physical illness. The legislative framework must treat everyone equally and recognize their right to make their own health decisions, including choosing MAiD.