A joint parliamentary committee has called for an indefinite halt to Canada's planned expansion of medical assistance in dying (MAID) to include mental illness as a sole criterion. The recommendation comes in a long-awaited report tabled Wednesday, concluding that the country is not prepared for the change.
Report Findings
The Special Joint Committee on Medical Assistance in Dying, comprising 12 members from both the House of Commons and the Senate, recommends amending the Criminal Code to indefinitely exclude individuals whose only underlying condition is a mental illness from MAID eligibility. The committee's work was based on testimony from 44 witnesses across six meetings.
“Some witnesses asserted that Canada is or will be ready for the expected expansion on 17 March 2027, others stated that the conditions for proceeding have yet to be met,” the report states. Key concerns include the lack of evidence-informed criteria for determining irremediability, challenges in distinguishing between a reasoned MAID request and suicidal intent, insufficiently resourced mental-health systems, and inadequate regulatory safeguards.
Background on MAID Expansion
In February 2024, legislation was passed to expand MAID to those with mental illness as the sole underlying condition, with implementation scheduled for March 2027. In 2021, Canada removed the requirement that death must be “reasonably foreseeable” for MAID eligibility. Patients are currently assigned to one of two tracks: Track one for terminal illnesses or near natural death, and Track two for cases where death is not reasonably foreseeable.
Concerns Over Irremediability and Suicide Risk
The report notes that witnesses were divided on whether it is possible to determine the incurability of mental disorders. Some argued that clinicians can assess irremediability, while others testified that it may never be possible to reliably determine irremediability in mental illness or distinguish truly irremediable suffering from treatable despair.
Testimony from Dr. Allison Crawford, chief medical officer of the 988 Suicide Crisis Helpline, highlighted overlaps with suicide crisis services. She reported that about 7% of helpline interactions—nearly 70,000 calls and texts—now mention MAID. Among contacts referencing MAID, 74% had endorsed thoughts of suicide in the previous two days, compared with 48% among other contacts.
Next Steps
The committee's recommendation adds to growing calls from physicians and disability advocates urging the government to rethink MAID criteria. The federal government now faces pressure to respond to the report's findings before the scheduled expansion date.
