Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Elaina Plott Calabro wrote an exposé on Canada’s euthanasia law that was published in the September edition of the Atlantic titled – Canada is Killing Itself. The article is too long to comment on in one article, so I have written a series of articles covering the important points.

One of the topics that Calabro tackles in are article is the question of further expansions of euthanasia in Canada. Calabro first tackles the topics euthanasia by advance request and euthanasia for children “mature minors” and writes:

Despite all of the questions surrounding Track 2, Canada isproceeding with the expansion of MAID to additional categories of patientswhile gauging public interest in even more. As early as 2016, the federalgovernment had agreed to launch exploratory investigations into the possiblefuture provision of MAID for people whose sole underlying medical condition isa mental disorder, as well as to “mature minors,” people younger than 18 whoare “deemed to have requisite decision-making capacity.” The government alsopledged to consider “advance requests”—that is, allowing people to consent nowto receive MAID at some specified future point when their illness renders themincapable of making or affirming the decision to die. Meanwhile, the QuebecCollege of Physicians has raised the possibility of legalizing euthanasia forinfants born with “severe malformations,” a rare practice currently legal onlyin the Netherlands, the first country to adopt it since Nazi Germany did so in1939.

On February 15, 2023 a Canadian government committee recommended the extension of euthanasia for people who request it in advance and to children. During the committee meetings the Québec College of Physicians urged the committee to support euthanasia for newborns with disabilities (infanticide).

Calabro then focusses on euthanasia for mental illness alone, which is currently scheduled to go into practise in March 2027. 

As part of Track 2 legislation in 2021, lawmakers extendedeligibility—to take effect at some point in the future—to Canadians sufferingfrom mental illness alone. This, despite the submissions of many of thenation’s top psychiatric and mental-health organizations that no evidence-basedstandard exists for determining whether a psychiatric condition isirremediable. A number of experts also shared concerns about whether it waspossible to credibly distinguish between suicidal ideation and a desire forMAID.

After several contentious delays, MAID for mental illness isnow set to take effect in 2027; authorities have been tasked in the meantimewith figuring out how MAID should actually be applied in such cases. The debatehas produced thousands of pages of special reports and parliamentary testimony.What all sides do agree on is that, in practice, mental disorders are already aregular feature of Canada’s MAID regime. At one hearing, Mona Gupta, apsychiatrist and the chair of an expert panel charged with recommendingprotocols and safeguards for psychiatric MAID, noted pointedly that “peoplewith mental disorders are requesting and accessing MAID now.” They includepatients whose requests are “largely motivated by their mental disorder but whohappen to have another qualifying condition,” as well as those with “longhistories of suicidality” or questionable decision-making capacity. They mayalso be poor and homeless and have little interaction with the health-caresystem. But whatever the case, Gupta said, when it comes to navigating thecomplex intersection of MAID and mental illness, “assessors and health-careproviders already do this.”

Alan Nichols

The argument was meant to assuage concerns about clinicalreadiness. For critics, however, it only reinforced a belief that, in somecases, physical conditions are simply being used to bear the legal weight of adifferent, ineligible basis for MAID, including mental disorders. In one ofCanada’s more controversial cases, a 61-year-old man named Alan Nichols, whohad a history of depression and other conditions, applied for MAID in 2019while on suicide watch at a British Columbia hospital. A few weeks later, hewas euthanized on the basis of “hearing loss.”

It is important to not that euthanasia for mental illness is already happening in Canada, but the person is required to have another medical condition. As Mona Gupta stated:

“people with mental disorders are requesting and accessing MAID now.” They include patients whose requests are “largely motivated by their mental disorder but who happen to have another qualifying condition,” as well as those with “long histories of suicidality” or questionable decision-making capacity. They may also be poor and homeless and have little interaction with the health-care system. But whatever the case, Gupta said, when it comes to navigating the complex intersection of MAID and mental illness, “assessors and health-care providers already do this.”

The Euthanasia Prevention Coalition is urging the Canadian government to do a complete review of the euthanasia law, which was promised but has never been done (Link).

The Euthanasia Prevention Coalition is also asking our supporters to sign and share the petition in support of Bill C-218, the bill that will prevent euthanasia for mental illness alone (Link).