MP Tamara Jansen introduced a new bill that would repeal the expansion of euthanasia to those with mental illness. Four years into the conversation about euthanasia for mental illness, we’re incredibly happy that there is another proposal to eliminate one of the most egregious parts of Canada’s euthanasia regime. 

History of the Planned Expansion of Euthanasia for Those with a Mental Illness 

Euthanasia for those with a mental illness was first raised in Bill C-7 in 2021, which originally set a date of March 17, 2023 when euthanasia for those with mental illness would be legalized. After a report by a committee of the Quebec legislature recommended against euthanasia for mental illness and an expert panel report on euthanasia for mental illness noted significant risks, the government passed Bill C-39, which delayed the expansion of euthanasia for mental illness until 2024. 

As that date approached, former Member of Parliament Ed Fast introduced Bill C-314, An Act to amend the Criminal Code (medical assistance in dying). If passed, that bill would have repealed the expansion of euthanasia to those with mental illness as the only condition causing their request. Although that bill received unanimous support from the Conservative, NDP, and Green Party, along with 8 Liberals, it failed to pass by a vote of 150-167.  

As ARPA noted at the time, such a close vote, especially on a social issue dealing with a matter of life and death for those with mental illness, sends a message that Canadians have serious reservations about expanding MAiD further. If only nine more MPs had voted in favour instead of against, the bill would have passed 2nd reading and advanced to committee for further study.  

In response to the close defeat of the bill and in light of concerns raised by nearly every provincial government that they weren’t prepared, the government decided shortly after to delay the expansion of euthanasia for mental illness for a second time, this time until 2027. In the wake of the vote, the Conservatives – who had unanimously voted in favour of entirely repealing the expansion – were riding high in the polls, were expected to form government, and promised to repeal the expansion of MAiD to those with a mental illness. But Trudeau’s resignation and Carney’s ascension led to a different outcome in the recent election. 

With no Conservative government in charge of things and no commitment from the Liberals to revisit the issue, MP Tamara Jansen used her opportunity to introduce a private member’s bill on the issue. Her Bill C-218 is identical to the previous one introduced by MP Ed Fast and intends to permanently eliminate – rather than just delay – the tragedy of euthanasia for mental illness. 

The Tragedy of Euthanasia for Mental Illness 

Every case of euthanasia is a tragedy. And every case of euthanasia in our health care system is fundamentally at odds with the central premise of health care of doing no harm. But extending MAiD to those with a mental illness is particularly tragic. 

Simple logic dictates that MAiD  isn’t appropriate for people with mental illness. People who have a mental illness are not able to give fully informed consent to MAiD. By definition, their reasoning isn’t entirely sound, and so they should not be put in a position where they could choose to end their life. We should be providing suicide prevention – not assisted suicide – for those who are suicidal because of a mental illness. 

As a nation, we have poured resources into suicide prevention across the country, particularly for people with mental illness. Canada now has a suicide crisis hotline to help people escape suicidal ideation. We should continue do to this rather than encouraging suicide assistance through MAiD. Indeed, offering suicide assistance undermines suicide prevention efforts. 

As a country, we raise awareness around mental illness and encourage people to seek help or treatment. For example, Bell Let’s Talk Day is all about reducing the stigma around mental illness and getting people the mental health care that they need. MAiD for mental illness entirely undercuts these efforts. Rather than encouraging people to access mental health care, legalizing MAiD for mental illness encourages people to end their lives instead. 

To really drive home the tragedy of euthanasia for mental illness, consider this story that we shared with young people at God & Government youth a few months ago: 

It’s February, and as you’ve experienced it is cold, and snowy. Just behind Parliament Hill the wind howls across the Alexandria bridge.  

It’s just after dinner time, and a man originally on his way home from the corner store is now standing on one of the struts that hold the bridge in place. Emergency vehicles have begun swarming around, the bridge has been cordoned off, and traffic is being redirected to the Portage bridge further up river. A camera crew from Ottawa CTV station, craving a good story, hover just off the bridge, attempting to see what the commotion is all about.    

Paramedics prepare warming blankets and pull out supplies. Police officers and other personnel chat to each other through earpieces. They’re waiting for someone. A moment later, an officer jumps out of a police car that pulls up just a few feet away from where the man clings to the buttress of the bridge.  

“What’s your name, son?” the officer hollers over the whistle of the wind. “Can we talk about this right now?” 

“I just don’t think I can do it anymore,” the man shouts back. “I’m done with everything. My depression is simply too much to bear. I don’t have any desire to live anymore.”  

“I see,” the officer shouts back, “well if that’s the case…”  

The officer jogs up to the side of the bridge, snow crunching under his heavy boots until he stands near the railing where the man is just within reach.    

He hoists himself up onto the railing, reaches over and stretches until he has a hold of the bottom of the man’s heel. With a sudden jerk, he wrenches the man’s right leg high into the air. He disappears into the darkness below. “We’re good,” the cop chirps into his radio, “it’s what he wanted.”    

The following morning’s headline in the Ottawa Citizen read, “Heroic Police Officer supports a young man’s right to Die with Dignity, in the face of overwhelming and debilitating depression.”    

Virtually no Canadian wants to live in such a country. And yet, legalizing euthanasia in any form but especially euthanasia for mental illness, functionally puts our health care system in the exact same position. 

The Road Before Us 

Bill C-218 again offers Canada the opportunity to step back from the euthanasia ledge and onto firmer ground that respects the value and dignity of very human life. We are grateful that another MP has taken up this issue and is pushing the government to repeal further expansion of euthanasia. 

The new Parliament after the spring election has a fairly similar makeup in government as when Bill C-314 – the previous proposal to scrap the planned expansion for euthanasia for mental illness – was voted on. Prime Minister Carney has not expressed where he stands on the issue of MAiD. Perhaps he will whip his caucus to defend the previous government’s law, but perhaps he will allow a free vote among his MPs on the issue. 

The fact that this is still a live issue and that now four separate pieces of legislation have arisen on this topic in just four years is a testament to your continual advocacy! You’ve worked hard to email and meet with your MPs, talk with your neighbours, and deliver nearly 250,000 flyers to spread the message of caring, not killing.  

This has contributed to the ongoing conversation, but with another bill on the table, we need to get back at it. Take a few minutes to email your own Member of Parliament expressing your support of Bill C-218 and ask them to support it as well. Copy Prime Minister Mark Carney, Minister of Justice Sean Fraser, and Health Minister Marjorie Michel on that email, encouraging the government to support the legislation as well. 

As Christians, we can continue to advocate for caring, not killing, in all circumstances. And we can continue to put pressure on our elected officials to do the same.   

Status: Completed first reading in the House of Commons

Description: Would eliminated the expansion of eligibility for euthanasia to those with mental illnesses. Bill C-7, the last piece of euthanasia legislation, had a sunset clause that would allow those with mental illnesses to be eligible for euthanasia. While the government delayed the implementation of this clause by another three years in Bill C-62, this bill proposed to scrap that clause entirely.

Analysis: It is incomprehensible that our society provides suicide prevention to one class of citizens and assisted suicide to another class of citizens. The extension of assisted suicide to those with mental illness effectively means that assisted suicide is a perfectly legitimate solution to suicidal ideation. Instead of offering assisted suicide to those with mental illnesses, we need to provide better mental health care and support to those who are suffering.

Action Items: Visit CareNotKill.ca for more information on all of these action items:

When Parliament legalized euthanasia and assisted suicide in 2016, many warned of a slippery slope. First legalized as a last resort for those nearing natural death, euthanasia and assisted suicide have since been expanded to people not nearing natural death (2021) and to those with mental illness (scheduled for 2027). In the meantime, safeguards have been removed. Between 2016 and 2022, nearly 45,000 Canadians were euthanized.

Professor John Keown, comparing euthanasia in the Netherlands and Canada, writes, “In 40 years, the Dutch have slid down the slippery slope. In fewer than 10, Canada appears to be veritably skiing.”

Bill C-7

Bill C-7, An Act to amend the Criminal Code (medical assistance in dying) was introduced in 2020 and received Royal Assent in March 2021. The bill removed the requirement that a person’s natural death be reasonably foreseeable, thus making persons with non-terminal illness eligible for euthanasia. It also created two different sets of safeguards, one for those who were nearing natural death, and another for those who were not. If a person is nearing natural death, they can be fast-tracked for euthanasia with fewer safeguards. If a person is not nearing natural death, there are a few additional safeguards such as a 90-day waiting period.

The Senate added a clause to Bill C-7 to permit euthanasia for mental illness as the sole underlying medical condition, starting in March 2023. That was later delayed until 2024, and then until 2027.

Care Not Kill Campaign

Since the mental illness expansion had not yet come into effect, ARPA Canada’s Care Not Kill campaign focused from 2021 to early 2024 primarily on cancelling that expansion. Many of you, our supporters, got involved in that campaign by delivering flyers, writing emails to your federal representatives, sending submissions to committee, or running bus ads. You sent a clear message that euthanasia should never be a solution for mental illness.

Last fall, MP Ed Fast introduced Bill C-314, which would have cancelled the plan to permit euthanasia for mental illness. Although the bill failed to pass (by only 17 votes), some members of all parties supported it. Earlier this year, nearly every province asked the federal government to delay the scheduled expansion of euthanasia indefinitely. The Conservative Party of Canada has committed to repealing this expansion if they form government following the next election. We can continue to encourage other parties to do the same.

Euthanasia should never be a solution for suffering. Euthanasia and assisted suicide encourage a culture of neglect for suffering, elderly, disabled, and vulnerable people. Canada should promote suicide prevention and life-affirming care for all. Given the successful pushback across Canada on the mental illness expansion, now is the time to call for additional safeguards in the law.

Repeal C-7

The Care Not Kill campaign is asking the government to repeal Bill C-7 entirely. That would not only cancel the mental illness expansion, but would end euthanasia for those who are not dying. It would also restore other safeguards that Bill C-7 removed.

Bill C-7 changed Canada’s law on assisted suicide to offer it as an escape from what is perceived as a difficult life, or even a difficult period of life. Only people with disabilities or chronic illness are offered assisted suicide as a solution for their suffering. The able-bodied who suffer are offered suicide prevention and various other supports. The implicit message is that some lives matter more than others. We need to call on the government to promote life-affirming care for all.

Just as we advocated for the repeal of euthanasia for those with mental illness, we can call for the repeal of euthanasia for those with disabilities or non-terminal illnesses.

Next Steps

With a federal election looming next year, we have an opportunity to ask candidates and MPs how they will protect vulnerable Canadians from euthanasia. We can encourage candidates to talk about the issue during their campaigns, and we can call on the next government to pass legislation to reverse Canada’s slide down the slippery slope when it comes to euthanasia. Stay tuned over the coming months for updated Care Not Kill materials and action items.

In Quebec, euthanasia deaths in 2022 increased by 45.5% compared to 2021. Euthanasia accounted for 6.6% of all deaths, compared to the national average of 4.1%. Michel Bureau, head of the Quebec Commission on end-of-life care, worries that euthanasia is no longer seen as a last resort within that province, stating, “We’re now no longer dealing with an exceptional treatment, but a treatment that is very frequent.”

Despite these disturbing statistics, the government of Quebec continues to push euthanasia as the solution to suffering, particularly in palliative care settings. This push is the focus of a recent legal challenge filed in the Quebec Superior Court.

Background

The National Assembly of Quebec passed The Act respecting end-of-life care in 2014 for the purpose of establishing an “integrated vision of palliative and end-of-life care.” The framework includes palliative care as well as euthanasia. Through that framework – and this is true throughout the country – euthanasia is one among many end-of-life care options.

The legalization of euthanasia throughout Canada in 2016 created a host of problems for federal and provincial governments as they craft legislation, regulations, and professional guidelines. One issue for governments is how to handle medical professionals who believe euthanasia is never the appropriate solution for suffering. Some provincial governments have tried to force doctors to facilitate euthanasia deaths, even if doctors do not have to provide the procedure directly.

Beyond individual conscience rights, another issue is whether institutions can refuse to offer euthanasia within their facilities. In June 2023, the government of Quebec amended their euthanasia law through Bill 11, An Act to amend the Act respecting end-of-life care. Among other changes, these amendments addressed questions of religious or conscientious objection when it comes to institutions providing euthanasia.

Religious Objection

Other provinces allow religious palliative care facilities to opt out of providing euthanasia. For example, British Columbia, when pressured to force a Catholic hospital to provide euthanasia, came up with a compromise that gives patients easier access to euthanasia without forcing religious institutions to provide it. You can read more about that here.

Quebec’s law was clear, until recently, that palliative care providers could decide whether euthanasia would be done on their premises. Bill 11 changed that in 2023, mandating that “no palliative care hospice may exclude medical aid in dying from the care it offers.” According to the government of Quebec, palliative care must include the option of euthanasia. This creates a dilemma for religious facilities opposed to euthanasia.

According to the Quebec palliative care association, as of March 2023 there were only four palliative care facilities in Quebec that did not offer euthanasia. One of these facilities is St. Raphael’s, a Catholic palliative care centre in Montreal. Its founders and supporters have clearly stated their opposition to euthanasia and their emphasis on relieving pain to enhance quality of life. Prior to the change in law, if a patient at their centre wanted to be euthanized, staff at the facility would send them to a provincially run facility. But now St. Raphael’s must either provide euthanasia or close its doors. The Catholic Archbishop of Montreal has filed a legal challenge, arguing that the law violates religious freedom.

Legal Precedent

Although we have seen disputes between Christian healthcare institutions and governments, such as those in British Columbia, the Archbishop’s legal challenge is the first of its kind in Canada. Whether the challenge succeeds or fails will set an important precedent for how religious freedom and religiously supported health care institutions are viewed in Quebec.

A win for the Archbishop would be binding precedent only in Quebec, but it would signal to other governments that Christian institutions must be allowed to provide care in a way that aligns with their beliefs and convictions.   This legal challenge is important, not simply because of what it means for St. Raphael’s and other religiously supported institutions in Quebec, but also for institutions across the country. Rather than pushing religious institutions out of providing health care, governments should give them the freedom to continue helping the sick and dying in their communities.

At the end of January, the committee studying euthanasia recommended an indefinite delay of the planned expansion to those with mental illness. You can read more about the Committee’s recommendations here. In addition to the Committee’s report, seven provinces and three territories wrote to the federal government asking for an indefinite pause on the expansion. Mainstream media, such as the Globe and Mail, also called on the government to cancel, instead of delay, euthanasia for those with mental illness.

Although the Committee did not place a timeframe on their recommendation for delay, the government chose to delay for three years, until March 17, 2027.

On February 1, just three days after the Committee tabled their report, the Minister of Health introduced Bill C-62 to delay the expansion. Although the Committee did not place a timeframe on their recommendation for delay, the government chose to delay for three years, until March 17, 2027.

Bill C-62

There are a couple of interesting things to note about Bill C-62.

First, as just mentioned, the bill would delay the expansion of euthanasia to those with mental illness for three years. Last year, almost to the day, the government introduced Bill C-39, which delayed the expansion for one year, saying they believed the health care system would be ready by early 2024. But now the government has introduced a bill to delay for another three years – pushing this until after the next federal election. With continued pushback on the expansion in the next three years, the government may be convinced to cancel the expansion entirely.

Second, in line with the committee’s recommendations, the bill requires the committee to reconvene one year before the expansion comes into effect. The study that was just completed by the committee focuses solely on the question of whether Canada is ‘ready’ to expand euthanasia to those with mental illness. But Bill C-62 makes no mention of studying ‘readiness.’ Instead, it requires a “thorough review of the eligibility for medical assistance in dying of any person whose sole underlying medical condition is a mental illness.” Later, the Bill clarifies that the committee may include “any recommended changes to the provisions of the Criminal Code relating to medical assistance in dying.” This means that it would be within the next committee’s mandate to recommend stopping the expansion of euthanasia entirely, instead of sticking simply to a question of ‘readiness.’  

Not Done Yet

Every Member of Parliament on the Joint Committee studying euthanasia agreed that the expansion needs to be delayed, with some going further and saying it should be canceled outright. Bill C-62 has already passed third reading in the House of Commons and has gone to the Senate. However, four out of the five Senators on the committee felt that a delay was unnecessary and potentially problematic. Some reports indicate that advocates for euthanasia expansion are encouraging the Senate to stop Bill C-62. If the Bill does not pass prior to March 17, Canadians with mental illness will be eligible for euthanasia.

The House of Commons is taking the right steps. But we need to continue to tell the Senate that Canadians want this delay passed. Please send an CareMail to your Senators encouraging them to pass Bill C-62 prior to the March 17, 2024 deadline.

If the Bill does not pass prior to March 17, Canadians with mental illness will be eligible for euthanasia.

Send the CareMail