The original deadline for the expansion of euthanasia to those with mental illness was March 17, 2023. However, at the beginning of February, in response to pressure from the public, the media, and medical professionals, the government introduced Bill C-39 to extend that deadline by one year, to March 17, 2024. Thankfully, that bill received royal assent on March 9, just eight days before the planned expansion.

The day before Bill C-39 was passed, Senators had the opportunity to question the Minister of Justice and the Minister of Health on the issue of euthanasia for mental illness. The Minister of Justice, David Lametti, made it clear that the government is still committed to making the expansion happen. The only reason cited for the delay is so that the government can ensure the regulations are clearly defined and understood.

Two Sides to the Debate

On one hand, Senators questioned the Ministers about the lack of consensus among medical professionals, legal scholars, and the general public about the expansion of euthanasia for those with mental illness. These Senators asked why the government does not abandon the expansion altogether due to the lack of professional consensus and the concerns that vulnerable Canadians will be killed instead of receiving the care they need. Other questions centred on data, safeguards, and funding for mental illness.

On the other hand, some Senators asked questions with regard to the slowness of implementing euthanasia for those with mental illness, suggesting that the government is unnecessarily making suffering Canadians wait to access euthanasia.

Notable Points

Much of the conversation about euthanasia for mental illness revolves around the question of irremediability; that is, whether a patient with mental illness can recover. This is where a major lack of consensus among medical professionals exists. Many psychiatrists say that mental illness is never irremediable and that a patient always has a chance of recovery.

Instead of focusing on this issue of irremediability, some Senators have chosen to focus on autonomy; that is, the right for patients to choose euthanasia if they are suffering in a way that they feel is intolerable.

In response to questions about irremediability, the Ministers of Justice and Health claim that a patient is not eligible for euthanasia if there is any doubt about whether they can recover. However, they do not propose making the law more strict, but simply trust that doctors will act appropriately. A major concern that the government does not address is that Canadians who wish to access euthanasia can simply go to a doctor who is open to defining their illness as irremediable and will end their life. It is often at this point that the conversation seems to shift increasingly away from medical arguments and towards arguments about autonomy.

The government also continues to stress that they believe there will only be a small number of Canadians accessing euthanasia for mental illness. But some Senators note that bad policies are not made acceptable if they only affect a small number of people, particularly when they end those people’s lives.

A second medical question in this debate is whether euthanasia will be provided to Canadians who are suicidal. The Minister of Justice argues that, even in the context of mental illness, euthanasia will not be provided to someone who is suicidal. Any arguments to the contrary he labels as misinformation. However, as one psychiatry professor states, “On the face of it, even if you look at what the word means, when somebody wants to die and they’re not dying, of course that means that they’re suicidal.” Concerns about euthanasia for those who may be suicidal are valid, and the Minister of Justice fails to show how the issues can be distinguished.

Another interesting point raised in the discussion was with regard to how provinces would respond to the expansion of euthanasia to those with mental illness. In particular, Quebec has already chosen not to allow euthanasia for mental illness. Alberta Premier Danielle Smith recently also objected to the government’s continued expansion of euthanasia, although she has not said whether her government will act on this objection.

While the federal government wants to have all the provinces on board with their expansion, the Ministers admit that they are working with criminal law and the provinces do not have to implement everything they are permitted to implement. So, if the federal government is unwilling to stop the expansion of euthanasia, provinces may have the opportunity to create stricter guidelines in their jurisdictions.

Where to from here?

It is fitting to close with the words of Senator Donald Plett, as he concluded his speech on Bill C-39:

“To those listening who are struggling with mental illness or who love someone with mental illness and to those who treat and support them, please know this fight is not over. The work has only begun … Bill C-314 has been tabled and will put an end to this reckless expansion. I look forward to continuing the fight in this chamber and I would encourage my colleagues to give the bill due consideration when it comes our way.”

Bill C-314, recently introduced in the House of Commons, seeks to entirely remove the expansion of euthanasia for those with mental illness. We are thankful that Bill C-39 has passed, giving an additional year to push for the complete removal of the expansion to those with mental illness. While it is troubling to hear comments from the Minister of Justice, the Minister of Health, and various Senators who wish to see euthanasia expanded, it is also very encouraging to hear the comments of MPs and Senators who speak boldly about this issue on behalf of vulnerable Canadians. We hope and pray that MPs, Senators, and the Canadian public will continue to engage boldly on this issue over the upcoming year. And we hope that Reformed Christians will be leading that charge.

Over the past few months, there has been a flurry of activity with regard to Canada’s euthanasia laws. You’ve heard from ARPA Canada about Bill C-39, Bill C-314, Bill S-248, committee hearings, and expert panels, all focused on the issue of euthanasia, not to mention the multiple components of euthanasia being debated, whether it’s safeguards, disability, mental illness, or mature minors. Christians involved in this issue have seen cause for both encouragement and discouragement just this month, and many times throughout the past year or two. If you find yourself getting confused about where things are at, you’re not alone. Let’s put it all in one place for a minute and take stock.

Bills Expanding Euthanasia in Canada

Looking back to March 2021, the government passed Bill C-7. Through this bill, they removed the requirement that death must be reasonably foreseeable in order for a person to access euthanasia. That meant that Canadians with various disabilities could access euthanasia, even if their disability would not naturally end their life in the foreseeable future. In addition, Bill C-7 set a date of March 17, 2023, when euthanasia for those with mental illness would be legalized.

Over the past two years, Canadians have increasingly expressed their fears about the implications of offering suicide to those with mental illness. Multiple news stories showed the slippery slope of euthanasia becoming a reality, where Canadians were being offered euthanasia against their will, and those with mental illness were being encouraged to end their lives. Many psychologists and psychiatrists recognized that there is no way to distinguish a request for euthanasia from suicidal thoughts, and stated fears that providing access to euthanasia would devalue the lives of those with mental illness and make them lose hope.

Currently, Bill S-248 is being debated in the Senate, but it has not yet passed 2^nd reading. This bill would allow Canadians to make advance requests for euthanasia – meaning that a person could decide now that they want to be euthanized at some later date when they cannot give consent. These types of requests are rightly prohibited for most medical treatment decisions because a person cannot know what their condition will be like in the future, or how they will feel about that condition if it happens.

Quebec has also introduced a provincial bill, Bill 11, that seeks to allow advanced requests in their province. Unlike the federal Bill S-248 which was introduced by a private member in the Senate and thus has a relatively low chance of passing, Bill 11 was introduced by the government (specifically by the minister responsible for seniors) and thus has a high likelihood of becoming the law of the land in Quebec.

Bills Slowing the Expansion of Euthanasia

At the end of 2021, a report by a committee of the Quebec legislature recommended against euthanasia for mental illness. A 2022 Expert Panel report on euthanasia for mental illness noted significant risks but ultimately suggested that no new safeguards needed to be added to existing legislation. The government is aware of concerns about euthanasia for mental illness, and they have backed off slightly, recently introducing Bill C-39, which will delay the expansion of euthanasia for mental illness until March 17, 2024. Unfortunately, the government’s reasoning is not due to concerns that this expansion is inappropriate. Instead, they stated that they are committed to making the expansion happen and are simply ensuring that the proper safeguards are in place. Meanwhile, many medical professionals claim that there is no such thing as proper safeguards that would protect vulnerable Canadians with mental illnesses.

Shortly after Bill C-39 was introduced, Member of Parliament Ed Fast introduced Bill C-314, which would entirely cancel the expansion of MAiD for those with mental illness. This is a huge step in the right direction and a signal that there is a willingness to stop the expansion of euthanasia. The debate on euthanasia and mental illness in the House of Commons reveals the support of many of MP Fast’s colleagues. NDP MP Charlie Angus also recently wrote on Twitter, “I will not vote to support extending the medical death program to those suffering mental illness, to those who are depressed or to children. Not on my watch.” While the Bill will need a majority of MPs to vote in favour, MPs from all parties seem to be increasingly concerned about expanding euthanasia for mental illness.

Committee Report on Euthanasia

Shortly after Bill C-314 was introduced, the Special Joint Committee on Medical Assistance in Dying released their final report after months of discussion and witness testimony. Ultimately, despite stating multiple worries that witnesses had about expansion, the majority of the committee recommended expanding euthanasia to those with mental illness (after the one-year delay), to minors, and to those who make advance requests. To ‘protect’ the vulnerable, the committee recommends a few safeguards as well as further consultation and a review process. However, the reviews would take place five years after euthanasia is already expanded, at a time when it is too late for those who have already had their lives ended through euthanasia. For further commentary on that report, you can read ARPA Canada’s statement and a recent op-ed.  

The latest recommendations from the Joint Committee are troublesome and point to some appetite for the continued expansion of euthanasia in Canada. Yet once again, there was opposition, even on the Committee. A minority of the Committee wrote a dissenting report, recommending that the government refuse to expand euthanasia. They also address the need for improved palliative care and protection for people with disabilities. We are encouraged to see strong opposition in these areas from some members of the Committee.

In short…

There has been a lot of debate in the past couple of years on the issue of euthanasia in Canada. We’ve seen excellent pushback on euthanasia for those with mental illness and may yet see that reversed. There will likely be further developments throughout 2023, and we must continue to push back against further expansion. It’s been a rollercoaster, with ups and downs, but we are thankful for the efforts of so many Canadians who are encouraging the government to care for vulnerable Canadians, rather than end their lives. For more on what you can do, go to carenotkill.ca for current action items.   

February 2, 2023

For immediate release

OTTAWA, ON – Today, the federal government introduced Bill C-39 to delay the expansion of MAiD to those with mental illness. The delay, initially announced by the Justice Minister in December of last year, will hold off the expansion until March 17, 2024. While this development indicates that the government recognizes there are problems with Canada’s MAiD legislation, simply delaying the inevitable is not good enough and much more needs to be done.

“Delaying the expansion of euthanasia with the promise of better safeguards will not solve the problems inherent in such an expansion,” said Mike Schouten, spokesperson for ARPA Canada. “Canada has made incredible strides in recent years to care for those suffering from mental illness. The increased openness to talking about our struggles and self-awareness about the harms of ignoring mental health challenges are all positive steps,” continued Schouten. “Making it possible for struggling Canadians to act on their suicidal desires will negatively impact the progress we’ve made in helping those with mental illness. We need the government to protect vulnerable Canadians by amending the legislation so that it protects those with mental illness from accessing euthanasia based on their condition.”

Witness testimony at the Joint Special Committee studying MAiD laws, much of it from the medical community, and numerous stories in the media have clearly demonstrated the harm that expanding euthanasia to those with mental illness would cause.

“Expanding assisted suicide for those with mental illness encourages a culture of neglect and devalues their lives,” said Schouten. “Euthanasia and assisted suicide should never be a solution for mental illness.”

ARPA Canada calls on the government and opposition parties to use Bill C-39 as an opportunity to do what is right and protect vulnerable Canadians by entirely removing the option of expanding euthanasia to those with mental illness.

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The Association for Reformed Political Action (ARPA) Canada has a long history of involvement with euthanasia laws and policy in Canada. ARPA was granted intervenor standing at the Supreme Court of Canada in the Carter case in 2016. They have also provided a variety of policy reports, research, and analysis on the topic. In 2020, ARPA launched the Care Not Kill campaign, a national grassroots initiative that educates Canadians on the harms of euthanasia as well as equipping people to engage respectfully on this sensitive topic.
 
For further comment or interviews, please contact Mike Schouten at 1-866-691-2772 or
[email protected]