Canada’s Medical Assistance in Dying (MAID) Program: Expansion Delayed to 2027

Canada has decided to postpone the expansion of its medical assistance in dying (MAID) program for individuals with mental illnesses. The initial implementation, scheduled for March 17, has been halted based on recommendations from a parliamentary committee, and concerns voiced by provinces regarding the readiness of the healthcare system. Responding to these concerns, legislation was introduced on Thursday to push the expansion to 2027.

Canada acknowledged the health system’s unreadiness for this expansion, echoing the sentiments expressed by provinces across the nation. Federal Health Minister Mark Holland emphasized the importance of system preparedness, stating that mental suffering is considered equivalent to physical suffering but is contingent on readiness. The Centre for Addiction and Mental Health (CAMH), Canada’s largest mental health hospital, expressed the need for more time to assess the situation. Concerns were raised about the adequacy of training for healthcare professionals in determining eligibility for euthanasia in individuals with mental illnesses.

The proposed legislation includes a provision for a review in two years to reevaluate the system’s readiness. This marks the second delay, as the expansion was previously put on hold for one year, extending until March of the current year. Advocacy group Dying with Dignity expressed disappointment over this second pause, deeming it a denial of constitutional rights for suffering individuals across Canada.

In 2021, Canada relaxed its euthanasia laws, no longer requiring a patient’s condition to be terminally ill. This change allowed individuals with serious and incurable conditions to request medically assisted dying. The number of such deaths rose significantly, from 1,018 in 2016 to over 13,241 in 2022, constituting about 4.1% of all deaths in the country. Statistics from 2022 revealed that 3.5% of written requests for euthanasia were rejected.

The average age of individuals seeking medically assisted dying in 2022 was 77 years old, with cancer being the most common underlying medical condition cited. Quebec stood out with the highest percentage of medically assisted deaths, accounting for 6.6% of all deaths in the province in 2022. Dr. Michel Bureau, president of Quebec’s commission on end-of-life care, cautioned that cases of medical aid in dying were expanding beyond terminal cancer, requiring doctors to maintain rigor within the legal limits.

It is noteworthy that other countries, such as Belgium and the Netherlands, have permitted euthanasia for psychiatric patients since 2002, albeit under stringent conditions. Canada’s decision to delay the expansion reflects the ongoing debate and careful considerations surrounding the extension of MAID eligibility to those with mental illnesses.