By Canadian Press

Government agrees people with mental illness should have access to MAID — in 2 years

Feb 23, 2021 | 12:35 PM

OTTAWA — The Trudeau government has agreed with the Senate that Canadians suffering solely from grievous and irremediable mental illnesses should be entitled to receive medical assistance in dying — but not for another two years.

The two-year interlude is six months longer than what was proposed by senators.

It is one of a number of changes to Bill C-7 proposed by the government in response to amendments approved last week by the Senate.

The government has rejected another Senate amendment that would have allowed people who fear being diagnosed with dementia or other competence-eroding conditions to make advance requests for an assisted death.

It has also rejected one other amendment and modified two others in a motion that was debated Tuesday in the House of Commons.

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“I believe that C-7 is one important and prudent step in ensuring greater respect for the autonomy of a broader category of Canadians who are suffering intolerably,” Justice Minister David Lametti told the Commons, expressing hope that the Senate will accept the government’s “reasonable” proposals.

Bloc Québécois MP Luc Thériault said his party will support the minority Liberal government’s response, assuring it will pass.

While the Bloc would have liked to go further to expand access to assisted dying, he said the bill does make some important progress on that front.

“It is very important to keep moving forward,” Thériault told the Commons.

Once approved by the Commons, the bill will go back to the Senate, where senators will have to decide whether to accept the verdict of the elected chamber or dig in their heels.

Bill C-7 would expand access to assisted dying to intolerably suffering individuals who are not approaching the natural end of their lives, bringing the law into compliance with a 2019 Quebec Superior Court ruling.

As originally drafted, the bill would have imposed a blanket ban on assisted dying for people suffering solely from mental illnesses.

A strong majority of senators argued that the exclusion was unconstitutional, violating the right to equal treatment under the law, regardless of physical or mental disability, as guaranteed in the Charter of Rights and Freedoms.

They voted to impose an 18-month time limit on the mental illness exclusion, which the government now wants to extend to two years.

Lametti said he still believes the exclusion is constitutional and he “does not believe we are entirely ready” to safely provide assisted dying for people with mental illnesses.

Nevertheless, he said the government has heard the concerns of Canadians who fear the exclusion may never be lifted and will, therefore, support a two-year sunset clause.

“We think 24 months is still an ambitious timeline to implement such an important change in Canada’s MAID (medical assistance in dying) policy but it still provides a fixed timeline in the relatively near future,” Lametti said.

During the two-year interlude, the government is also proposing to have an expert panel conduct an independent review of the issue and, within one year, recommend the “protocols, guidance and safeguards” that should apply to requests for assisted dying from people with a mental illness.

Until the exclusion is lifted, senators had wanted to clarify that it does not apply to people with neurocognitive disorders like Alzheimer’s disease. However, the government has rejected that amendment.

In rejecting advance requests, the government motion argues that the Senate amendment on that issue “goes beyond the scope of the bill” and requires “significant consultation and study,” including a “careful examination of safeguards.”

Lametti said he knows many Canadians will be disappointed by the government’s rejection of that amendment. But he said the issue should be examined during the legally required five-year parliamentary review of the assisted dying law, which was supposed to have begun last June but has yet to materialize.

The government has agreed, however, to a modified version of a Senate amendment to finally get that review underway within 30 days of Bill C-7 receiving royal assent.

The government is proposing the creation of a joint Commons-Senate committee to review the assisted-dying regime, including issues related to mature minors, advance requests, mental illness, the state of palliative care in Canada and the protection of Canadians with disabilities. The committee would be required to report back, with any recommended changes, within one year.

The government has also agreed to a modified version of another Senate amendment to require the collection of race-based data on who is requesting and receiving medical assistance in dying.

It is proposing to expand that to include data on people with disabilities and to specify that the information be used to determine if there is “the presence of any inequality — including systemic inequality — or disadvantage based on race, Indigenous identity, disability or other characteristics.”

That is in response to the strenuous opposition to Bill C-7 from disability rights advocates who maintain the bill sends the message that life with a disability is a fate worse than death. They’ve also argued that Black, racialized and Indigenous people with disabilities, already marginalized and facing systemic discrimination in the health system, could be induced to end their lives prematurely due to poverty and a lack of support services.

Some critics have also raised concerns about unequal access to assisted dying for marginalized people, rural Canadians and Indigenous people in remote communities.

The government’s response did not satisfy either the Conservatives, who largely opposed the original bill, or the New Democrats, who object in principle to the unelected Senate making substantive changes to legislation passed by the Commons.

NDP MP Charlie Angus criticized the “unelected and unaccountable Senate” for expanding assisted dying to “people who are depressed.”

Conservative MP Michael Barrett moved an amendment to the government motion, that would delete the proposed sunset clause on the mental illness exclusion.

He further slammed the government for ignoring the concerns of disability rights advocates and signalled that his party will not go along with the government’s “fevered rush” to pass what he called a “deeply flawed” bill.

“That’s why we’re here today, to stand up for them and be the voice that this government cannot ignore,” Barrett said.

The government is hoping to have the bill passed by both parliamentary chambers by Friday to meet the thrice-extended court-imposed deadline for bringing the law into compliance with the 2019 ruling.

But with the Conservatives signalling that they may drag out debate on the Senate amendments, the government will ask the court on Thursday to give it one more month — until March 26.

This report by The Canadian Press was first published Feb. 23, 2021.

Joan Bryden, The Canadian Press