In 2021, Parliament set up a special committee of MPs and Senators to study the issue of “medical assistance in dying” (or MAiD) and to make recommendations to Parliament. The Special Joint Committee on Medical Assistance in Dying released its “Choices for Canadians” report on February 15.
The Committee recommends expanding MAiD further, even though Canada’s existing MAID regime has major problems. Canada already has one of the most permissive euthanasia regimes in the world and has failed to protect vulnerable Canadians. Further expansion will only exacerbate the problems.
The Committee addressed three areas for expansion; MAiD where a mental disorder is the sole underlying medical condition, MAiD for “mature minors” (i.e. older children), and MAiD by advance request – meaning that a person can ask now to be euthanized later, when they have lost the capacity to give consent.
On MAiD for mental illness, the Committee’s report summarized arguments that witnesses made about whether mental illness is ever irremediable, whether being suicidal is different than wanting to be euthanized, and whether Canadians will choose MAiD due to lack of access to services.
Meanwhile, a 2021 report by a committee of the Quebec legislature recommended against MAiD for mental illness. And a 2022 Expert Panel report on MAiD for mental illness noted significant risks and concluded, “This report is the beginning of a process, not the end.”
The Committee endorses the government’s decision to delay legalizing MAiD for mental illness until March 2024, acknowledging that potential problems have not been adequately addressed. But they support legalizing it anyway, assuming the problems will work themselves out. The Committee says it should reconvene five months before MAiD for mental illness begins to discuss it again.
Next, the Committee recommends legalizing MAiD for “minors deemed to have the requisite decision-making capacity upon assessment.” Here too, there are major gaps in the research, and multiple witnesses told the Committee about the need for further consultation and research, about the need for greater access to supportive services for youth, and about the limited capacity of minors to understand and make a decision to end their own life at their age.
The Committee admits it is “important to proceed cautiously in allowing MAiD for mature minors.” Hence, it recommends that an independent expert panel study and evaluate the provision of MAiD to minors in the five years after it is legalized. Permit, then study. Experiment, that is. Who knows what problems they will discover in their study five years from now, but there’s no undoing the past. There’s no bringing euthanized children back from the dead.
The Committee supports conducting “consultations” with minors to get a sense of their views on MAiD, as this remains largely unknown. But again, for this Committee, it’s legalize first, consult after.
Finally, the Committee recommends that the government “allow for advance requests following a diagnosis of a serious and incurable medical condition, disease, or disorder leading to incapacity” despite the difficulty in predicting the rate of decline and anticipating in advance what a person might later feel is an intolerable condition, after he has lost the capacity to give (or refuse) permission to euthanize him.
The report also addresses the fact that many Indigenous people are worried about what MAiD means for their communities, and that they have not been adequately consulted. Yet, MAiD is already available to them and is having an impact on their communities.
The Committee report raises more problems than it resolves. In March 2021, Parliament passed Bill C-7, which was supposed to legalize MAiD for mental illness in March 2023. They legalized it at a future date, then spent two years trying to justify the forthcoming legalization. They failed. Then they delayed for another year. The Committee commits the same folly. Commit to legalizing now; justify later.
We cannot afford to play catch-up on implementing safeguards, monitoring implementation, and researching risks after expanding euthanasia and ending thousands more lives. MAiD is irreversible, and the federal government must recognize the inherent problems with any further expansion.
Daniel Zekveld is a Policy Analyst with the Association for Reformed Political Action (ARPA) Canada.