Ottawa wants to postpone expanding medical assistance in dying for a year

(OTTAWA) Canadians whose “sole underlying medical condition” is mental illness will not be eligible for medical assistance in dying for another year, under a bill introduced Thursday by the Liberals.

Updated February 2

David Fraser

The Canadian Press

Justice Minister David Lametti has tabled his bill in the Commons to delay this expansion of eligibility criteria until March 17, 2024.

“We have to be careful. We must move forward step by step, making sure that people in the profession, Canadian society as a whole, have internalized this step,” Minister Lametti told reporters on Thursday.

“To be honest, we might have gone with the original date (March 17), but we want to be sure. We want to play it safe. We want everyone to be on the same page. »

The Liberal government had agreed to expand the eligibility criteria in its update to the Medical Assistance in Dying Act, in 2021, following senators amended the bill. The senators had argued that excluding people with mental illness would violate their constitutional rights.

But the amended law provided for a two-year period to delay this enlargement. However, this period must expire on March 17, unless Parliament adopts a new law. The Liberals therefore have six weeks to pass the new bill, which would add a third year to the two-year deadline.

Minister Lametti maintained that he had the agreement of the New Democratic Party and the Bloc Québécois to pass the bill in this short period of time.

Cautious New Democrats

NDP MP Alistair MacGregor said in a statement that he was concerned regarding the expansion and fully supported the one-year delay. “Liberals can’t just postpone it: they need to get better supports and treatment options for people with mental illness,” he said.

The Senate will also have to approve the decision to postpone this expansion of medical assistance in dying until next year.

Federal officials said the delay will allow more time for the government to develop standards of practice to assess more complex requests for medical assistance in dying. The explanations were given during a technical briefing for the media.

These standards will need to be adapted by provincial and territorial regulators and clinicians, a process that is expected to take place in March, it says.

Federal officials said an accredited medical assistance in dying program is also being developed for clinicians. It should begin rolling out in the fall and be completed by the end of the year.

More data and training

They said the postponement also allows the government to better collate data on medical assistance in dying cases. Officials say they expect a relatively small number of new applicants to apply as a result of the expanded criteria.

New regulations, which allow for “enhanced data collection”, came into force at the beginning of the year. These data will go beyond simple demographic details, to examine how other treatments were offered to patients before the process of medical assistance in dying.

Helen Long, CEO of Dying with Dignity Canada, said she was “deeply disappointed” on behalf of those waiting to apply under the expanded program.

“I feel like it’s a long time,” she said. And I think for people with treatment-resistant mental disorders who were excluded, they continue to be denied compassion and prolong their suffering. »

M^me Long argues that preventing people with mental disorders from accessing medical assistance in dying is discriminatory and perpetuates the stigma that they lack the capacity to make their own health care decisions. .

Carolyn Bennett, federal Minister of Mental Health and Addictions, says the training curriculum for practitioners is “pretty ready”, but the postponement will give them more time to dig into it. The minister also maintains that certain provinces had indicated that they were not ready.

M^me Bennett said the “additional time” would help ensure that the people who assess these cases, and the practitioners who perform them, “know they did it exactly the right way,” as do “experts and patients deserve it”.

Conservatives once morest enlargement

The government has heard many voices calling for more time, Minister Lametti also pleaded on Thursday. “And at that point, it became a matter of duration. And those negotiations led to where we are today. »

Tory MP Michael Cooper said on Twitter that the one-year postponement was not enough and that “this dangerous expansion” of the procedure should be dropped altogether.

The Tories have argued that it is difficult for doctors to determine when a person’s suffering from a mental disorder has passed the point of treatment, so the policy might lead to “avoidable deaths”.

“One year will not solve the problems. Experts are clear that irremediability cannot be determined in the case of mental illness,” Cooper said.