Euthanasia for mental illness now likely to become legal in Canada after latest vote

CANADA – The Canadian Liberal Party pushed through expanded medically assisted dying legislation Thursday night, moving Canada closer to a future where people with mental illnesses will be able to claim a medically assisted death.

After weeks of debate in the Canadian House of Commons, the Liberals, with the help of the Bloc Québécois, invoked closure on the legislation Thursday afternoon. Closure has been used sparingly by the Liberals, but it ensures the end of debate and a vote, which was expected late Thursday evening.

With the Bloc’s support, the bill passed through the House late Thursday, with the NDP, Conservatives and a handful of Liberal MPs voting against it.

Before the vote, Canadian Conservative leader Erin O’Toole asked why the government was rushing such an important piece of legislation through the house.

“When mental health advocates and thousands of Canadians have questions about this substantive change to how we address vulnerable people, people in palliative stages of disease and our publicly funded medical health system, why would the government limit reasonable questions of concern?”

Justice Minister David Lametti argued the government was simply moving the bill forward before a looming court-ordered deadline in two weeks. He said MPs had received more than enough time to debate the bill.

“We have given this House more than ample opportunity to debate this bill; 139 members of this place have spoken for close to 45 hours on this critical piece of legislation,” he said.

Lametti also pointed out the Conservatives were offered opportunities for more debate, but declined them on three separate occasions recently.

The new assisted dying legislation is the Liberals second attempt at a bill on the issue. Shortly after coming to power in 2015, they brought in legislation, but it was found unconstitutional in 2019 by a Quebec Superior court.

The court found the requirement that someone have a reasonably foreseeable death was unconstitutional; ruling that someone in extreme suffering, with no prospect of that suffering ending, should have the same right as someone who can see their death coming.

The court gave parliament a year to amend the legislation and the government has sought and received four extensions to that deadline. But the fourth and last extension expires on March 26.

Removing the reasonably foreseeable death provision to respect the court decision opened up the question on people who are living with a mental illness. When Lametti first introduced the bill last year, it specifically ruled out people with “only” a mental illness from receiving a medically assisted death.

Senators voted to change that with a provision that would have the exclusion of mental illness expire within 18 months. Lametti changed the 18-month expiry to two years, but accepted the Senate’s change to include people with mental illness in the legislation.

Conservative MP Rob Moore said the Senate’s changes effectively make the bill an entirely different piece of legislation and it should receive more study, with the advice of more experts.

“When we studied [medically assisted dying] in Bill C-7, the mental illness component was not a part of it and this is causing grave concerns,” he said. “This is certainly putting the cart way before the horse.”

Under the bill, the two-year reprieve will allow for a new joint committee of senators and MPs to study the issue and recommend safeguards for the mentally ill. The group will also look at other outstanding concerns around advanced directives and whether mature minors should be able to access medically assisted dying.

The government will also strike an expert medical panel to provide advice within a year of the legislation passing and the committee of senators and MPs has to begin its work within 30 days of the bill passing.

Lametti said it has long been the plan for parliament to consider issues around mental health and the Senate’s amendments don’t change that.

“It’s a serious question. We know that it’s a difficult question, we know that it touches all of us profoundly,” he said. “It was always our intention to look at mental illness carefully in the parliamentary review. We’re still going to do that so the only thing that changed is the timeframe.”

Even if the parliamentarians make no changes over the next two years, someone seeking a medically assisted death for a mental illness would need the support of two experts that their condition was incurable with no hope for improvement.

Because the House of Commons did not accept all of the Senate’s proposed changes, the legislation has to go back to the red chamber for another vote.  It is rare, however, for the Senate to refuse to pass a bill that the House has considered a second time.

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