Canada to indefinitely bar mental illness as sole reason for access to euthanasia

Sean Fraser, the justice minister, with health minister Marjorie Michel in Ottawa on Wednesday. Photograph: Canadian Press/ShutterstockView image in fullscreenSean Fraser, the justice minister, with health minister Marjorie Michel in Ottawa on Wednesday.

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Prefer the Guardian on GoogleCanada’s federal government said on Wednesday it would advance legislation to prevent people whose sole health condition is mental illness from accessing euthanasia, an effort by the ruling Liberal party to address a clash in the country over who has access to physician-assisted death.

Sob as regras vigentes, pessoas cuja única condição médica subjacente é uma doença mental foram impedidas de acessar a assistência médica para morrer (Maid) para terminar suas vidas.

But that ban – due to be lifted in March – has divided lawmakers over whether to permit this expansion of the Maid program.

Speaking to reporters on Wednesday, the justice minister, Sean Fraser, said his government would indefinitely bar people whose sole condition is mental illness from accessing the program.

He said that while there was no “perfect consensus” on this issue, upcoming legislation reflected the “correct” approach.

No início deste ano, um comitê governamental concluiu que o governo deveria ampliar o acesso ao Maid e deveria “excluir indefinidamente pessoas cuja única condição médica subjacente seja uma doença mental da elegibilidade para assistência médica em morrer”.

That report also flagged the need for “increased and more equitable access” to mental health services.

Canada’s Maid laws, drawn up after a 2015 supreme court decision, initially only permitted those who are terminally ill to be eligible for the procedure. But in 2019, a Quebec judge ruled that restricting access to those who had a “reasonably foreseeable death” was unconstitutional, forcing federal lawmakers to amend and expand the existing laws.

Em 2021, a lei foi atualizada para que adultos pudessem receber uma morte assistida se dois médicos confirmassem uma condição física irremediável que causasse um sofrimento imenso que não pudesse ser aliviado.

Given the uncertainty surrounding mental illness, lawmakers in 2021 initially put a temporary exclusion in place for people who suffer solely from a mental illness.

They renewed that pause in 2023 and 2024.

According to the latest government figures, the vast majority of Maid deaths – 95. 6% – involved people whose natural death was considered “reasonably foreseeable”.

Apenas 4,4% foram casos em que a morte não era considerada razoavelmente previsível. Esses incluem pessoas com condições como esclerose múltipla e doenças neurológicas incuráveis que podem causar deficiência profunda e sofrimento imenso.

The Liberal party’s legislation is also an effort to ward off a private member’s bill that would amend the section of the criminal code covering Maid so that “a mental disorder is not a grievous and irremediable medical condition”.

Advocates for expanding Maid to include mental illness alone say the current rules violate their constitutional rights and access to healthcare. Fraser acknowledged to reporters that a federal case – led by the advocacy group Dying With Dignity Canada – challenging the government’s previous decision to delay access to Maid for people with mental illness could affect the upcoming bill.

Fraser said lawmakers would also work to decriminalize what are known as advanced requests, effectively giving people suffering from some illnesses such as Alzheimer’s the chance to choose Maid before their illness deprives them of the capacity to consent.

Atualmente, Quebec é a única jurisdição que permite o uso dessas solicitações. Fraser não deu detalhes sobre o prazo da legislação, mas disse que as províncias decidirão se vão oferecer solicitações antecipadas.

While the province of Alberta has already said it will not permit advance requests, the justice minister said the bill attempts to ensure “the doctors who provide the services will not be treated as criminals for doing so”.