We are living in topsy-turvy times when people say their rights are being violated because the government is not helping them die quickly enough.
But that is the central claim of a lawsuit launched this week.
On Monday, a woman with bipolar disorder and a man with PTSD filed a Charter challenge in an Ontario court. They claim their rights are being violated because they cannot access medical assistance in dying (MAID) given that they only suffer from a mental illness, and not a physical condition.
Both individuals can compellingly argue they are being discriminated against on the basis of a mental illness. Adults with physical conditions can currently access MAID. The Supreme Court’s original MAID decision also contains logic that could be used to support their case.
Even so, we hope the government vigorously opposes their challenge.
For one thing, the breathtaking expansion of MAID to its current form has not been driven by any consensus in public opinion or the medical community. Rather, it has been driven by a very small number of actors.
Consider the history of how we got to where we are today:
In response to a 2015 Supreme Court decision striking down a blanket prohibition on physician-assisted death, Parliament introduced a legal framework governing access to MAID. That framework limited eligibility to adults with medical conditions for whom a “natural death” was “reasonably foreseeable.”
In 2019, a single, lower-court Quebec judge ruled this requirement of “reasonable foreseeability of natural death” was unconstitutional. Rather than challenge this controversial decision, the Trudeau government chose not to appeal it.
Instead, the government introduced a bill to expand MAID to adults with physical conditions whose death is not reasonably foreseeable. In the Senate, a tiny minority of senators tacked on a provision saying individuals suffering solely from mental illness would also be eligible for MAID.
While the law passed, Parliament has twice postponed the eligibility expansion for mental illness. It did so most recently this February, pushing back MAID eligibility for mental illness to March 2027.
Parliament postponed this expansion because it received voluminous feedback from provincial health ministers, heads of psychiatry, physicians and others that the health-care system is not ready to assess whether individuals suffering from mental illness meet MAID’s eligibility criteria.
Put simply, there is no consensus — in the courts, medical community or public opinion — that MAID should be expanded to those whose death is not reasonably foreseeable. Only 40 per cent of Canadians favour expanding MAID to those with mental illness, according to a 2024 study in the British Medical Journal. And only 19 per cent of those surveyed even understood one does not need to be terminally ill to be eligible.
Rather than accepting the Quebec court’s ruling unchallenged, Ottawa ought to revisit the vital question of whether death needs to be reasonably foreseeable to be eligible.
Second, Charter claims are not judged solely based on individual interests. The courts conduct a two-step analysis: Has an individual’s rights been violated? If so, is the violation justified in light of other factors?
The applicants could likely establish that their rights have been violated. But the government could convincingly argue that societal factors justify this limitation.
Already, numerous organizations — including the Canadian Human Rights Commission — have sounded the alarm that individuals who are homeless or have physical disabilities are turning to MAID. They are doing so not because they want to die but because they are desperate.
Sadly, it is far easier for them to access MAID than supports like social housing or health-care resources that enable them to live with dignity.
There are hundreds of thousands of Canadians struggling with acute and interconnected issues of homelessness, addiction and mental illness. Expanding MAID to those with mental illness risks making MAID an easy out for society to ignore their suffering.
In addition, many members of the medical community question whether MAID for mental illness can ever be properly assessed, given the difficulties of determining if mental illnesses are incurable — which is one of the requirements for eligibility. Many people with mental illnesses may also not be in the right state of mind to judge whether they want to live.
Conservative Party leader Pierre Poilievre has already said a Conservative government would oppose the expansion of MAID to those with mental illness. It remains to be seen whether a Liberal government will mount any opposition to this court challenge.
We believe any government ought to. There is far too great a risk of MAID’s further expansion imperilling the lives of an already vulnerable population. If even a single wrongful death were to result from the expansion, it would make the whole project unworthy.
Who’s funding this challenge? If the judgement is in the favour of the litigants will it apply to all of Canada?
The Trudeau regime is hiding behind a powerful lobby group which it funds and grants non profit status to. On the surface it appears that the group, not the regime, is behind this court challenge. In reality, the regime is suing itself in order to overturn a democratic decision made in Parliament, all so they can gain access to mass murder people deemed mentally ill. The case will be presided over by a handpicked liberal friendly judge.
That should make people think. Once they gain access to murder the mentally ill, it will open the door to mass murder on a scale Canada has never seen. They can murder homeless, mentally ill, addicts, and anyone who has a mental infirmity (seniors with dementia or Alzheimer, brain injury patients, and a lot more). Even worse, they can deem political enemies of the state to be mentally ill and murder them as well. Now you know why they’re willing to go to such lengths to overturn the wait until 2027.
It is my belief that advanced requests for MAID in case of dementia should be allowed. At a simplistic level, I should be able to submit an advanced request for MAID when my dementia reaches the point where I no longer recognize my spouse or children or assigned guardian.
I see it as my right to avoid becoming a burden (emotional and financial) to my family and also to avoid consuming precious health care resources.
In your example wouldn’t your ability to sign an advance request be questioned? Or did you mean that you would indicate in an advanced request that the inability to recognize certain people should be the time that MAiD could be carried out?
Your second interpretation is what I meant to say. With the advance request in my legal file, once I no longer recognize tho0se certain people my wish for MAID would be carried out. Hope that helps!
Understood.
Advance requests for euthanasia due to dementia are a slippery slope, especially with Canada’s permissive MAID industry. Who decides when it’s time for you to die? It won’t be you, no matter what the piece of paper you signed says.
In Canada there have been documented incidents where the patient wasn’t ready to die yet and tried to fight off the “provider”. Instead of respecting the patient’s wishes, they sedated the patient with IV opioids and killed them anyway. In Belgium a patient who fought was smothered with a pillow. In Canada, MAID practitioners are exempt from being charged under the Criminal Code.
I don’t understand why this type of discussion never recognizes that this scenario has already played out when it comes to another very vulnerable group – individuals with disabilities. It’s exactly the same reasoning and same issue for both – death not reasonably foreseeable and people choosing MAID because our system won’t provide the necessary support. Nor is there any consensus on the issue. Perhaps we just don’t care as much??
Advance directives are a very different animal. The person decides what type (if any) of medical care they want when they no longer have the capacity to make personal care decisions. In other words, the question becomes one of capacity as opposed to when anyone thinks you “should” die.
The vulnerable groups are not just those with physical illness, mental illness or disabilities. It needs to be understood that physical illness can be chronic or life ending; mental illness also can be chronic or in the case of dementia and other mental illnesses, life ending; a disability is chronic, but life ending? Yet the criteria the assessors must consider are mostly similar. How does this make sense? A recent paper discusses this problem: https://philmed.pitt.edu/philmed/article/download/212/77
The paper is invalid because it naively assumes that MAID practitioners follow the rules governing their “profession”. There is ample proof that they don’t. There is a wealth of evidence that ineligible patients can “doctor shop” for approval and MAID assessors even help them to find a doctor who will sign the paperwork. Mental illness patients are already being murdered illegally under MAID. In one case the victim’s cause of death was listed as “hearing loss”. People are being murdered for reasons like credit card debt and fear of homelessness. It doesn’t help that there’s no accountability and MAID practitioners are immune from criminal prosecution. Here’s a chilling paper which describes how MAID has become a breeding ground for serial killers:
https://link.springer.com/article/10.1007/s10730-024-09528-3