OTTAWA — Critics of Canada’s assisted-dying regime are accusing the Liberal government of pairing a prohibition on MAID for mental illness with a controversial expansion allowing advance requests for people who lose decision-making capacity.Justice Minister Sean Fraser announced Wednesday that the government will introduce legislation this fall to indefinitely exclude mental illness as a sole underlying condition for medical assistance in dying.The same bill will remove federal barriers to advance requests, allowing provinces and territories to establish their own regimes for people diagnosed with conditions such as dementia.Pro-life advocate Amanda Achtman accused the government of deliberately joining two distinct policies in one bill.“The Liberal government is incredibly sly,” Achtman wrote on X. “They intend to table a bill banning death for depression while expanding death for dementia.”“Those properly opposed to euthanasia will not be able to support this bill, despite having campaigned for months to stop MAID for mental illness.”Achtman, founder of the Dying to Meet You project, said the approach could force MPs who support the mental-illness exclusion to vote for advance requests as well..Fraser also confirmed the government will vote against Conservative MP Tamara Jansen’s Bill C-218, which would state that “a mental disorder is not a grievous and irremediable medical condition” under the Criminal Code.Fraser said the term “mental disorder” is too broad and could exclude people with neurocognitive or neurodevelopmental conditions from MAID.Federal guidance distinguishes the Criminal Code term “mental illness” from conditions such as dementia, autism spectrum disorder and intellectual disabilities.“The Justice Minister took issue with Tamara Jansen’s Bill C-218 because it would prevent those with mental disorders from qualifying for euthanasia,” Achtman said.“It seems the government wants to uphold MAID for autism and advance MAID for dementia.”A diagnosis of autism, dementia or another disability does not automatically make someone eligible for MAID. Under the Criminal Code, an applicant must have a serious and incurable illness, disease or disability, be in an advanced and irreversible decline and experience enduring, intolerable suffering that cannot be relieved under conditions they consider acceptable.The applicant must also possess decision-making capacity, make a voluntary request and give informed consent, subject to limited existing exceptions..Health Canada says someone whose only condition is mental illness is currently ineligible, while a person with mental illness alongside another qualifying medical condition “may be eligible” following an individual assessment.Achtman argued this means people with mental illness can already receive MAID when they also have a qualifying physical illness or disability.“In Canada, if you’re depressed but able-bodied, you don’t qualify for MAID,” she wrote. “But, if you’re depressed and use a wheelchair, you do qualify for MAID.”“Canada already euthanizes people with mental illness if they also have a physical illness, disability, or neurological condition.”Using a wheelchair alone does not qualify someone for MAID. The person must satisfy every eligibility requirement under the Criminal Code.Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, said advance requests create fundamental questions about consent once a patient becomes incapable of communicating or making medical decisions.“Because someone’s now incapable of consenting or requesting, it’s a good idea now to do this because they might have asked for it in the past?” Schadenberg said Wednesday.“The whole concept of consent becomes very problematic.”Schadenberg questioned who would ultimately determine whether the conditions contained in an advance request had been met.“Who makes the decision in the end? Some family member, some doctor who says, ‘Oh, I guess this was requested in the end,’” he said. “To me, it’s almost very eugenic.”Achtman also criticized Ottawa’s response to Quebec, which has accepted advance MAID requests since October 2024 despite the absence of a corresponding exemption in federal criminal law.“Today the federal government rewarded Quebec for breaking federal law by euthanizing people without contemporaneous consent,” she said. “Now, the government intends to expand death for dementia nationwide.”“Protecting those with dementia from dehumanization is the new life issue of our time.”.Federal briefing documents say providing MAID through an advance request remains an offence under the existing Criminal Code. More than 1,600 advance requests were believed to have been registered in Quebec by June, although publicly available federal information does not establish how many people have received MAID through that process.Quebec’s framework permits someone diagnosed with a serious and incurable condition leading to incapacity, such as Alzheimer’s disease, to specify observable symptoms that could later trigger an assessment after the person loses capacity.An advance request does not automatically result in MAID, and the person must satisfy the provincial eligibility criteria before it can be administered.Jansen said Conservatives offered to amend Bill C-218 to ensure it applies specifically to mental illness and does not capture conditions such as dementia.“We are not going to allow wording to be the obstruction in a bill that will save lives,” Jansen said.Conservative MP Andrew Lawton accused the Liberals of “playing politics with people’s lives” by promising their own legislation while opposing C-218.He said combining advance requests with the mental-illness exclusion was “very cynical” because Parliament must pass legislation before the existing exclusion expires on March 17, 2027.The government has not yet released the text of its proposed legislation.
