Today, Parliament’s Special Joint Committee on Medical Assistance in Dying (AMAD Committee) released a report recommending that “the Government of Canada amend the Criminal Code to indefinitely exclude persons whose sole underlying medical condition is a mental illness from eligibility for medical assistance in dying”.
If adopted, this recommendation would cancel Canada’s planned expansion of euthanasia and assisted suicide where mental illness is the sole underlying condition (known as “MAID MI-SUMC”).
CLF’s Executive Director & General Counsel Derek Ross, who appeared before the Committee in an earlier study, comments:
““Canadians struggling with mental illness deserve our full support - support that prioritizes care over death, hope over defeat, and is, without exception, life affirming. It is important that our laws resist the normalization of death as a medical “solution” to suffering. Today’s recommendation is an important step forward in living up to Canada’s promise, set out in the Convention on the Rights of Persons With Disabilities, to take all necessary measures to uphold the right to life and ensure its effective enjoyment by Canadians with mental illness on an equal basis with others.””
BACKGROUND
Although mental illness does not currently qualify as an “illness, disease, or disability” for the purposes of MAID eligibility under the Criminal Code, this is scheduled to change on March 17, 2027, due to a “sunset clause” in Bill C-7. That Bill, passed in 2021, expanded MAID eligibility to those whose death is not “reasonably foreseeable” (known as “Track 2 MAID”). This meant that, as of 2021, individuals could receive euthanasia even if they were not dying, and even if their underlying condition would not cause their death – opening the possibility of MAID for mental illnesses.
Many groups, including CLF, expressed concern about the prospect of psychiatric euthanasia and offering death as a medical “solution” for mental illness, and the government agreed to delay such expansion, initially to 2024, then to 2027.
Now, after hearing extensively from stakeholders, health care professionals, human rights experts, and the disability community, the AMAD Committee has recommended that this expansion be halted. CLF welcomes this news, after years of advocating for life-affirming care and mental health supports.
CLF made detailed submissions to the AMAD Committee in each of its studies (2022, 2023, and 2026), highlighting concerns surrounding compliance with existing safeguards and human rights obligations, patients’ lack of access to assistance in living and ongoing socioeconomic barriers which effectively undermine any notion of “autonomy” for many who might receive MAID.
CLF submitted a letter to the AMAD Committee earlier this year, and we are grateful to see our concerns reflected in the Committee’s report. This letter, which can be read below, highlights human rights and constitutional concerns around expanding MAID for mental illness.
maid for mental illness is not constitutionally required
As CLF explained in its letter, the question before the Committee is whether a mental illness itself should form the sole basis for eligibility for MAID. The Supreme Court of Canada has never dictated that Parliament must legalize MAID in such circumstances. To the contrary, the proposed expansion of MAID for mental illness goes beyond the circumstances contemplated by the Supreme Court of Canada in Carter. In that case, the Court expressly stated that MAID for “psychiatric disorders” fell “outside the parameters” of its decision (see para 111).
Contrary to what some have suggested, Canadian courts have not recognized a constitutional right to MAID, including for mental illness. MAID MI-SUMC is not constitutionally required, and in fact many considerations weigh against expanding MAID for mental illness. This is explained comprehensively in a peer-reviewed article in the Manitoba Law Journal (co-authored by Prof. Mary Shariff of the University of Manitoba, Prof. Trudo Lemmens of the University of Toronto, and CLF’s Derek Ross).
not all Distinctions are discriminatory
CLF has also maintained that a distinction which excludes mental illness from MAID eligibility is not necessarily discriminatory, particularly given the broad lack of consensus on when such illness becomes irremediable – a key parameter for eligibility established by the Supreme Court in Carter (see CLF’s 2022 Background Paper).
In fact, the lack of medical consensus on the irremediability of mental disorders was previously emphasized by a Québec Select Committee, leading it to recommend “that access to medical aid in dying not be extended to persons whose only medical condition is a mental disorder” – that recommendation was adopted by the National Assembly and is now reflected in Québec’s Act respecting end of life care (s. 26).
Moreover, Alberta passed Bill 18 into law last month, which similarly excludes MAID MI-SUMC and Track 2 MAID from the province’s healthcare program. When Alberta first introduced this legislation, CLF’s Derek Ross and Professor Brian Bird (Peter A. Allard School of Law) co-authored an op ed featured in The Globe and Mail, explaining why such parameters are both constitutionally sound and ethically justified (read more here). Alberta’s new law reflects additional recommendations from CLF and other groups, clarifying that hospitals and palliative care communities will not be forced to offer euthanasia, and that conversations about euthanasia should never be initiated, unsolicited, by a health care professional.
MAID MI-SUMC risks PERPETUATing INEquality, not alleviating it
CLF’s latest letter to the AMAD Committee also emphasized the risk of perpetuating inequality by expanding MAID for mental illness, contrary to claims that excluding MAID MI-SUMC violates equality rights.
Introducing MAID MI-SUMC – especially where mental health supports are often inaccessible – risks perpetuating harm for many individuals, not alleviating it. This is discussed in greater detail in CLF’s 2022 Background Paper.
According to data from Crisis Services Canada (referred to in CLF’s last Brief to the AMAD Committee), approximately 80% of people who attempt or die by suicide exhibit warning signs such as “[i]solation, withdrawal from previously enjoyed relationships and activities”, “protracted anxiety or agitation”, and “[e]xpressions of hopelessness, helplessness, purposelessness”. This raises serious ethical questions about whether Canada’s health care system should be facilitating the deaths of people whose suffering so closely mirrors the suffering of suicidal individuals and could be due to suicidality.
For these and other reasons, scholars have warned that MAID MI-SUMC may perpetuate disadvantage by “portray[ing] death as preferable to a disabled life”, rather than responding to “underlying inequalities”. CLF highlights these and other concerns expressed by the United Nations’ Committee on the Rights of Persons with Disabilities (CRPD), particularly in the context of Canadians receiving MAID for suffering associated with systemic ableism and marginalization, which, scholars have warned, could be exacerbated by expanding MAID for mental illness. The CRPD has already expressed that it is “extremely concerned” about the expansion of MAID in Canada.
In this context, there would be a heightened risk of generating what UN experts have referred to as a “two-tiered system in which some would get suicide prevention and others suicide assistance, based on their disability status and specific vulnerabilities”.
It is difficult to see how Canada can be committed to suicide prevention and supporting people with mental health issues, on the one hand, and to offering state-sponsored death solely for mental illness, on the other.
What’s Next
CLF has long advocated for the equal right to life and its protection for persons with disabilities on an equal basis with others, urging greater safeguards and life-affirming care and supports.
CLF has repeatedly reminded the Canadian government of its obligations under the Convention of the Rights of Persons with Disabilities, particularly in relation to the expansion of MAID in Canada. CLF will continue to highlight concerns expressed by UN human rights experts in our parliamentary consultations, submissions to lawmakers, and media reports, as well as our academic conferences and resulting scholarly publications.
CLF welcomes the recommendation of the AMAD Committee to halt the proposed expansion of MAID MI-SUMC. Now, much work remains to ensure that this recommendation is passed into law, and to prioritize supports that offer all Canadians the ability to live with dignity. CLF also remains engaged in responding to the recommendations of a parliamentary committee in 2023, which called for the expansion of MAID for “mature minors” and for those who have lost capacity but made an advance request.
CLF’s longstanding work defending every person’s inherent right to life will continue, anchored in our deep conviction that every human life deserves respect and full legal protection (as set out in Article 10 of the UN Convention of the Rights of Persons with Disabilities).
READ CLF’S LETTER
LEARN MORE
Learn more about CLF’s advocacy and concerns around Canada’s MAID regime
Read more about Alberta’s new MAID Bill (royal assent received May 14, 2026), and CLF’s advocacy in this regard
Read CLF’s report on Parliament’s pause on expanding MAID for mental illness to 2027
Read CLF Lawyers’ February 2024 Open Letter to Parliament to Halt the Expansion of MAID for Mental Illness
Read CLF’s November 2023 report and its Follow-up Brief to the AMAD Committee’s Recommendation 13 (to expand MAID MI-SUMC), urging the government to prioritize mental health supports and not euthanasia for mental illness
Read CLF’s Analysis of the AMAD Committee’s February 2023 Final Report on MAID for Mental Illness
The Vulnerable Persons Standard (of which CLF is a supporting organization) 2023 submission to the AMAD Committee
Read CLF’s Analysis of the AMAD Committee’s September 2022 Interim Report on MAID for Mental Illness, and CLF’s report on its Brief (in French and English) and Background Paper submitted to the AMAD Committee in May 2022