Opposition parties willing to help Liberals delay MAID expansion

Posted on December 13, 2022 in Health Policy Context

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TheStar.com – politics/political-opinion
Dec. 11, 2022.   By Althia Raj, National Columnist

The Trudeau government could find quite a few partners — possibly even unanimous support for access to assisted dying for mentally illness.

If the federal Liberals want to respond to growing concerns and delay the introduction of Medical Assistance in Dying (MAID) for those solely suffering from mental illness, opposition parties tell the Star they’re willing to work with the government.

“New Democrats take those concerns very seriously,” said NDP MP Alistair MacGregor, who sits on a special parliamentary committee studying Canada’s MAID regime. “New Democrats would closely look at and consider any legislation brought forward to delay the use of MAID for people who suffer solely from mental illness.”

Just last month, Justice Minister David Lametti told the Star’s “It’s Political” podcast that any delay to the scheduled mid-March expansion would require legislation and he suggested that would be difficult. “I appreciate that others would want us to slow it down, but it would require an Act of Parliament, in my view, to overturn that sunset clause that’s already there. And that in and of itself is a challenge in the current Parliament,” he said.

But a few quick emails to opposition parties suggest that, actually, the Liberals would find quite a few partners — possibly even unanimous support — to postpone the date of entry of MAID to those solely suffering from mental illness.

In considering a pause, MacGregor told the Star, the NDP would want to ensure that the Liberals take time to put in place “better treatment, supports, and poverty reduction efforts.” A response to concerns that some Canadians are seeking MAID because they can’t access proper medical treatments to alleviate their suffering, or access social programs or live adequately on their disability benefits.

The Conservatives have long called for a delay and MP Michael Cooper confirmed there is consensus in the party to support an extension.

“Literal life-or-death legislation deserves thorough review and consultation to ensure the most vulnerable people are protected,” Cooper and his colleagues MPs Stephen Ellis and Dominique Vien said earlier this month in a statement. They noted the Liberals failed to properly fund a Canada Mental Health Transfer and accused the government of leaving Canadians struggling with mental illness behind.

Bloc Québécois’ spokesman Julien Coulombe-Bonnafous suggested his party might support a pause, but said it wanted to see a proposal from the government first. The Bloc helped the Liberals push through a Senate amendment in the spring of 2021 that expanded the MAID regime to people solely suffering from mental illness. It gave the government two years to prepare for it. Since then, however, a Quebec National Assembly committee issued a report recommending aid in dying not be extended to persons whose only medical condition is a mental disorder — and the Bloc usually echoes the will of the province’s legislature.

Even the Greens are onside. “If the process needs more time,” party leader Elizabeth May said, “we would support the time needed.”

The federal government knew this expansion of MAID would be controversial. When it asked an expert panel to offer recommendations it noted concerns over whether a person’s condition could accurately be assessed as “incurable” or “irremediable,” challenges in assessing a patient’s capacity to request MAID, and challenges in disentangling a common symptom of a desire to die from a genuine MAID request to end enduring unbearable suffering.

Ottawa expected it would have one full year after the expert panel on MAID and mental illness issued its recommendations to draft new rules. But the expert panel was two months late, and the joint Senate and House of Commons’ committee studying the issue is also behind schedule. It doesn’t plan to report back until February — just a few weeks before the new rules kick in. In the meantime, there is no formal guidance for practitioners who will be asked to decide who is allowed to die through MAID and who is not.

It’s a difficult assessment to make since experts say there is no way to tell whether a patient might get better over time or through new treatments — and yet it’s an assessment that carries serious legal implications for practitioners.

The Association of Chairs of Psychiatry in Canada, which represents psychiatry department heads at Canada’s 17 medical schools, issued a statement this month calling for a pause. “Further time is required to increase awareness of this change and establish guidelines and standards to which clinicians, patients and the public can turn to for more education and information,” said Dr. Valerie Taylor, of the University of Calgary.

That intervention wasn’t welcome by MAID advocates. Many, like Dr. Derryck Smith, a psychiatrist and University of British Columbia emeritus professor, felt the association was acting like a Monday morning quarterback, requesting a delay after failing to participate in the process. He questioned whether what was driving the concern was rather an opposition to MAID, as approximately 50 per cent of psychiatrists don’t support the expansion to those whose sole underlying condition is mental illness.

But even Smith acknowledges everyone is waiting for the parliamentary committee to report back and then for the government to issue directives. “We need guidance on what the nuances in the law are going to be as of March of 2023,” he said. “How government is going to implement them is not clear to me.”

It’s not clear to anyone. It’s why the Liberals should get on the phone with the opposition parties and delay implementation a bit longer. Too much is at stake.

https://www.thestar.com/politics/political-opinion/2022/12/11/trudeau-government-is-moving-too-fast-to-expand-access-to-assisted-dying.html?source=newsletter&utm_content=a05&utm_source=ts_nl&utm_medium=email&utm_email=0C810E7AE4E7C3CEB3816076F6F9881B&utm_campaign=top_158487

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