Canada Plans to Indefinitely Exclude Mental Illness from Medical Assistance in Dying
The Canadian Liberal government intends to introduce legislation this fall to permanently bar individuals whose sole condition is mental illness from accessing medical assistance in dying, citing diagnostic uncertainty and gaps in mental health support.
The Canadian Liberal government plans to table legislation in the fall to indefinitely exclude people whose sole suffering stems from mental illness from accessing medical assistance in dying (MAiD). Justice Minister Sean Fraser stated that there is a lack of consensus on determining when mental illness is irremediable and expressed concern about inadequate access to mental health support. Fraser insisted the government's position is based on what it sincerely believes is right, rather than political calculations.
Determining whether suffering caused by mental illness is permanent presents greater difficulty than assessing whether a terminal physical illness is irreversible. Psychiatrists, disability advocates, and people with lived experience argue that excluding mental illness from MAiD can deny autonomy to those enduring severe, treatment-resistant psychiatric suffering. Critics have also raised concerns that the exclusion could allow the government to avoid addressing the broader lack of mental health support, fueling debate over whether mental illness should be treated similarly to terminal physical illnesses such as cancer or ALS.
Canada's proposed approach contrasts with laws in the Netherlands and Belgium. Dutch law allows for assisted suicide in cases of unbearable suffering with no prospect of improvement, explicitly including psychiatric disorders subject to stringent assessment requirements. Belgian law similarly does not exclude psychiatric illness from euthanasia considerations for serious, incurable conditions causing persistent, unbearable suffering, including psychological suffering. In both countries, doctors must conclude that the suffering is unbearable, the condition is incurable, reasonable treatment alternatives are unavailable, and the wish to die is persistent and voluntary before proceeding. Despite these provisions, such cases remain rare; in Belgium, psychiatric conditions accounted for 1.6% of medically assisted suicide cases in 2025.
Public responses gathered by The Coast regarding MAiD for mental illness were mixed. Supporters cited bodily autonomy and dignity, while opponents pointed to uncertainty about the permanence of mental illness, the potential for government abuse, and ethical concerns.