Ottawa to Propose Permanent MAID Exclusion for Mental Illness Alone
Justice Minister Sean Fraser says Ottawa will table legislation this fall to bar medical assistance in dying indefinitely where mental illness is the sole underlying condition. The Globe and Mail Sole underlying condition means mental illness is the only medical basis for the request.
Fraser pointed to continuing concerns about inadequate access to mental-health services for MAID cases tied to mental illness. Under current law, eligibility on that basis is scheduled to take effect on March 17, 2027. Parliament must pass a new law before that date if it wants to stop the expansion.
The planned bill does more than extend the ban. It will also set rules for advance requests. That means a person could consent to MAID while still able to make decisions, with the help provided later after an illness removes the ability to consent.
The practical point here is that the bill runs on two separate tracks. One track closes eligibility tied to mental illness alone. The other track creates a path tied to earlier consent and later loss of capacity. The wording will have to keep those two tracks apart.
MAID first became legal in Canada in June 2016 for people whose deaths were deemed reasonably foreseeable. Under that 2016 law, a request was not allowed when a mental disorder was the sole underlying condition.
Bill C-7 later excluded people whose sole underlying condition was mental illness, for a 24-month period. Under Bill C-7, the ministers of Health and Justice had to table the Expert Panel on MAID and Mental Illness report in each House of Parliament within 15 days of receiving it.
On March 9, 2023, Parliament extended that temporary exclusion until March 17, 2024. Former Bill C-39 then amended the MAID law to continue the exclusion where mental illness was the sole condition. The government tabled further legislation to delay expansion by three years. Health Canada
On Feb. 1, 2024, the government introduced a bill to extend the exclusion again. Bill C-62 would extend the ban where mental illness is the sole underlying condition for three more years by amending section 6. Department of Justice Earlier this year, a majority of members of a joint House of Commons and Senate committee recommended an indefinite exclusion for mental illness alone. Dying With Dignity Canada has spent more than two years in court challenging the ban for mental illness alone, and the case is still before the courts.
The broader context here is a shift from short delays to a lasting rule. Temporary bans work like a timer. Parliament must return every few years to renew them. An indefinite bar would remove that timer and leave it to a future Parliament to reopen the question.
Looking at legislative strategy, the government appears to favour settling two difficult files in one bill. Advance requests answer cases of gradual decline and loss of capacity. The mental-illness exclusion answers concerns about readiness in psychiatry and mental-health care. Together, they let Ottawa set out a full position on consent, capacity and vulnerability before March 2027.
In my view, there are three pressure points to watch as the bill is drafted. First, language. Sole underlying condition has been the working phrase through each change, and any new wording would change the scope. Second, process. The Expert Panel record and the joint committee record have shaped federal decisions so far, and the government will have to answer to those records. Third, courts. The existing court challenge will test indefinite wording against Charter arguments that have shaped MAID law since 2016. The result will turn on justification, safeguards and evidence about access to care, not on Parliament's intent alone.
