What Canadians should know about MAID

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A traditional looking maid in black uniform stands beside a hospital bed and patient holding a serving tray of syringes and drugs.
Changes to MAID eligibility could promote political pressure for its use when alternatives exist. Clker-Free-Vector-Images via Pixabay and Mohamed_hassan via Pixabay, manipulated by lee lim

Controversial criteria updates approach 

Laws regarding Medical Assistance in Dying (MAID) have been subject to much discussion and contemplation since made legal in 2016. Laws governing MAID in Canada have undergone multiple revisions and amendments over time and are up for a revision again in March 2024. The Legislature is looking into extending the eligibility criteria to people whose sole medical condition is mental illness.   

A federal legislation that allows eligible Canadian adults to request medical assistance in dying was passed by The Parliament of Canada in June 2016. Then Bill C-7, an act to amend the Criminal Code in relation to MAID, was introduced in the Parliament on October 5, 2020. It called for changes in the eligibility criteria for MAID. The Bill was passed on March 17, 2021, and took effect immediately.   

The Government of Canada announced on December 15, 2022, through the Ministers of Justice, Health, and Mental Health and Addictions that legislation will be introduced to seek an extension of the temporary exclusion of eligibility for individuals with mental illness alone. Bill C-39 was tabled by the government on February 2, 2023, which would prolong the temporary exclusion of eligibility of MAID in cases when a person’s only underlying medical condition is a mental disorder until March 17, 2024.  

Bill C-39 was approved by Royal Assent on March 9, 2023, and went into force right away. Government officials believe that this delay will provide them with more time to develop practice standards and training and allow for better data collection and sharing.   

Many Canadian organizations working to support those with mental health conditions have expressed their concerns regarding the provision. One of the prime organizations in Canada that works with people with mental health condition and addictions, The Centre for Addiction and Mental Health (CAMH), released an official statement publicly expressing their concerns regarding the provision.  

On their website, CAMH mentions that their key concern is the lack of agreement amongst experts on whether mental illness can be considered “irremediable” for the purposes of MAID, and what criteria should be used to determine whether a person is suffering from an irremediable mental illness. “CAMH believes that governments at all levels must first and foremost improve access to quality mental health care as well as the social supports needed by the most vulnerable to recover their mental health.” They also mention that there is disagreement amongst experts on whether a request for MAID can be distinguished from suicidal intent.  

Additional concerns also centre on access to mental health care and the social determinants of health. Harm reduction advocates worry that people suffering from drug addictions could be administered MAID instead of other public health initiatives that have been shown to enhance results but continue to receive insufficient funding from the government.  

An article by National Post highlighted that advocates for addicts and the houseless cannot be blamed for being concerned about where things are headed, especially considering the widespread lack of government support for “safer supply” programmes, supervised injection sites, and other harm-reduction initiatives. Despite evidence to the contrary, initiatives are sometimes blamed for exacerbating the opioid crisis.  

As per their website, the Federal Government is working with provinces, territories, and health care professionals to ensure that eligible Canadians are able to request MAID according to the law, and that the appropriate protections are in place. However, nothing much has changed since the provision for extension of exclusion was passed. As the deadline for making a decision approaches, the Canadian public should be watching to see what conclusion are drawn by the federal government and its officials.  

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