7. Technical Briefing Deck
Bill C-62, An Act to amend An Act to amend the Criminal Code (medical assistance in dying), No. 2
Purpose
- To extend the exclusion of eligibility for receiving medical assistance in dying (MAID) in circumstances where the sole underlying medical condition identified in support of the request for MAID is a mental illness (MI-SUMC) for a period of 3 years, until March 17, 2027.
- To ensure the safe provision of MAID in these circumstances by allowing more time for the uptake of key resources by the medical and nursing communities and to provide provinces and territories with additional time to ensure healthcare system preparedness.
Background
- On March 17, 2021, former Bill C-7 expanded eligibility for MAID to persons whose natural death is not reasonably foreseeable. It also temporarily excluded eligibility to receive MAID in circumstances where a person’s sole underlying medical condition for MAID is a mental illness.
- In March 2023, former Bill C-39 extended the temporary exclusion for eligibility for one year, until March 17, 2024, to provide more time for materials to support the safe delivery of MAID in these circumstances to be finalized and disseminated.
- In the absence of legislative change, this exclusion will be automatically repealed on March 17, 2024, at which point MAID in these circumstances would become lawful, if the existing eligibility criteria and safeguards are met.
Federal Action
The Federal Government has made important investments to support the safe assessment for MAID in complex cases, including mental illness, and increase understanding of MAID practice:
- Supporting the development of a model MAID Practice Standard and a companion document Advice to the Profession designed for use by regulatory bodies and clinicians in addressing complex requests for MAID, including where mental illness is involved (published March 2023);
- Working closely with the Canadian Association of MAID Assessors and Providers (CAMAP) on the development of a nationally accredited bilingual MAID curriculum (launched in August 2023);
- Strengthening and enhancing existing data collection on MAID by amending the Regulations for the Monitoring of MAID (enacted January 1, 2023, with new data to be reported in 2024); and,
- Engaging with Indigenous Peoples to better understand their perspectives on MAID (including through Indigenous-led activities, and online engagement).
Current Context
- Significant progress has been made in supporting practitioners and the health system to support the assessment of complex cases, including those with mental illness as a factor.
- However, the government has heard that provinces, territories and health care delivery systems want further delay in the expansion of the law, to allow time for federal-provincial-territorial collaboration to ensure a consistent and safe approach, with appropriate safeguards, across the country.
- On January 29, 2024, the Special Joint Committee on Medical Assistance in Dying (AMAD) tabled its report examining the degree of preparedness for the safe application of MAID for persons whose sole underlying condition is a mental illness.
- While recognizing that important progress had been made, AMAD concluded that the medical system in Canada is not prepared to deliver MAID where a mental disorder is the sole underlying medical condition. It recommended:
- an additional delay until the Minister of Health and the Minister of Justice are satisfied, in consultation with provincial and territorial counterparts and Indigenous Peoples, that it can be safely and adequately provided.
- re-establishing AMAD again before the law changes in order to verify the degree of preparedness attained.
Overview of Bill C-62
- The Bill would extend the temporary MAID mental illness exclusion for three years (until March 17, 2027).
- It would do this by amending section 6 of former Bill C-7, which currently sets the coming into force date of the repeal of the mental illness exclusion to March 17, 2024.
- A three-year extension will provide necessary time for:
- provinces and territories and their partners to further prepare their health care systems and ensure supports are in place;
- professional regulatory bodies to consider updates to guidance materials, as needed; and
- practitioners to undertake training and become familiar with available supports, and gain confidence in applying the guidelines and safeguards.
- The Bill also proposes that within two years after royal assent, a Joint Committee of Parliament undertake a review relating to eligibility of persons whose sole condition is a mental illness. If it prepares a report, it must table it with each house of Parliament.
Annex: Relevant Materials
- Final Report of the Expert Panel on MAID and Mental Illness
- Model Practice Standard for Medical Assistance in Dying
- Regulations for the Monitoring of Medical Assistance in Dying
- Reports of the Special Joint Committee on Medical Assistance in Dying (AMAD):
- Government Responses to the Special Joint Committee on Medical Assistance in Dying:
- Date modified: