View From the Legislature

At its inception, those who were advocating that Canada should allow for doctor assisted suicide assured policy makers and concerned Canadians that its application would be rarely used and narrowly applied. The federal Liberal government was clear that Medical Assistance in Dying (MAID as it has become commonly known in Canada), would only be legally allowed in cases where death was imminent and in situations of a patient suffering significant physical pain. While many were concerned that this would be the beginning of a slippery slope, few could have imagined how steep the slope would be and the speed at which it would be travelled.

In only a few short years, Canada has become not only one of the most permissive countries in the world when it comes to MAID, but was scheduled to begin allowing in March for medically assisted suicide for those suffering solely from a mental illness. It was only earlier this week that the federal Liberal Health Minister decided to put a “pause” on the expansion of MAID to patients whose sole condition is a mental illness. And one gets the sense that the Liberal government moved very reluctantly to that position.

Part of the reason that a pause was implemented is the medical community itself was becoming increasingly vocal in its concerns. Some of the most prominent voices came from Manitoba as Dr. Jitender Sareen, a professor and head of the department of psychiatry at the University of Manitoba, led a group of national psychiatry chairs advocating to stop the expansion.

Dr. Sareen made the case that the practice standards to guide psychiatrists and clinicians are inadequate and that it was not acceptable to offer death to a person who has not had the opportunity to get better with proper treatment. Other psychiatrists testified before a Parliamentary Committee pointing out that it would be almost impossible for medical professionals to decide whether a person suffering from a mental illness is beyond treatment.

The voices of medical professionals in delaying the expansion of MAID has been incredibly important. In 2017 when Manitoba was leading the country in bringing forward legislation to protect medical professionals from being required to perform MAID, it was the voices of the medical profession that had the strongest impact. As Health Minister at the time, I know this legislation would not have passed unanimously in the Manitoba Legislature without the support of health professionals.

But a larger question will need to be answered and debated regarding this latest desire by the Liberal government to expand MAID. It was clear from the Liberal Health Minister’s comments that the pause is an issue of timing and not one of belief. Given the strong resistance demonstrated across Canada to the expansion of MAID and the fact that the current federal Liberal government is facing a looming election with very low support, it is logical to wonder if this delay isn’t simply about politics.

But medical professionals, led by those in Manitoba, have raised some very important and serious questions that will not go away after an election, regardless of the outcome. Questions regarding both patient vulnerability and medical professionals’ ability to assess treatment outcomes cannot be taken lightly. Also there are broader questions around Canada’s experience with MAID that need to be examined thoughtfully, not through an election lens, but through one that properly weighs the consequences of policy decisions and the concerns of Canadians.

Stopping the expansion of MAID is the right decision. But Canadians are right to feel wary about the Liberal government’s intentions on this important issue.