Expert says government decision to delay assisted-dying expansion not necessary

OTTAWA -

The chair of a federal expert panel on medically assisted death is questioning what the Liberal government is hoping to accomplish by delaying the expansion of the assisted-dying regime.

"I don't think it's necessary," Dr. Mona Gupta said in an interview.

She said the federal government has already followed through with its commitment to study the expansion, which will allow people whose sole underlying condition is a mental disorder to seek a medically assisted death.

The expert panel determined the proper safeguards are in place for the change to happen on March 17, but the government has faced pressure from critics who disagreed with the expansion.

Canada's original medical assistance in dying law, which Parliament passed in 2016, legalized medical assistance in dying, also known as MAID, for people who were suffering intolerably and whose death was reasonably foreseeable.

A series of court challenges and a parliamentary review resulted in new legislation in 2021 that recognizes a Quebec Superior Court ruling, which said limiting MAID eligibility to those whose death is reasonably foreseeable was unconstitutional.

The 2021 update included a "sunset clause" to allow the government time to conduct an independent study before expansion of the program to include people whose sole underlying condition is a mental disorder.

The strict eligibility criteria include a minimum 90-day evaluation period by at least two independent assessors. People must be informed about alternative means to alleviate their suffering, and offered a chance to withdraw their request at any time.

Justice Minister David Lametti announced late Thursday that the government will seek the delay, saying it is listening to concerns the health-care system might not be prepared to handle complex cases involving mental disorders.

Gupta, who is a psychiatrist and associate professor at l'Universite de Montreal, said she does not know what will be accomplished by the delay.

"I do know that there are people who are opposed to this practice," she said.

"I do not believe that anything that could possibly happen in three months, or a year or two years, or whatever the time period is going to be, is going to change their point of view."

It's not clear how long the delay will be, but Lametti said the government is not backing away from the plan to expand the program.

"We do have to respect decisions of the courts," he said Thursday. "They have said that medical assistance in dying is a right that Canadians have, and so the process will continue to move forward but we're going to do it in a measured and prudent way."

The Liberals plan to introduce new legislation in the House of Commons once Parliament resumes in late January and seek the support of other parties to pass it quickly.

Gupta said it is up to the people who are raising concerns to work with the federal government to "very clearly" indicate what more they would like to see done.

"They bear some responsibility to say what it will take in order for people with mental disorders to be allowed to exercise their Charter rights," she said.

"Even the premise that this is required, I think needs to be questioned. Why do we need to have all sorts of new things in place that we don't have for everybody else in Canadian society who makes a MAID request?"

She said critics have failed to properly explain what they require in order to be satisfied with the expansion moving forward.

"We need to ask ourselves the question about whether this readiness argument, which is being brought forward at the 11th hour, is not merely a way to camouflage the real argument, which is certain people are opposed to this practice," she says.

"But they don't want to say it, because that's already been litigated, and the government's have already accepted that."

Dr. Jocelyn Downie, a law professor and medical ethics expert, said she was disappointed but not surprised by the decision because there has been a "massive campaign to put pressure on the government to do precisely this."

"It's been, I would say, very effective, not just in terms of the effectiveness of getting this result, but it's been effective at creating a sense of public concern and expert concern about this."

Downie added she does not think a delay is the right decision from a legal and clinical perspective.