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The original deadline for the expansion of euthanasia to those with mental illness was March 17, 2023. However, at the beginning of February, in response to pressure from the public, the media, and medical professionals, the government introduced Bill C-39 to extend that deadline by one year, to March 17, 2024. Thankfully, that bill received royal assent on March 9, just eight days before the planned expansion.

The day before Bill C-39 was passed, Senators had the opportunity to question the Minister of Justice and the Minister of Health on the issue of euthanasia for mental illness. The Minister of Justice, David Lametti, made it clear that the government is still committed to making the expansion happen. The only reason cited for the delay is so that the government can ensure the regulations are clearly defined and understood.

Two Sides to the Debate

On one hand, Senators questioned the Ministers about the lack of consensus among medical professionals, legal scholars, and the general public about the expansion of euthanasia for those with mental illness. These Senators asked why the government does not abandon the expansion altogether due to the lack of professional consensus and the concerns that vulnerable Canadians will be killed instead of receiving the care they need. Other questions centred on data, safeguards, and funding for mental illness.

On the other hand, some Senators asked questions with regard to the slowness of implementing euthanasia for those with mental illness, suggesting that the government is unnecessarily making suffering Canadians wait to access euthanasia.

Notable Points

Much of the conversation about euthanasia for mental illness revolves around the question of irremediability; that is, whether a patient with mental illness can recover. This is where a major lack of consensus among medical professionals exists. Many psychiatrists say that mental illness is never irremediable and that a patient always has a chance of recovery.

Instead of focusing on this issue of irremediability, some Senators have chosen to focus on autonomy; that is, the right for patients to choose euthanasia if they are suffering in a way that they feel is intolerable.

In response to questions about irremediability, the Ministers of Justice and Health claim that a patient is not eligible for euthanasia if there is any doubt about whether they can recover. However, they do not propose making the law more strict, but simply trust that doctors will act appropriately. A major concern that the government does not address is that Canadians who wish to access euthanasia can simply go to a doctor who is open to defining their illness as irremediable and will end their life. It is often at this point that the conversation seems to shift increasingly away from medical arguments and towards arguments about autonomy.

The government also continues to stress that they believe there will only be a small number of Canadians accessing euthanasia for mental illness. But some Senators note that bad policies are not made acceptable if they only affect a small number of people, particularly when they end those people’s lives.

A second medical question in this debate is whether euthanasia will be provided to Canadians who are suicidal. The Minister of Justice argues that, even in the context of mental illness, euthanasia will not be provided to someone who is suicidal. Any arguments to the contrary he labels as misinformation. However, as one psychiatry professor states, “On the face of it, even if you look at what the word means, when somebody wants to die and they’re not dying, of course that means that they’re suicidal.” Concerns about euthanasia for those who may be suicidal are valid, and the Minister of Justice fails to show how the issues can be distinguished.

Another interesting point raised in the discussion was with regard to how provinces would respond to the expansion of euthanasia to those with mental illness. In particular, Quebec has already chosen not to allow euthanasia for mental illness. Alberta Premier Danielle Smith recently also objected to the government’s continued expansion of euthanasia, although she has not said whether her government will act on this objection.

While the federal government wants to have all the provinces on board with their expansion, the Ministers admit that they are working with criminal law and the provinces do not have to implement everything they are permitted to implement. So, if the federal government is unwilling to stop the expansion of euthanasia, provinces may have the opportunity to create stricter guidelines in their jurisdictions.

Where to from here?

It is fitting to close with the words of Senator Donald Plett, as he concluded his speech on Bill C-39:

“To those listening who are struggling with mental illness or who love someone with mental illness and to those who treat and support them, please know this fight is not over. The work has only begun … Bill C-314 has been tabled and will put an end to this reckless expansion. I look forward to continuing the fight in this chamber and I would encourage my colleagues to give the bill due consideration when it comes our way.”

Bill C-314, recently introduced in the House of Commons, seeks to entirely remove the expansion of euthanasia for those with mental illness. We are thankful that Bill C-39 has passed, giving an additional year to push for the complete removal of the expansion to those with mental illness. While it is troubling to hear comments from the Minister of Justice, the Minister of Health, and various Senators who wish to see euthanasia expanded, it is also very encouraging to hear the comments of MPs and Senators who speak boldly about this issue on behalf of vulnerable Canadians. We hope and pray that MPs, Senators, and the Canadian public will continue to engage boldly on this issue over the upcoming year. And we hope that Reformed Christians will be leading that charge.