Canada prepares to expand assisted death amid debate

Canada is preparing to expand its medically assisted death framework to become one of the broadest in the world, a change some want to delay due to concerns vulnerable people have easier access to death than to a life without suffering.

Starting in March, people whose sole underlying condition is mental illness will be able to access assisted death. Mental illness was excluded when the most recent medical assistance in dying (MAiD) law was passed in 2021.

That will make Canada one of six countries in the world where a person suffering from mental illness alone who is not near their natural death can get a doctor to help them die.

People will still need to apply and be deemed eligible by two clinicians who must determine whether they have an irremediable condition causing them intolerable suffering and whether they have capacity – whether they understand and appreciate their condition, the decision and its consequences.

“Tired-of-life cases in Canada are happening,” said Madeline Li, a cancer psychiatrist specializing in palliative care who put together an assisted death framework for her Toronto hospital network.

“I’ve become very comfortable with MAiD for people who are dying. I am less comfortable for expanding indications. … We’ve made MAiD so open you can request it for basically any reason.”

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