Lametti won’t commit to delaying expansion of medically assisted dying despite growing calls to do so

OTTAWA – Justice Minister David Lametti was pressed to delay the expansion of medical assistance in dying, amid growing reports Canadian institutions aren’t ready for the change, but declined to promise any pause.

The medically assisted death system didn’t initially include any provision for allowing people faced solely with a mental illness to commit suicide, but in a 2019 rewrite of the law, Senators expanded the scope and gave the government two years to come up with regulations before the law automatically expanded to include mental illness.

Starting in March, people with a mental illness will be able to seek medically assisted death provided they have the support of two doctors or nurse practitioners. To delay that expansion, Lametti has said would require an Act of Parliament.

Conservative MP Rob Moore suggested the government was moving too quickly on this front as there were clear indicators that doctors and hospitals were not ready.

“Are you willing to put the brakes on that expansion until, clearly, we get some guidelines in place that protect vulnerable Canadians?” He asked Lametti during testimony at a House of Commons committee Monday.

Lametti said he understood the concerns people have about the system and he has heard concerns the system is not being used appropriately. He said they have put good standards in place and it is up to doctors to follow those rules.

“It is up to the medical profession to ensure that those standards are met. It’s up to the medical profession to underline that MAID is about individual choice for people who qualify under the criteria that are there,” he said.

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He said any cases of MAID that happen outside of the rules the government has set shouldn’t be taking place at all.

“I underscore that when those criteria are not met and the regime has not been followed there’s a criminal act there, and then it’s up to police to investigate.”

Following the initial passage of the law, the government directed an expert panel to come up with guidelines for how medically assisted dying would work for people with a mental illness.

The panel called for more guidelines and training for doctors who participate in MAID. Ongoing reviews and research into its use and for work with both doctors and patients to determine whether a person faces an illness that is incurable or is in a state of reduced capability.

In recent weeks, an association representing the chairs of psychiatry at Canada’s medical schools, warned that doctors are not ready, and other physicians and hospitals have expressed concerns about the expansion.

The law specifically states that people seeking MAID should not receive external pressure to do so, but there have been reports of at least one staffer at Veterans Affairs Canada suggesting MAID to veterans looking for help.

Moore said all of these concerns are coming before the system is expanded and he is concerned.

“This is a case where not only are the province’s are not ready for this, not only are professionals not ready, according to the association of chairs of psychiatry, but the federal government itself, it doesn’t seem to know what it’s doing.”

Lametti said the government is closely monitoring how MAID is being used and this will continue after the expansion. He said they’re looking at ways to improve how the system works.

“We have put a great deal of resources into the system, but we will continue to monitor your concerns, concerns that are being raised by Canadians,” he told MPs. “We’ll work in good faith to make sure that Canadians are ready for mental disorder as a sole criterion for seeking MAID.”

Asked directly, for a yes or no answer on whether he would delay the expansion set to come in March, Lametti said he couldn’t provide one.

“In good policy, there’s very rarely a yes or no answer.”

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