Medical Assistance in Dying and Mental Illness under the New Canadian Law

On June 17, 2016, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying) came into force. In the lead-up to the introduction of the legislation, the issue of whether mental illness should be an exclusion criterion for access to medical assistance in dying attracted considerable attention (i.e., excluding both patients with a mental illness and some other co-morbidity, and patients whose sole underlying condition is a mental illness). The Provincial Territorial Expert Advisory Group on Physician-Assisted Dying and the Federal Special Joint Committee of the House and Senate on Physician Assisted Dying both heard testimony on each side of this issue, but both ultimately recommended against having mental illness as an exclusion criterion. Intending to go against these recommendations in part, the government attempted to exclude all individuals whose sole underlying condition is a mental illness. However, after a review of what the legislation actually says and means, as well as the scientific literature on mental illness, we conclude that, despite the government’s intention and statements to the contrary, the legislation does not actually exclude all individuals whose sole underlying condition is a mental illness. The government should therefore stop giving the public misleading and incorrect information. By disseminating misinformation, the government ensures that individuals (by definition experiencing enduring and intolerable suffering) may be denied access to medical assistance (by health practitioners who have been misled by the misinformation) when they are entitled to such access under the legislation passed by Parliament.