The Report We’ve All Been Waiting For | Top 10 highlights

I dare say we have been waiting for this report with bated breath. 

On Wednesday June 17th, the Special Joint Committee on Medical Assistance in Dying released its 98-page report with one chief recommendation: 

That the Government of Canada amend the Criminal Code to indefinitely exclude persons whose sole underlying medical condition is a mental illness from eligibility for medical assistance in dying. 

So many physicians, psychiatrists, professors, policy analysts, disability advocates, Indigenous advocates, family advocates, and international experts contributed testimony and briefs to inform the committee. 

Eventually, the evidence could not be ignored. As the report puts it:

The Committee heard claims that practice standards, guidance documents, and assessor training demonstrate readiness, but the strongest evidence pointed the other way.

Here are some other sections that we at CPL are especially grateful to see in the report:

1. There is no “right to MAID” in Canada.

“As a Department of Justice official explained, ‘The Criminal Code doesn’t provide a right for MAID. It simply decriminalizes certain offences if certain rules are followed.’” (p. 8) 

2. It is impossible to predict irremediability with mental illness.

“Nevertheless, other witnesses testified that it would not be possible – either at this moment or at any future time – to reliably determine irremediability in mental illness.” (p. 13)

3. MAID threatens the doctor-patient relationship. 

“Furthermore, according to Dr. Harvey Max Chochinov, the availability of MAID may undermine the therapeutic relationship. The strength of that relationship is, in his opinion, the most helpful factor for predicting successful outcomes.” (p. 14) 

4. MAID requests cannot be differentiated from suicidality. 

“However, others testified that the delineation between MAID requests and suicidality was not framed by clear guidance, was inherently difficult or was altogether impossible. (p. 15-16) 

5. The distinction between mental and physical conditions is not so clear cut.

“Gabrielle Peters, representing Disability Filibuster, stated that ‘[t]he division between physical and mental illness is asserted and maintained by the medical model and the Canadian state.’ She added that ‘[c]o-occurrence of chronic illness and mental illness is common.’” (p. 17)

6. Existing health care options are inadequate and need to be improved. 

“Witnesses such as Dr. Coelho and Dr. Allison Crawford further pointed out that long wait times and inequitable access to care ‘can produce or exacerbate the suffering that may drive MAID requests and suicidal thoughts and behaviours.’” (p. 22) 

7. MAID undermines suicide prevention efforts. 

“Some witnesses warned that expanding MAID may lead to the ‘so-called suicide contagion effect’, ‘Werther effect,’ and undermine suicide prevention efforts.” (p. 23) 

8. MAID is culturally biased toward individualism. 

“Professor McCormick described the numerous factors contributing to make ‘indigenous people … one of the most vulnerable sectors of Canadian society,’ such as a history of colonization and ongoing oppression, minimal access to opportunities and services, and disproportionately high rates of unresolved trauma, illness and suicide. He also viewed MAID as being ‘culturally biased … , in that it emphasizes the individual’s right to autonomy and choice without taking others into consideration.’” (p. 32) 

9. Psychiatric euthanasia disproportionately affects vulnerable demographics. 

“According to Dr. van Os, most of those who request psychiatric euthanasia are traumatized, marginalized and living in poverty, and women are more likely than men to request psychiatric euthanasia. Professor Sheehy also highlighted research finding that between 69% and 77% of those receiving psychiatric euthanasia in countries where it is allowed are women.” (p. 38) 

10. Our terminology is still unclear in these matters of life and death. 

“The committee also notes that the continuing ambiguity surrounding questions of terminology – ‘mental illness’ or ‘mental disorder’ – would benefit from greater clarity and consensus.” (p. 40) 

That’s our quick roundup of the key highlights from the main portion of the report. You are also welcome to peruse and share the committee’s report if you like.

Stay tuned for more news and commentary in the coming days that is sure to feature this development.

And, while we take a moment to celebrate this win, let’s stay mindful that Canada’s existing euthanasia regime (even without this planned expansion) is already among the most permissive in the world. We have so much work to do to protect and defend all lives.

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