Untangling MAID for mental disorders from advance requests for MAID

News & Updates | February 8, 2024 | Sarah Dobec

Home / News & Updates / Untangling MAID for mental disorders from advance requests for MAID
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Note from DWDC: If your sole underlying medical condition is a mental disorder, you are not eligible to apply for medical assistance in dying (MAID) until March 17, 2027. Learn more


Medical assistance in dying (MAID) has been in the headlines recently as the government responds to issues of the parliamentary review. We have heard from many supporters who wanted clarification about the recent recommendation to delay MAID for mental disorder (again), and whether that impacts advance requests for MAID. We thought we would shed some light on both issues to help clarify. 

In a nutshell 

MAID for those whose sole underlying condition is a mental disorder (MD-SUMC) includes conditions mainly within the domain of psychiatry, such as depression and personality disorders. It does not include neurocognitive and neurodevelopmental disorders, nor other conditions that may affect cognitive abilities such as such as dementia, Alzheimer’s, Huntington’s and Parkinson’s. 

Some people with neurocognitive and neurodevelopmental disorders, such as dementia, can qualify for MAID under the existing legislation, if they meet all the criteria. There are currently no amendments being considered for advance requests – they are not yet legal in Canada despite strong support across the country. 

MAID MD-SUMC should become a legal option on March 17, 2024, as set out in Bill C-7 in 2021. However, recently the government tabled Bill C-62 to delay MAID MD-SUMC, yet again. If this delay occurs, it will impact those who suffer intolerably from a mental disorder and who were waiting for access to MAID assessments. This delay has no implication on advance requests for MAID.  

DWDC is actively advocating for the end of the sunset clause on MAID MD-SUMC on March 17, 2024, and for legal advance requests for MAID. 

The longer response 

Bill C-7 – passed in March 2021 – removed the requirement that a person’s death be reasonably foreseeable to be eligible for MAID. Bill C-7 temporarily excluded eligibility for individuals with a mental illness as their sole underlying medical condition until March 17, 2023, to prepare; this date was then delayed through Bill C-39 until March 17, 2024.  

In contrast, there has been no legislation introduced in regard to advance requests. To make advance requests for MAID legal, there would have to be a bill and action to amend the Criminal Code. 

The Special Joint Committee on MAID (AMAD) whose work began in May 2021 was tasked with reviewing five issues including mature minors, the state of palliative care, the protection of people with disabilities, MAID for those whose sole underlying condition is a mental disorder, and advance requests for MAID. 

An Expert Panel on MAID and Mental Illness was struck in August 2021 to initiate an independent expert review “respecting recommended protocols, guidance and safeguards to apply to requests for medical assistance in dying by persons who have a mental illness.” 

The Expert Panel delivered their final report and guidance in May 2022. The AMAD committee delivered their final report and recommendations in February 2023. Regarding MAID MD-SUMC and advance requests for MAID, the AMAD report recommended: 

Recommendation 21: That the Government of Canada amend the Criminal Code to allow for advance requests following a diagnosis of a serious and incurable medical condition disease, or disorder leading to incapacity.   

No action has been started by the Government of Canada regarding advance requests for MAID, despite strong support across the country. 

Recommendation 13: That, five months prior to the coming into force of eligibility for MAID where a mental disorder is the sole underlying medical condition, a Special Joint Committee on Medical Assistance in Dying be re-established by the House of Commons and the Senate in order to verify the degree of preparedness attained for a safe and adequate application of MAID (in MD-SUMC situations). Following this assessment, the Special Joint Committee will make its final recommendation to the House of Commons and the Senate. 

Despite strong testimony to the re-established AMAD committee that the country is prepared for safe and adequate application of MAID MD-SUMC, they recommended yet another delay. The government then tabled Bill C-62 to delay MAID MD-SUMC for three more years, until March 2027. This delay has no implication on advance requests for MAID, but it certainly does for those who suffer intolerably from a mental disorder who were waiting for access to MAID assessments. 

For more facts on MAID visit our Get the Facts on MAID page, and our Myths and Facts page on our website. 

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