Ottawa’s MAID plan undermines suicide prevention

Canada faces a fundamental contradiction between preventing suicide and expanding MAID to people suffering solely from mental illness

Canada’s 9-8-8 suicide prevention helpline has received more than 1 million calls and text messages since its launch in late 2023. That averages out to more than 300,000 per year.

Yet under current law, Canada is set to expand euthanasia, or medical assistance in dying (MAID), to people with mental illness as their sole underlying condition beginning March 17, 2027. If that expansion happens, some will be deemed worthy of suicide assistance while others will receive suicide prevention.

That contradiction goes to the heart of Canada’s suicide prevention efforts. Canada must continue to direct people to the help they need rather than offering MAID to people suffering from mental illness.

Thankfully, a federal committee convened this spring to study MAID and mental illness, releasing its final report in June. Ultimately, the committee made a single recommendation: that Canada exclude people with mental illness as their only condition from MAID.

In 2023, a previous iteration of the committee believed MAID for mental illness should move ahead, but that Parliament needed to delay it for one year. In 2024, the committee recommended waiting until the ministers of health and justice were satisfied that it could be safely implemented.

In remarks to the current committee, Dr. Allison Crawford, the chief medical officer of 9-8-8, Canada’s Suicide Crisis Helpline, said that there is an overlap between people experiencing suicidality and those considering MAID. In fact, up to seven per cent of interactions with the helpline mention MAID.

Among those who reference MAID, 74 per cent had thought about suicide in the past two days, compared with 48 per cent of those who do not reference MAID. Dr. Crawford highlighted that suicidality cannot be distinguished from requests for MAID, as those who reference MAID in conversation with the helpline have a much higher degree of suicidality.

Crawford also noted fears of suicide contagion due to public messaging that promotes death via MAID as a solution for mental suffering, undermining suicide prevention efforts.

This time, the committee has gone further, recommending an indefinite exclusion of MAID for mental illness. Despite repeated study, the problems with MAID for mental illness have not gone away since Parliament first took up the issue in 2021.

In addition to concerns about undermining suicide prevention, there are no consensus or established criteria for determining whether mental illness can ever be considered irremediable. If it cannot be determined that a person will not recover, offering MAID rather than continuing treatment risks ending the life of someone who could get better.

As a result, most psychiatrists continue to oppose MAID for mental illness and instead seek to treat hopelessness and prevent suicide.

Alternatively, some MAID advocates argue that the availability of euthanasia helps prevent suicides. Psychiatrist John Maher addressed that argument in his testimony before the committee: “The argument that somehow a messy death justifies supporting [medically assisted] suicide misses the point completely. What it justifies is treatment to prevent getting to a messy death or MAID in the first place.”

In a supplementary report, member of Parliament and physician Marcus Powlowski noted that prohibiting MAID for mental illness protects individuals who are despondent and want to die because many of them will get better. It also protects the person’s family and loved ones, who would be deeply impacted by their loss.

Powlowski also points to the need for care, writing that “one’s degree of unhappiness in life is also largely, sometimes overwhelmingly, determined by one’s social circumstances- whether you have people who care about you, whether you are loved, whether you have adequate housing, food, or a fulfilling job.”

Those circumstances can change. But allowing MAID for mental illness disincentivizes such care, instead encouraging hopelessness.

Parliament must act quickly to stop the expansion of MAID to people with mental illness before March 17, 2027, and continue to promote suicide prevention and care.

Daniel Zekveld is a policy analyst with the Association for Reformed Political Action (ARPA) Canada