Canada Delays Medically Assisted Death for People With Mental Illness

Canada has indefinitely put on hold plans to extend its medically assisted dying program to people whose only medical condition is a mental illness.

The legislation, known as MAiD, was introduced in 2016 for people with terminal illnesses. In 2021, eligibility was broadened to include patients with incurable conditions who were not necessarily nearing the end of their lives.

The next expansion had been scheduled for March 2027 and would have allowed access to MAiD for people living with a mental illness as their sole underlying condition.

However, Justice Minister Sean Fraser announced on Wednesday that the planned expansion would be suspended indefinitely.

“While there is not a perfect consensus on this issue, we believe this is the correct approach,” Fraser said.

Those who support expanding MAiD to patients with mental illness alone argue that denying them access to assisted dying breaches their constitutional rights and limits their access to healthcare.

Opponents, however, say medical understanding of mental illness remains insufficient for professionals to reliably determine who should qualify for assisted death.

The decision to suspend the MAiD expansion came shortly after an Ontario family alleged that their 83-year-old grandmother, Brigitte Stegemann, had been euthanized without valid consent because she was not mentally capable of making the decision.

According to Stegemann’s granddaughter, Brigitte Kranendonk, the 83-year-old answered every question incorrectly during a cognitive assessment intended to establish whether she could consent to MAiD. She reportedly believed that two of her living siblings had died.

Two days before Stegemann’s assisted-dying procedure, Kranendonk said she spoke with her grandmother to ensure that she understood what was about to happen.

“I used very frank terms. I said: ‘Do you know that you’re going to die on Friday?’”

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The 83-year-old appeared stunned and cried for about 45 minutes. “I’ve made a mistake,” Stegemann, whom her family affectionately called “GG” or “Oma”, repeatedly said, according to her granddaughter.

“She was bawling. Inconsolable,” Kranendonk told the Daily Mail.

Kranendonk said that, 48 hours after Stegemann had reacted so distressfully to the prospect of MAiD, her grandmother died with her hands clasped in prayer. She also alleged that Stegemann was covered in her own blood after an initial attempt to insert an intravenous line went wrong and was carried out by a nurse who was not wearing gloves.

“She was a vulnerable human being, and they saw an opportunity,” Kranendonk said.

She believes the MAiD practitioners may have been improperly influenced by ideology and has called for the circumstances surrounding the procedure to be investigated.

It is understood that the practitioners and care home, who have not commented publicly, maintain that Stegemann had legally consented to proceed.

The suspended expansion of MAiD to people who are solely mentall ill would not have made Stegemann ineligible for the procedure, as she had been diagnosed with stage 4 stomach cancer, which qualifies as a terminal illness. 

However, critics of the expansion believe that the suspension could save lives, as some individuals who may be better served by improved access to housing and healthcare would not not be able to apply to MAiD to alleviate their suffering. 

Fraser also emphasized his ‘concern’ about ‘a lack of consensus in the medical community about the irremediable nature of certain mental illnesses.’ 

Canadian legislators said they will introduce a new law that codifies indefinitely suspending MAiD’s expansion.

But the law would also allow patients who have progressive incurable diseases to consent to assisted death before their health deteriorates so much that they are no longer able to. Advanced consent to MAiD is currently illegal. 

This is a breaking news story. More to follow.