suppliedIs it easier to access mental health support or Medical Assistance in Dying (MAID)? Soon the latter may rival the former. MAID is a practice in which a physician assists a patient in ending their life. As of 2024, Canada is one of the few countries that has legalized access to MAID. In 2015, the Supreme Court of Canada deemed outlawing MAID a deprivation of dignity and autonomy. The 2016 law permitted MAID for those 18 and older meeting specific conditions. By 2022, the government reported 44,958 deaths by MAID.
But the continuous struggle for people experiencing homelessness, mental health issues, and use substances is only becoming more prevalent. The lack of access to support for these issues is also a failure to ensure dignity and autonomy. But instead of meaningfully improving these things, the Government of Canada is looking to expand access to MAID.
Early this year, the government delayed its plans to expand MAID to patients struggling with mental health and substance use. Originally, the government was going to make the change in March 2024, but postponed it. Mark Holland, the federal health minister, stated that the country was not ready for this change. Talks have also arisen over allowing “mature minors” to access euthanasia given that they meet the necessary criteria. This would leave the procedure open for those under 18. It’s clear the government still intends to expand access to MAID, despite opposition from mental health practitioners, disability groups, faith communities, and several provincial ministers of health.
Quality of life is both a factor in seeking MAID and something the federal government has undeniable influence over. This can include things such as access to housing, mental health support, and employment. Before expanding access to MAID, the federal government needs to seriously examine its failures in supporting those citizens in the most dire need of support.
A 2023 poll found that 11 per cent of Canadians strongly agreed with expanding MAID to those afflicted by either poverty or homelessness. Another 16 per cent moderately agreed with this. We shouldn’t be so comfortable with letting people die because institutions don’t provide them with adequate care. We should be pressuring institutions to provide better care to those marginalized by society.
Since the legalization of MAID in 2016, there’s evidence that people who were unable to find affordable housing turned to MAID partly because of this. This simply isn’t acceptable. The government’s focus should be on expanding support for poverty, and homelessness. Additionally, it needs to put real effort into creating better access for substance use and mental health supports.
Improved care and support has been shown to be a driving factor in individuals decision to withdraw their MAID request. Canada’s 2022 MAID report shows that from 298 individuals that withdrew their MAID request, 41.8 per cent did so after finding palliative care sufficient. Palliative care aims to reduce symptoms of serious illnesses, thus improving quality of life. Similarly, providing better mental health support and housing could improve the lives of those who aren’t necessarily near the end of life but are experiencing poverty or mental illness.
Statistics from Canada’s Centre for Addiction and Mental Health (CAMH) show that one in five Canadians experience a mental illness. Youth aged 15 to 24 are even more likely to suffer from mental illness or substance abuse than any other age group. Of all mental health issues, 70 per cent begin during childhood and adolescence. Of those minors, 75 per cent don’t receive specialized treatment. But if the federal government gets its way, they could receive MAID instead.
It’s projected that 21 per cent of Canadians will at some point in their lives fit the criteria for addiction. That’d be a huge portion of the population to give access to MAID. Especially if accessing MAID is the easiest, quickest option.
Furthermore, the federal government’s recent proposed changes imply that substance use disorder and mental illness are simply incurable. The Canadian Mental Health Association (CMHA) has previously emphasized that it’s “not possible” to dictate the incurability of a mental illness. It firmly opposes the proposed expanding MAID to people with mental illness and substance use disorder. Many former drug users and harm reduction advocates want the government to start addressing the real problems at hand. Which would mean a renewed focus on the social and economic welfare of its citizens.
Marie Claude-Landry, chief commissioner of the Canadian Human Rights Commission (CHRC) summarizes the issue perfectly. She states that “in an era where we recognize the right to die with dignity, we must do more to guarantee the right to live with dignity.” Improvements in housing, job opportunities, and drug regulation should be a top priority for our government. As well as more investment in the development of effective rehab programs. In fact, any further amendments to MAID would highlight further disparities between the services provided to Canadian citizens. Recognizing this as a problem would be the first step to ensure a better life for all Canadians.
