Canada suspends plans to expand assisted dying to people with mental illness

Image source, Bloomberg via Getty ImagesImage caption, Justice Minister Sean Fraser said the decision to pause the expansion was a difficult one.

1. If you have been affected by any of the issues raised in this story, information and support can be found at the BBC's Action Line.
2. In Canada, support can be found at the Suicide Crisis Helpline by dialling 988.
3. What is a 'safe death'? Mentally ill woman asks for assisted dying in Canada.

Canadá deve “excluir indefinidamente” pessoas com transtorno mental da eutanásia assistida, diz relatório Publicado em 17 de junho.

Eu poderia viver 30 anos, mas planejo morrer': Como a lei de morte assistida está dividindo os canadenses.

Canada says it will indefinitely suspend plans to expand its medically assisted dying law to people whose sole condition is mental illness, citing a lack of consensus on who would be eligible.

Isso acontece depois que um painel parlamentar no início deste ano recomendou que a morte assistida por meio médico — conhecida como Maid in Canada — não fosse expandida.

On Wednesday, Canada's justice minister, Sean Fraser, said that "while there is not a perfect consensus on this issue, we believe this is the correct approach at this particular time.

Supporters of extending the programme to those with mental illness alone argue that not doing so violates their constitutional rights and access to healthcare.

A federal case remains before the courts challenging the government's earlier decision to delay access to Maid for people with mental illness.

Fraser acknowledged this is an issue that the Supreme Court could weigh on in the future.

Wednesday's announcement means that Canadians with mental illness as their sole condition will not be able to access assisted dying by March 2027 as previously planned.

O governo, em vez disso, introduzirá uma nova lei nas próximas semanas que suspende essa expansão indefinidamente, disse Fraser.

Essa proposta de legislação também permitirá que pacientes com uma doença incurável em progresso consintam em morrer assistida antes que sua saúde se deteriore a ponto de não poderem fazê-lo.

Entretanto, ele deixará a decisão final nas mãos das províncias individuais.

Advanced requests are not currently legal under federal law, but are allowed in Quebec for those with serious and incurable illnesses.

Estas não são decisões fáceis, mas acreditamos que serão as corretas," disse Fraser.

Medically assisted dying became legal in Canada in 2016 for people with terminal illnesses, who still account for the vast majority of cases.

Após um processo judicial no Quebec, foi ampliado em 2021 para pessoas com condições incuráveis, mas cujo falecimento não era iminente. No Canadá, esse mecanismo é conhecido como “track two” Maid.

Canada was first set to expand its assisted dying laws to people whose sole condition is mental illness in 2023, but it delayed doing so twice to allow for time to study its potential delivery.

Advocates for expanding assisted dying to people with mental illness alone say they should have the same rights as patients with other types of illness.

Mas surgiram preocupações sobre se as doenças mentais são atualmente compreendidas bem o suficiente pela medicina para determinar a elegibilidade adequada.

Quando ouço que não há consenso na comunidade médica sobre a natureza irremediável de certas doenças mentais, isso me dá uma razão real de preocupação," disse Fraser.

Claire Brosseau, a woman with treatment resistant bipolar 1 disorder who is part of the federal case challenging Canada's current laws, told the BBC earlier this year that assisted dying would offer her "a safe death.

Brosseau's lawyer, Michael Fenrick, told the BBC on Wednesday that the government's decision is "deeply disappointing.

People will continue to suffer intolerably while the case goes through the courts," he said.

More broadly, some experts have also raised concerns that Canada's assisted dying programme has become a tool to alleviate the suffering of people who would be better served by improved access to affordable housing and healthcare, and not an option of last resort.

Em um relatório no início deste ano, um comitê parlamentar observou opiniões divergentes sobre a questão, mas recomendou que o Canadá “exclua indefinidamente pessoas cuja única condição médica subjacente seja uma doença mental” do suicídio assistido.

It added that there is a "pressing need for increased and more equitable access to adequate mental health services.

The conclusions were made after committee members heard from doctors, advocates and experts from countries that do allow assisted dying for people solely with mental illness, like the Netherlands and Belgium.

Not all committee members agreed with its recommendation, and some released a dissenting report arguing the process was "fundamentally flawed" and "biased.

Pesquisas sugerem que a maioria dos canadenses apoia o acesso à morte assistida por meio médico, mas esse apoio diminui quando se trata apenas de pacientes com transtornos mentais.