Medical assistance in dying (“MAID”) laws are relatively recent in Canada. Laws authorizing MAID were first introduced in Canada in 2016 and later amended in 2021. Further amendments, which were initially set to come into effect in March 2023, have been postponed for at least an additional year. MAID is a complex topic and the laws surrounding it require a delicate balance of competing considerations – from preserving a person’s dignity to protecting those who are vulnerable. It is not surprising, therefore, that MAID laws have been subject to considerable review and development since their inception. It is expected that MAID laws will continue to evolve as the concept develops and lawmakers’ understanding of the various complexities continues to grow.
Since the introduction of MAID laws, a total of 31,664 Canadians have died with MAID between 2016 to 2021. In 2021, 10,064 Canadians died with the procedure, accounting for 3.3% of deaths in Canada that year.
The Supreme Court of Canada in the landmark decision in Carter v Canada, 2015 SCC 5 unanimously ruled that section 14 and paragraph 241(b) of the Criminal Code which prohibited medically assisted suicide violated section 7 of the Charter protecting the life, liberty and security of the person. In June 2016, Parliament passed Bill C-14 which amended parts of the Criminal Code to allow physicians and nurse practitioners to administer MAID to eligible adults in accordance with specified safeguards. Under this law, a criterion in determining whether an individual had a “grievous and irremediable medical condition” for the purposes of MAID eligibility was that their natural death was “reasonably foreseeable.”
In March 2021, Parliament passed Bill C-7 after the Superior Court of Quebec’s decision in Truchon v Canada, 2019 QCCS 3792. In Truchon, the Superior Court found that the “reasonably foreseeable” death requisite was unconstitutional. As a result, the eligibility criteria was expanded even further and two sets of safeguards were created: one for those whose deaths are reasonably foreseeable and one for those whose deaths are not reasonably foreseeable.
The 2021 amendments temporarily excluded from MAID eligibility any person whose sole underlying medical condition is a mental illness. The temporary exclusion was set to expire in March 2023, but has been extended for another year, as further detailed below. The purpose of the temporary exclusion and extension is to give the government more time to consider expert recommendations in this area.