Experts calling for delay to MAiD legislation that will add mental disorders as options for assessment

This report contains details that some viewers may find upsetting

Medical Assistance in Dying (MAiD) was legalized in Canada in 2016 for people suffering from physical illness.

Now in March 2023, that legislation is going to be taken a step further to allow those who are suffering from a mental disorder to have MAiD as an option available to them.

It's a step that Dr. Valerie Taylor supports coming into effect, but she and other psychiatrists are calling for the legislation to be delayed so they can be more prepared for its eventual role out.

Taylor is the department head of psychiatry at the University of Calgary and is also the chair of the Association of Chairs of Psychiatry in Canada (ACPC).

She said they aren't wanting to block the legislation that is slated to come next year, but they are wanting more time.

"We know that great work is being done at a federal level to ensure that the appropriate safeguards and training pathways are prepared. But, we're already into December, we have people reaching out asking about this and we're concerned that at a provincial level, we're not going to be ready to implement this come March 17," said Taylor.

The ACPC has put forward recommendations that it wants to be implemented before the new legislation takes effect.

The recommendations are:

· Strengthened education on suicide prevention and access to mental health and addiction care pathways;

· Develop an operational definition of irremediability for different mental disorders;

· Develop guidelines and procedures to assist clinicians in differentiating suicide to need access to MAiD;

· Develop standardized education tools for training psychiatrists and other health professionals; and

· Provide supports to gather data, and evaluate the new law and its implementation.

Taylor said some of these recommendations are already being worked on and implemented, but says they are still concerned.

"A lot of good work has gone into this and we don't want to see it rushed in the eleventh hour simply to meet an arbitrary deadline," said Taylor. "We just want to make sure we're all on the same page."

Taylor doesn't think this is something that needs to be delayed for another year or two and believes implementation can still take place in 2023, but noted that as practitioners who talk with people every day, they are not ready yet.

If the current timeline doesn't change, she believes delays could be felt, causing people to potentially suffer longer and creating confusion for practitioners.

"I am sure that the details that are going to come from the federal government are going to be helpful for this. But it still becomes very complex. How do we deal with forensic patients—people within the jail system who are requesting this? That's a different issue to try to ascertain."

She noted that a delay would also allow each province more time to develop proper implementation, saying that while it is federal legislation, the process falls on each province.

In a statement to CTV News Winnipeg, the office of the Minister of Health said it is aware of some of the concerns that have been expressed by experts.

"The safety and security of our most vulnerable people remains at the forefront of our actions as we take a careful and considered approach to the implementation of MAiD for persons living with a mental disorder," the statement said.

"We will continue to listen to the experts, including those at the front lines and those with lived experience, and collaborate with our provincial and territorial counterparts to ensure that a strong framework is in place to MAiD assessors and providers before MAiD becomes available to those for whom mental disorders is the sole underlying condition."

Taylor reiterates that she does not want to get in the way and prevent this from being put in place, but knows it has to be done properly to work.

"I am not the right person to dictate what is a sufficient level of suffering to an individual, if somebody has a mental illness for which all treatments have been tried and nothing works and they are in severe psychological pain. I think that this should be something that can be considered for them just like for other illnesses. I do believe, however, that it's going to take nuanced assessments," said Taylor.

If you are in crisis and looking for support, you can call 211 to be connected to the appropriate agency or go to mb.211.ca to find a list of available crisis resources.

Help is also available from the Manitoba Suicide Prevention and Support Line at 1-877-435-7170 or by visiting reasontolive.ca.