Question Period Note: Medical Assistance In Dying (MAID)

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KEY MESSAGES
MAID - General
• Medical assistance in dying (MAID) is a complex and deeply personal issue.
• Every individual’s end-of-life journey is different, and MAID may be an option for some who are suffering intolerably due to a serious medical condition.
• MAID is available only for those who are assessed as eligible, and the Criminal Code sets a high bar with multiple stringent eligibility criteria and robust procedural safeguards.
Advance Requests
• The Criminal Code does not permit the provision of MAID based on an advance request.
• We are committed to ensuring that the framework for MAID protects those who may be vulnerable, and supports autonomy and freedom of choice.
• That is why the Government launched a national conversation to hear views from people in Canada on this issue in fall 2024.
• On October 29, a What We Heard report was published on the national conversation, reflecting key themes. However, it does not include recommendations or commitments.
Mental Illness
• We continue to work with the provinces and territories and other key stakeholders to prepare health care systems for MAID eligibility for persons with a mental illness as a sole underlying condition when the temporary exclusion is lifted in March 2027.
• We look forward to supporting a Parliamentary Review on health system readiness for the MAID eligibility for persons with mental illness which is to begin by February 2026.
IF PRESSED
Q1 : Since Quebec has now brought its own advance request framework into effect, what would happen if a Quebec physician provides MAID based on an advance request in accordance with provincial law?
A1:
• The Government of Canada acknowledges the work the Government of Quebec has conducted on advance requests and their interest in having the Criminal Code amended so that it can be permitted for residents of Quebec.
• We are aware that some residents of Quebec have made advance requests for MAID based on provincial legislation.
• As the Criminal Code applies uniformly across Canada and does not permit MAID based on an advance request, providing MAID pursuant to an advance request remains an offence under the Criminal Code.
Q2 : If pressed on the key findings of the What We Heard Report on the national conversation on advance requests
A2 :
• Over 47,000 people across Canada participated in the consultations on advance requests for MAID through an online public questionnaire, regional and national virtual roundtables, and public opinion research.
• It is clear in the feedback that there are diverse views on this complex issue.
• While most participants were in support of the concept of advance requests, there were concerns about safe implementation. The feedback stressed the importance of clear rules and health system capacity. There was some opposition that stated that no safeguards would be sufficient.
Q3 : If pressed on whether the Government of Canada plans to allow advance requests for MAID
A3 :
• MAID based on an advance request remains prohibited under the Criminal Code.
• The objective of the national conversation was to hear from health care providers, provincial and territorial governments, persons with lived experiences, persons with disabilities, Indigenous people and the public on complex issue of advance requests for MAID.
• The Government is carefully considering the findings from the national conversation. No decisions have been made about expanding eligibility to allow for advance requests.
Q4 : If pressed on readiness for the lifting of the temporary exclusion of MAID for those whose sole underlying condition is mental illness?
A4 :
• We recognize that mental disorders can cause suffering on par with that of physical illness. We also know that some experts, health care providers and stakeholders are concerned about MAID for individuals about MAID for individuals whose only health condition is mental illness due to issues like suicidality and irremediability.
• We continue to work with the provinces and territories and other key stakeholders on MAID for individuals whose only condition is mental illness and to engage with Indigenous Peoples on MAID. We look forward to supporting a Parliamentary Review on health system readiness for the MAID eligibility for persons with mental illness which is to begin by February 28, 2026.
Q5 : If pressed on media stories alleging that people are seeking MAID due to lack of needed services?
A5:
• The federal framework for MAID is set out in the Criminal Code of Canada and sets a high bar with stringent eligibility criteria. No one can receive MAID solely on the basis of a lack of social supports, such as housing and mental health services.
• Improving access to social and health services remains a priority for governments in Canada.
• We are committed to continuing to work with provinces and territories to improve access to health and social supports for all people in Canada.
Q6: If pressed on the recently released report from the Ontario Chief Coroner’s Office MAID Death Review Committee and subsequent media stories reporting on MAID being provided to persons with dementia who may be vulnerable to coercion. (87 words)
A6:
• Medical assistance in dying is a health service provided by provinces and territories within a federal legal framework that sets out strict criteria for eligibility and robust safeguards.
• The federal legal framework for MAID is carefully designed to affirm and protect the inherent and equal value of every person's life.
• In accordance with the federal legal framework on MAID, assessors must be of the opinion the person is capable of making decisions with respect to their health and if the assessors cannot form this opinion, then MAID cannot be provided.
Q7: If asked about the level of funding provided to medical assistance in dying compared to palliative care
A7:
· Federal funding for MAID aims to support provinces and territories and stakeholders to put in place resources and tools to support safe and appropriate MAID services.
· Funding for palliative care is used to advance the government’s Action Plan on Palliative Care to support work by provinces and territories and stakeholders to enhance access to palliative care services.
· From 2022 to 2027, the federal government will spend approximately $20M to support better access to palliative care services and $10M to support the safe and appropriate provision of MAID services.
Q8: If pressed about the annual growth rate in MAID provisions in 2024
A8:
• Health Canada’s Sixth Annual Report on MAID found that the total number and calculated rate of growth in MAID provisions is slightly lower than projections in the media.
• Based on the data for 2024, approximately 16,500 people received MAID in 2024, representing an increase of 6.9%. This is a significant reduction in the rate of growth since last year (16.9%).
• The rate of growth in overall MAID provisions has been shrinking since 2019. However, it will take several more years before long-term trends can be conclusively identified.
Q9: If pressed on the final report of the United Nations Committee for the Rights of Persons with Disabilities stating that Track 2 MAID discriminates against persons with disabilities and should be repealed.
A9:
• Every individual’s end-of-life journey is different, and MAID may be an option for some who are suffering intolerably due to a serious medical condition.
• The federal legal framework for MAID has been carefully designed with eligibility criteria and safeguards to affirm and protect the inherent value of every person's life.
• To be eligible for MAID, a person must have a serious and incurable medical condition, be in an advanced state of irreversible decline in capability and be experiencing enduring and intolerable suffering related to their medical condition. They must also be over the age of 18 and capable of making decisions with respect to their health.
• Enhanced safeguards are in place for individuals who request MAID under Track 2 to provide additional protection. These include that the person must be informed of available and appropriate means to relieve their suffering, and must be offered consultations with professionals who provide those services.
• The Government of Canada remains committed to ensuring that the federal legal framework for MAID reflects the needs of people in Canada, protects those who may be vulnerable, and supports autonomy and freedom of choice.
Q10: If pressed on the final report of the United Nations Committee for the Rights of Persons with Disabilities finding that Track 2 MAID is disproportionately accessed by women and persons in marginalized situations.
A10:
• The federal legal framework for MAID has been carefully designed with eligibility criteria and safeguards to affirm and protect the inherent value of every person's life.
• The most recent available data (2023) show that a larger proportion of women (56.7%) than men (43.2%) receive MAID under Track 2.
• However, these findings are consistent with overall population health trends where women are more likely to experience long-term chronic conditions, which can cause enduring suffering but would not typically make a person’s death reasonably foreseeable.
• Community-level analyses available in the MAID Annual Report indicate that people who receive MAID do not disproportionately live in lower-income or disadvantaged communities.

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KEY STATS
• According to Health Canada’s Sixth Annual Report on MAID, 16,449 people received MAID in 2024.

• The number of MAID provisions in 2024 represents an increase of 6.9% over 2023. This suggests growth is slowing compared to previous years (2019 to 2023) which had an average growth rate of approximately 30%.

• Since Quebec brought in its provincial legislative framework for advance requests for MAID on October 30, 2024, more than 1,600 advance requests are believed to be registered in Quebec’s digital registry. Some reports suggest that MAID has now been provided in at least one instance based on an advance request.