Thank you, Mr. Chair and committee. I will endeavour to stay within the five minutes.
My name is Sonu Gaind. I'm a psychiatrist and professor at the University of Toronto, a past president of the Canadian Psychiatric Association and the former chief of psychiatry of two large Toronto hospitals. I've written chapters on suicide for international medical textbooks, and I was the physician chair of the Humber River hospital's MAID team. I'm not a conscientious objector.
Thank you for the chance to speak here.
As you know, the prior AMAD committee concluded that we were not ready to provide MAID solely for mental illness, because MAID assessors could not predict irremediability. They'd actually be wrong more often than they'd be right, and they could not filter out suicidality. This particularly risked marginalized individuals seeking death as a treatment for social suffering.
In 2024, the committee recommended an indefinite pause, and Parliament enacted a three-year delay. Since then, none of those issues have been resolved. Instead, we have even more evidence showing we are not ready to provide MAID for mental illness. In fact, doing so would be the height of irresponsibility.
MAID reporting data mostly tracks illness suffering and ignores many known suicide risk factors, so we can't know the full scope of how much suicidality fuels MAID requests. Despite this limitation, we have evidence showing strong suicide risk factors fuelling especially track 2 MAID. This would get even worse if MAID was provided for solely mental illness.
Feeling a burden, loneliness and isolation are known suicide risk factors that we already see as significant drivers in about half of all track 2 cases. Those with mental illness have higher rates of psychosocial suffering. It is impossible to filter this out, since these factors related to life suffering are actually the same as suicide risk factors. There is nothing to filter. It's the same thing.
Data also shows signals of marginalization associated with track 2 MAID. In 2024, the Ontario coroner concluded that those getting track 2 MAID were much more likely to live in neighbourhoods with higher residential instability, higher material deprivation and greater dependency. Despite using less sensitive geographic-based proxy data rather than individual-level markers, we still see those signals emerge.
Dr. Gupta previously testified that she was not concerned about twice as many women as men getting psychiatric euthanasia in Europe. We're already seeing more women than men getting track 2 MAID. All these things would get even worse if MAID was provided for mental illness and addictions.
Since 2023, international groups looking at Canada have warned against MAID for mental illness. In 2025, the International Association for Suicide Prevention concluded that due to the inability to predict who will have “a poor or hopeless prognosis, and [who] will substantially improve, with or without treatment” for mental illness, “we should not allow” psychiatric euthanasia. Also in 2025, the American Psychiatric Association released its position opposing physician-assisted death solely for mental illness.
This is not about partisanship. This is about evidence.
In contrast, the same people who wrongly claimed in 2024 and earlier in 2023 that we were ready then are again claiming that we are ready now. The accumulated evidence shows they are even more wrong now than they were in the past.
Last time, I called prior assurances of readiness “reassurance theatre”. Unfortunately, this has continued, with expansion ideologues suggesting we just need a consensus or to engage in a Delphi process to sort these things out.