Evidence of meeting #4 for Medical Assistance in Dying in the 45th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was equality.
A recording is available from Parliament.
Professor Emerita, School of Disability Studies, Toronto Metropolitan University, As an Individual
They're not breaking the law. That's the problem. They're interpreting the law liberally. They have—
Senator, Saskatchewan, CSG
Certainly they would be breaking the law if they were providing MAID to those with mental illness as a sole underlying cause, which many of you seem to be suggesting.
Professor Emerita, School of Disability Studies, Toronto Metropolitan University, As an Individual
I'm not sure any of us did suggest that.
What I'm suggesting is that they're in a position where much of the suffering that their patients are speaking of is not medical in nature, yet under the MAID regime, as long as there is a significant physical disability to which this suffering can, at least in part, be attributed, then the requirements for eligibility are met and it's a legal death. However, that isn't, surely, what this Parliament or the court intended.
Liberal
The Joint Chair Liberal Marcus Powlowski
Thank you.
Last of all we go to Senator Wells for one minute and 50 seconds.
Senator, Alberta, PSG
Thank you.
Dr. Frazee, the committee received a letter from the president of the Federation of Medical Regulatory Authorities of Canada, signed by the medical regulatory heads from across Canada, all saying that medical regulatory authorities in Canada are ready for the expansion of MAID for persons with a mental illness.
Based on what you've shared with us today, what additional evidence should Parliament consider before expanding track 2 MAID for persons with a mental illness, knowing that the regulatory bodies have clearly said they have a duty to be ready?
Professor Emerita, School of Disability Studies, Toronto Metropolitan University, As an Individual
I would request that you pay close attention to the evidence and the arguments being advanced right now in the constitutional challenge to track 2 MAID that I'm sure you're aware of as it works its way through the courts. You have heard and you will hear from many of the organizational plaintiffs representing people with disabilities across the country. I hope our voices will be heard.
Senator, Alberta, PSG
Would you say we should leave this decision up to the courts rather than Parliament?
Professor Emerita, School of Disability Studies, Toronto Metropolitan University, As an Individual
No, I'm sorry. I didn't mean to imply that. I meant that you will find well-reasoned evidence ready for your review and for you to weigh and to give weight to in appropriate measure, and not just what the provinces are saying.
Liberal
The Joint Chair Liberal Marcus Powlowski
Thank you very much.
With that, we conclude the second panel. I would like to thank all the witnesses for coming today and for their very important testimony. We certainly have heard from you. Thank you.
We will suspend.
Liberal
The Joint Chair Liberal Marcus Powlowski
I call the meeting back to order for the third and last panel.
In this panel, we have Dr. Kerri Froc, associate professor at the University of New Brunswick; Daphne Gilbert, full professor at the University of Ottawa's faculty of law; and Isabel Grant, University Killam Professor, University of British Columbia, who will be sharing her time with Elizabeth Sheehy, professor emerita of law at University of Ottawa, by video conference.
I'll start with Dr. Froc, followed by Dr. Gilbert, followed by the two on video.
Each of you has five minutes. With about 30 seconds to go, I will try to indicate that fact.
Dr. Kerri Froc Associate Professor, University of New Brunswick, As an Individual
Thank you very much. Good evening. I very much appreciate the invitation to appear.
I'm a constitutional law professor at the University of New Brunswick. My teaching and research focuses on the charter, equality rights and the interaction of equality and section 7. I publish extensively in those areas.
At the outset, I want to be clear that the charter does not require extension of MAID to mental illness as a sole underlying condition. Carter does not establish that requirement and section 15 does not compel it.
I'd like to make three points. The first is that Carter does not constitutionally require the extension of MAID to mental illness. The second is that any group advancing a section 15 equality claim must demonstrate that partial decriminalization transforms an exemption from criminal liability into a benefit under federal law. This would be a novel claim with no authoritative precedent. The third is that even if that hurdle is overcome, substantive equality under section 15 does not require full decriminalization. Truchon assumes that equality requires identical treatment as between groups with disabilities. It does not.
Turning first to Carter, it was a section 7 decision grounded in causation. The claimants had to show that state action caused the deprivation of life, liberty or security of the person.
The violation of the right to life depended on the Supreme Court's acceptance that the law caused premature death. It accepted that some individuals with “grievous and irremediable” conditions would take their own lives prematurely for fear that they would be incapable of doing so when their suffering became intolerable. This “cruel choice”, in the court's words, also imposed psychological suffering.
At the point of physical incapacity, the prohibition engaged liberty and security of the person because it precluded autonomy over one's life and it prolonged suffering. Carter did not mandate the extension of MAID beyond that defined class.
The court accepted that the state has a legitimate objective in protecting vulnerable persons from being induced to commit suicide and that carefully designed limits are permissible. It says that drawing lines is justifiable through “stringent limits that are scrupulously monitored and enforced.”
I will now turn to Truchon and section 15. Truchon is often relied upon to support an equality argument, but the case is less stable doctrinally than is sometimes suggested. Section 15 is engaged when the state provides a benefit or imposes a burden unequally. Parliament is not providing MAID as a benefit. It has created a limited exemption from the criminal law. Characterizing that exemption as a benefit would be a significant and novel extension of section 15, not supported by existing Supreme Court jurisprudence, such as Auton, or any other lower court decision. Parliament, under the Criminal Code, is not providing access to MAID to anyone.
Moreover, even if the “benefit” framing is accepted, section 15 prohibits distinctions that are substantively discriminatory—those based on prejudice, stereotyping or that perpetuate disadvantage. Here the distinction reflects the recognized limits of medical knowledge, the inability to reliably determine irremediability in mental illness and the difficulty of separating suicidality from MAID requests. Treating those differences as material is not stereotyping or perpetuating disadvantage. Section 15 requires evidence about the claimant group, and differential treatment that corresponds to their circumstances is not discriminatory—
Associate Professor, University of New Brunswick, As an Individual
Okay.
Truchon did not address the benefit problem and equality is not about the ability to make choices exclusively. It's only when limits on autonomy are linked to stereotyping or the perpetuation of disadvantage that they may result in a violation of section 15.
Therefore, the current law reflects an attempt to respond to materially different risk profiles in a way that manages the distinct nature of mental illness in the MAID context.
Thank you, and I would appreciate any questions.
Liberal
Professor Daphne Gilbert Full Professor, University of Ottawa, Faculty of Law, As an Individual
Members of the committee, thank you for inviting me to join you this evening. I'm realizing that tonight, I'm the odd person out in this gathering.
My name is Daphne Gilbert. I am a full professor at the University of Ottawa, faculty of law. I have taught constitutional and criminal law for over 25 years and have researched MAID since the Carter decision. I am also vice-chair of Dying with Dignity Canada, though I appear here in my individual capacity as a law professor.
I will focus my remarks solely on MAID where mental illness is the sole underlying condition, MI-SUMC, as I understand this committee's mandate to be limited to that issue and not to all of track 2 MAID.
The exclusion of individuals who would otherwise qualify for MAID but for the fact that their grievous and irremediable condition is a mental illness is discriminatory and violates section 15 of the charter, the equality guarantee. It has been six years since the government accepted that it had to permit people with MI-SUMC to request MAID, yet it continues to delay implementation.
I will quote the Supreme Court of Canada in Attorney General v. G, a 2020 decision:
People with mental illnesses face persistent stigma and prejudicial treatment in Canadian society, which has imposed profound and widespread social, political, and legal disadvantage on them.
This exclusion adds medical disadvantage to that list.
Consider the classic image of an iceberg. The small visible tip above water represents the very limited number of individuals who would ultimately qualify for MAID MI-SUMC. Clinicians agree that only a small number of people will ever meet the stringent eligibility criteria and rigorous safeguards. This matters because one justification for continued exclusion is a speculative claim that large numbers of people will become eligible if the ban is lifted. There's no evidence to support that claim.
The much larger mass of ice beneath the surface represents the thousands of individuals harmed by the language and rationale of exclusion. They are harmed by the suggestion that because of mental illness, they lack decision-making capacity, must be protected from themselves and that their suffering is somehow less real or less serious than physical illness.
In 2026, we are reinforcing historical stigma and paternalistic assumptions, attitudes we claim to reject. Public campaigns, like Bell's Let's Talk days, encourage honest conversations about mental health, but the law continues to infantilize those with mental illness. Our commitment to equality is measured not by empty messaging but by equal legal treatment.
As affirmed in 2026 by the Supreme Court of Canada, the section 15 analysis has two steps.
First, does the law create a distinction based on an enumerated or analogous ground? Here, it clearly does. The exclusion differentiates on the basis of disability by treating those with mental illness differently from those with physical conditions.
Second, does the law impose a burden in a way that reinforces, perpetuates or exacerbates disadvantage? Again, the answer is yes. The law denies access to MAID and, in doing so, reinforces stigma and harmful stereotypes: that individuals with mental illness are incapable and in need of protection from themselves. These messages affect not only the small number who might qualify, but also the broader community, who hear them echoed in legal and policy settings like these committee sessions.
This breach of section 15 cannot be justified under section 1. The stated objectives—protecting vulnerable individuals and ensuring system readiness—do not support a blanket exclusion. Following repeated extensions, there is no clear benchmark for readiness. A constitutional violation cannot rest on an undefined and shifting standard. In contrast, those working within the MAID system have indicated that they are ready. Nor is the exclusion minimally impairing. A blanket prohibition denies any possibility of individualized assessment. At minimum, there must be a mechanism to allow individuals to be assessed, as discussed in the G case.
Finally, the exclusion produces no salutary effects. Rather than protecting vulnerable individuals, it deepens stigma and marginalization.
I remind this committee that decision-making capacity is at the heart of all MAID requests. To suggest that an entire category of competent adults should be denied a legal medical service is profoundly discriminatory.
I look forward to your questions.
Liberal
The Joint Chair Liberal Marcus Powlowski
You're under time.
Professor Sheehy and Professor Grant, you have five minutes between you. I assume you know who's going to start.
Professor Elizabeth Sheehy Professor Emerita of Law, University of Ottawa, As an Individual
Yes, that's me. Thank you.
Thank you for inviting us to speak to the committee tonight. I will deliver our remarks and Professor Grant will answer questions.
Professor Grant and I are legal scholars with a combined 75 years of collective experience working on violence against women. We've published multiple papers on track 2 MAID. If MAID is extended to those whose sole disabling condition is mental illness, it will disproportionately end the lives of mentally ill women, just as track 2 already disproportionately ends the lives of disabled women. As scholars who have devoted their lives to ending violence against women, we urge you not to take this discriminatory path.
The UN Committee on the Rights of Persons with Disabilities highlighted the ableist assumptions underlying track 2 and urged its repeal, including the planned extension to mental illness. The committee expressed its concern about the disproportionate number of women accessing track 2 and the role of gender-based violence in the marginalization of disabled women.
It's important to understand that when one allows doctors to provide MAID to people to end difficult lives as opposed to hastening difficult deaths, one inevitably targets the most marginalized Canadians. Health Canada data backs this up. Approximately 59% of all track 2 deaths in 2022 and 2023 were women, as were 57% in 2024. Track 2 recipients are younger, more likely to live alone and more likely to report loneliness, perceived burdensomeness and a lack of dignity in their lives as reasons for seeking MAID. Ontario data suggests they are more likely to live in the most marginalized neighbourhoods and less likely to have family members as next of kin. Professor Grant has demonstrated the discriminatory impact of track 2 on women, which will only worsen if MAID is extended to mental illness.
When we examine the jurisdictions that allow psychiatric euthanasia, we see it's overwhelmingly women who are dying. In one study, researchers found that of 100 patients who applied for psychiatric euthanasia in Belgium based on at least one psychiatric disorder, 77% were women. Those women were on average just 47 years old. Dr. Marie Nicolini and her colleagues found that between 69% and 77% of those receiving psychiatric euthanasia in countries where it is allowed are women.
Research helps explain why this pattern occurs. Dr. Nicolini explains that the gender breakdown for psychiatric euthanasia is virtually identical to the gender breakdown for attempted suicide. Almost twice as many women attempt suicide, but more men complete it, because men choose more violent means to end their lives. Most women who attempt suicide do not go on to die from suicide. Psychiatric euthanasia risks turning the disproportionate numbers of women who attempt suicide into completed suicide by offering a way to die that is portrayed as peaceful and painless.
Male violence contributes to women's mental illness through such conditions as depression and PTSD, but this violence is also disproportionately targeted at women with mental illness. Stats Canada data indicate that 25.9% of women with mental illness report sexual violence, at least double the rate experienced by other women. People with mental health disabilities also face three times the risk of intimate partner violence.
Alarmingly, male violence also contributes to suicidality. A recent study published in The Lancet demonstrated that women who have experienced intimate partner violence were four times more likely than other women to have attempted suicide. Those who had experienced sexual abuse within a relationship were seven times more likely to have attempted suicide. Data from the Netherlands and Belgium show that 36% of those who died from psychiatric MAID had a history of trauma—for example, from physical and sexual abuse. We know that it is women who are disproportionately subjected to physical and sexual violence, yet Canada collects no data on the role of trauma in MAID requests.
Prof. Elizabeth Sheehy
Canada's resources should be focused on providing better supports for women with mental illness to escape male violence and to live dignified lives, not on developing secretive curricula for training people to facilitate their suicides.
We urge this committee to take the UN recommendations seriously and have the courage to put an end to the prospect of MAID on the sole basis of mental illness. Canada will never be ready to facilitate the suicides of women with mental illness.
Just as a reminder, please direct your questions to Professor Grant. She will respond on behalf of both of us.
Thank you.
Liberal
The Joint Chair Liberal Marcus Powlowski
Thank you, Professor Sheehy.
First up is Mr. Cooper for four minutes and 50 seconds.
Conservative
Michael Cooper Conservative St. Albert—Sturgeon River, AB
Thank you, Mr. Chair.
Professor Froc, the only time that the Supreme Court, in Carter, touched on MAID for psychiatric disorders was in the context of finding that slippery slope concerns and data from other jurisdictions were not relevant because they “would not fall within the parameters suggested in these reasons”—this is at paragraph 111—that they are “the product of a very different medico-legal culture” and that “These cases offer little insight into how a Canadian regime might operate.”
Do I have that right?
Associate Professor, University of New Brunswick, As an Individual
That's right. Carter was responding to a very particular set of facts before it. Those facts and the evidence included the evidence from other countries. It was specifically asked and talked about MAID in relation to mental illness at one paragraph. It said that it was not dealing with that case, and it was not dealing with that on the facts before it. Those are really the limitations of Carter.
Carter also didn't deal with section 15, which I'm pleased to talk about, too, because I don't think equality rights mean extending the criminal exemption as well.
Conservative
Michael Cooper Conservative St. Albert—Sturgeon River, AB
Just to be clear, nowhere in Carter did the court specifically recognize a charter right with respect to MAID in the context of mental illness being the sole underlying condition.
Associate Professor, University of New Brunswick, As an Individual
No. Carter was dealing with a blanket prohibition that existed at the time. It was asked to evaluate that blanket prohibition in relation to section 7. As I mentioned, it was dealing with state action there, because the court accepted, on the facts, that people possibly were terminating their lives prematurely because they may become physically incapacitated. We're not dealing with that here with mental illness.