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.
The Joint Chair Hon. Yonah Martin
Okay. That's not much time.
You were talking earlier about the concerns that what gets called autonomy can sometimes be a response to abandonment, poverty, isolation and a lack of support.
This is a question for Dr. Maher.
If assessors are already being trained to focus narrowly on consent and capacity, how can Parliament trust the system to safely handle cases where mental illness will be the sole underlying condition? Would you further expand on what is happening right now with the system?
Psychiatrist, Ontario Association for ACT & FACT
Certainly. It's a nuanced discussion.
We treat people like they're Mr. Spock in the literature and in our discussions of capacity. They're not. They're messy. They're driven by emotions and despair and hopelessness. The very offering of MAID is a message at that point in time that we don't have anything else for them.
The undermining of the clinical relationship by the very offering of MAID is profound. Unless you're living it and experiencing it, I'm not sure how to communicate what it means to rob people of hope, especially when they're having to struggle over time.
Monsieur Thériault talked about whether I am going to make somebody suffer for 30 years. If they've lived for 30 years, they've been living a life. What has that life been for them? To say that they shouldn't have had those 30 years.... They made a choice to live.
Autonomy is my choice to do what I want with my body. I can kill myself. That can sound callous, but it's not. People thoughtfully plan their own deaths. I can tell you stories of how people plan their suicides. If you have some fantasy that everybody does this horrible, impulsive thing, it's uncommon. It's about 10% of people. To be clear, the impulsivity is not genuine impulsivity. They have rehearsed it in their heads for months. We have research showing that. That's autonomy: I can do what I want.
I'm objecting to the system being set up to induce, to seduce, to invite and to rob people of hope. That's not what we, as a country, should be doing to the vulnerable.
Liberal
The Joint Chair Liberal Marcus Powlowski
Thank you, Dr. Maher.
Last of all is Senator Loffreda for two minutes.
Senator, Quebec (Shawinigan), ISG
Thank you.
Dr. Maher, thank you. We don't want to rob people of hope. We all need hope.
My question for you and Dr. Lyon, if you'd like to bring in his expertise, if we have the time, is this: Given the inherent uncertainty in these assessments, would you agree with an additional national safeguard, such as a mandatory specialized second opinion, to ensure consistency and to protect vulnerable individuals?
Data oversight and public confidence are so important, and public trust in this regime depends on transparency, consistency and the ability to monitor outcomes in real time. The current data collection, from what I gather and what I've heard this evening, is not sufficient to capture the complexity of these cases, including the unsuccessful requests, the reasons for refusal and indicators of vulnerability, such as a lack of access to care or social supports.
What's your experience with that and your judgment of that?
Psychiatrist, Ontario Association for ACT & FACT
Psychiatrists have biases. There are reasons some psychiatrists are strongly in favour of and are ready and happy to do MAID assessments. We come with biases.
If you're asking what the data says about capacity assessments, it's very easy to sort out who's extremely psychotic or profoundly depressed. It's very easy to sort out who's doing really well and is quite capable and rational, which would be the majority of people. What's complicated is the grey zone, and the grey zone is substantial. The data says that about 75% of psychiatrists will agree on what they're seeing, and if you have 25% disagreeing, that's pretty significant.
I frankly view the capacity issue as a red herring. I've thought this for a long time. People are focused on the idea that we have to decide whether they're able to decide. That stuff is done every day in psychiatry, and it's called a capacity assessment for treatment decisions. Insofar as you're calling MAID a treatment decision, then this fits into that category.
To say it's somehow special or different does not, in fact, reflect the reality of the day-to-day work of mental health care. Are some people better at doing capacity assessments than other people? Absolutely. If I have 40 years of experience, I'm going to see things differently than if I were a fresh grad.
Liberal
The Joint Chair Liberal Marcus Powlowski
Thank you, Dr. Maher.
Thank you both, Dr. Lyon and Dr. Maher, for your time.
We'll briefly suspend while we bring in the next panel.
Conservative
Andrew Lawton Conservative Elgin—St. Thomas—London South, ON
I have a point of order.
Mr. Chair, I think we lost about 11 minutes in the first panel because of the technical issue. We're about 20 minutes over now. I was hoping you could confirm when we have resources until and whether we'll have time for all our rounds with all the remaining panels.
Liberal
The Joint Chair Liberal Marcus Powlowski
We have resources up to 9:45, and we'll try to be done by then. I think we might want to curtail the last panel a bit to get all the testimony in.
Is everyone in agreement on that? I think we all want to finish as close to 9:30 as possible.
Liberal
The Joint Chair Liberal Marcus Powlowski
Hopefully everyone will be in agreement on cutting some time from the third panel if necessary, but we have up to 15 minutes—
Senator, Alberta, PSG
Could we not cut back on both panels instead of shortchanging the third panel? I think that's fair.
Liberal
The Joint Chair Liberal Marcus Powlowski
We could, if everyone's in agreement on that. We could cut everybody short by 10 seconds, say, for the next panel as well.
Is everybody in agreement on 10 seconds right across the board?
Liberal
The Joint Chair Liberal Marcus Powlowski
Is everyone okay with that? We'll take 10 seconds off everybody, and hopefully that will get us closer to getting in on time.
Liberal
The Joint Chair Liberal Marcus Powlowski
I've been asked to quickly read this again, because someone misunderstood the translation process in a question previously.
I'd like to confirm that sound tests were made successfully.
Before we continue, I would ask all in-person participants to consult the guidelines written on the card on the table. These measures are in place to help prevent audio and feedback incidents and to protect the health and safety of all participants, including the interpreters. You will also notice a QR code on the card, which links to a short awareness video.
I would like to make a few comments for the benefit of the witnesses and members.
Please wait until I recognize you by name before speaking. For those participating by video conference, click on the microphone icon to activate your mic, and please mute yourself when you're not speaking. For those on Zoom, at the bottom of your screen, you can select the appropriate channel for interpretation—floor, English or French. For those in the room, you can use the earpiece and select the desired channel. I'll give a reminder that all comments should be addressed through the chair.
With that, I would like to welcome our second panel.
We have Gabrielle Peters, co-founder of Disability Filibuster, as well as Catherine Frazee, professor emerita, school of disability studies, Toronto Metropolitan University. They're going to be sharing five minutes. We also have Dr. Michelle Hewitt, board chair for Disability Without Poverty, and Krista Carr, chief executive officer of Inclusion Canada.
We'll start off with five minutes to Ms. Peters and Dr. Frazee.
Ms. Peters, I think you're going to go first, and my understanding is that because of some medical problems and problems with breathing, we may have to go beyond the allocated five minutes, so we'll give you a bit of leeway.
If you'd like to start, Ms. Peters, I believe you have a video—
Liberal
The Joint Chair Liberal Marcus Powlowski
Okay. Dr. Frazee is going to have a video.
Ms. Peters, go ahead.
We're trying come as close as we can to fitting you both into five minutes. Please go ahead.
Co-Founder, Disability Filibuster
I'll do my best. I appreciate the disability accommodation. Thank you.
One of the hats I wear is that I sit on Providence Health Care's psychiatry lived experience research advisory committee. I am always struck by the urgency accorded to the expansion of MAID for mental illness versus that of providing funding for comprehensive mental health care, supports, services, a livable income and housing for those with mental illness. Injustice can often be measured in time.
We know that neither people nor policy are islands unto themselves, yet MAID is discussed as if it exists inside a vacuum, free of influence from or consequence to society. In the little time I have, I am going to address a couple of persistent myths that constantly derail and impede rather than build understanding.
Myth one is the claim that people oppose expanding MAID because they believe mental illness is less real than physical illness, and they treat it as less significant and less worthy of support. This claim is false. The division between physical and mental illness is asserted and maintained by the medical model and the Canadian state. A two-tier health care system has been built around mental health due to the exclusion of many essential elements from Canada's public health care system. The average provincial and territorial mental health care funding lags behind that of many peer countries. Proportionally, Canada's public spending on mental illness is lower than its occurrence among all illnesses. People with mental illness face particular threats to their civil rights and higher levels of police interactions and incarceration.
Stigma requires power. Without power, stigma is just someone's bad opinion. When it comes to claims asserted by the myth, the call is coming from inside your house—not ours. As disabled people, we understand disability as one large tent. The experience of oppression is not the same, but the cause of it is. Please remember that the majority of disabled people have more than one disability. Co-occurrence of chronic illness and mental illness is common.
Myth two is that failing to expand MAID is discrimination. This claim is also false. This and other assertions made by proponents of MAID reflect a profound lack of understanding of disability, disability rights history and the causes and consequences of—and solutions to—the discrimination and injustice disabled people experience. Those eager to offer aid in accessing death to an autonomy-deprived population are certainly making a choice, but why?
At least one study has found that support for euthanasia on the basis of mental illness was positively correlated with holding attitudes of stigma towards people with mental illness. Further, a forthcoming chapter by Trudo Lemmens and Scott Kim demonstrates that parity arguments logically lead to absolute autonomy—death on demand for anyone.
This aligns with disability analysis that for years has asked, why us? The co-opting of or, at best, the outdated and incorrect understanding of disability rights invoked in the name of expanding MAID is evidence of the absence of disabled knowledge and understanding. MAID is, among many things, authored by epistemic injustice and must be repealed, not expanded.
Thank you.
Liberal
The Joint Chair Liberal Marcus Powlowski
Dr. Frazee, I understand you have a video. We'll go to your video.
Dr. Frazee has made a video because of her trouble in communicating.
Dr. Catherine Frazee Professor Emerita, School of Disability Studies, Toronto Metropolitan University, As an Individual
[Transcription of video presentation:]
I want to begin by acknowledging both the nature and the limits of what I bring today. I speak as someone who has moved through the world for seven decades with significant physical disability. I've spent a career analyzing that experience within the frameworks of law, policy and culture.
I want underscore that your work on this committee must be grounded in the authority of what the law calls “mental illness”, authority earned through neurodivergence, psychiatric survival, intersectional identity and mad scholarship. Seek out persons who have not only lived these realities, but worked them into deep understanding.
That's a different undertaking from finding individuals who will speak about their own desire for MAID. First-person accounts have a place here, but they are not a substitute for epistemic authority, and this committee must be clear about the difference.
Between 2021 and 2023, I was part of a working group on the MAID practitioner training curriculum. My full account is published this month in the Canadian Journal of Disability Studies, and it's appended to my written testimony.
What I encountered there was a culture immune to the self-reflection and humility that ought to attend any decision to authorize death. My questions about whether a MAID applicant's despair arose from a life without validation or support were rejected as threats to autonomy. Vulnerability was narrowed to irrelevance. What remained in the curriculum trains assessors to, yes, verify capacity and consent but to look no further, as if the law’s demand for conscientious scrutiny had never existed.
In Carter v. Canada, Justice Smith staked this regime's legitimacy on trust in medical judgment—on physicians applying, in her words, the “very highest level” of scrutiny, the safety of their practice contingent upon “the skills and commitment of the physicians who are responsible”. I have watched that commitment up close in a curriculum designed to make practitioners look away. The trust that the court and Parliament placed in medical judgment has not been honoured.
On that evidence, this committee cannot responsibly contemplate expansion of a regime that has not learned to be accountable for the power it already wields.
Thank you.
Liberal
The Joint Chair Liberal Marcus Powlowski
Thank you.
Next is Dr. Michelle Hewitt. We'll try to hold you to five minutes.
Michelle Hewitt Board Chair, Disability Without Poverty
Thank you.
My name is Michelle Hewitt. I'm the chair of Disability Without Poverty. As the chair of DWP, I want you to know that research from UBC will tell you that 75% of the people living in Vancouver's Downtown Eastside have mental illness. These people don't want MAID. They want supports to live their lives in dignity and to be able to thrive.
Today, I want to tell you about my husband, Victor Enns, who used MAID to die on December 9, 2025. Victor did not want to die. Victor was a poet and a writer. Along with listening to music, he enjoyed life. He had a wicked sense of humour, he cared for everything that was going on in the world, and he had a deep love for his family.
Victor was diagnosed with chronic depression in his twenties, and he was 70 when he died. Around 30 years ago, he got good support from psychiatrists and found a cocktail of drugs that managed his depression well. If MAID for mental illness existed earlier, Victor might have accessed it during a prior depressive episode. Instead, with more time and good care, his depression was under control.
The most disabling part of Victor's life was chronic pain from severe osteoarthritis, but he had good control with an opioid. In 2022, he lost his family doctor. This precipitated a series of events that led to his losing access to that opioid and being prescribed too much of something else, which led to respiratory depression, hypoxia and a week in a medical coma. After that, he was prescribed Suboxone. Victor wanted his original opioid back, as it worked better. However, ironically, he was told he couldn't have it in case he had another respiratory depression and died.
Early in 2025, Victor requested psychological testing, as he felt something wasn't right. The testing said that he had some cognitive changes, but there was no way of knowing how much the drugs that he took for his pain control or the events surrounding his week in a coma played into this. He was diagnosed with early dementia.
Victor then started to comment that he thought MAID would be in his future. The possibility of dementia scared him. He was also rapidly reaching the limit that he would be prescribed Suboxone. In May 2025, Victor submitted the paperwork, still thinking of it as something for the future. When we got a date for the assessment, Victor prepared by writing a list of reasons that he thought he should qualify. Within 10 minutes of arriving, including introductions and explanations of what MAID is, Victor was told that the assessor had already decided he had qualified and that he could have either track 1 or track 2. As Victor had no intention of using it in the short term, he'd put track 2. Within 25 minutes, the assessor was gone.
The second assessor arrived, telling us he agreed with his colleague. The whole time was spent filling in paperwork. He also said that he'd be happy to assess Victor as track 1 or track 2, and he'd follow his colleague's recommendation for track 2. He left after 30 minutes, telling us when his holidays were so that Victor could plan his death around them.
Victor was no more likely to die in the foreseeable future than I am from my MS. There was never any attempt, as designated in the legislation, to try to see whether other options would help him. They never saw us again until his life ended through MAID.
From that time onwards, Victor's mental illness worsened as his paranoia increased, his pain increased and he reached the limit of the Suboxone. The sum total was that, with no support and no pain control, he chose MAID.
Do not believe that MAID provides choice and dignity in death. We were told that we could have Victor die only before the provider started his working day or at the end of it, so we chose 4 p.m., only because it was easier than 8 a.m. We had said that Victor could spend only a small amount of time lying on a bed because it caused him so much pain. He'd not slept in a bed for two years. That was ignored, as he was told to get on the bed far too early.
With the late arrival of the doctor and with Victor lying in a bed with no painkillers—because we didn't think he'd need another dose, but everything was running so late—led to him screaming for them to kill him. The IV was poorly placed, meaning they had to switch arms, and I could not be at his side as he died. We were shouting at each other across the room to say goodbye.
I don't think Victor's experience is an outlier. The current MAID program is severely broken, and it doesn't do what you think it does. Victor was not in control. The only thing he is is dead, and he didn't want to die. He felt he had no other option.
The current program clearly has such major issues that you should not consider an expansion, particularly for something as controversial as mental illness as the sole condition. Track 1 needs some careful attention, and track 2 needs shutting down.
I've come here today to share the most painful aspects of my husband's death, which is not easy to do, so please ask me questions.
Thank you.
Liberal
