Medical Assistance in Dying Committee on April 27th, 2026

[Kevin Young]

I would add that we find that a lot of people come to the emergency departments and to hospitals because they're not able to access care in the community. This type of care is care that needs to be offered on a continuous basis over a longer period of time. Not having access in the community has been a big barrier.

The Ontario Hospital Association, together with many hospitals across the province, has been a very strong advocate of increasing home care and home care access for those with mental health, and of trying to increase access in the community to various types of treatment, including cognitive behavioural therapy, as well as rTMS and ECT. Despite all that, although we've made gains, we still fall well behind what we think would be a reasonable amount of care that's available equitably across the province.

[F. Gigi Osler]

Thank you for that.

I have two quick follow-up questions.

First, in 2016, when Bill C-14 became law, was there consensus on MAID? You did talk about needing consensus.

Second, in 2021, when MAID became legal for those whose natural death was not reasonably foreseeable, was there consensus?

[Melissa Prokopy]

There was certainly more consensus than there is now. We work closely with colleges, the government—

[F. Gigi Osler]

Was that in 2016 or 2021?

[Melissa Prokopy]

It was both.

Our objective is to create a framework to allow organizations to adapt in their specific circumstances. As I alluded to earlier, a number of our members are faith-based organizations. They have worked through their own challenges to encourage and promote access and patient choice. It hasn't always been easy, but certainly we've worked collectively as a group to try to make that accessible in ways that not only meet the needs of the patient, but also recognize some of the access and equity challenges the sector is facing.

[The Joint Chair, Liberal, Marcus Powlowski]

Thank you, Ms. Prokopy.

We'll go to Senator Wells for the last three minutes.

[Kristopher Wells]

Thank you, Chair.

Dr. Sareen, you said that without an international standard, we cannot regulate the extension of MAID for MI-SUMC. However, multiple jurisdictions offer MAID in some form for persons with a mental illness. For example, the Netherlands uses the concept of “due care” as a base standard, with the assurance that a person is competent and conscious. This is the same in Belgium and Luxembourg. Spain and Colombia have developed other standards.

Why would these standards not be considered acceptable for us in Canada to use as guidance should this committee decide to extend MAID for MI-SUMC? What do these jurisdictions have that Canada does not have?

[Jitender Sareen]

Thank you for your question.

It's very important to remember that very few countries have allowed that. If you look at the data very carefully and look at the legal framework in Netherlands, you see that a person still has to go through a number of treatments. The provider can actually stop. That's one part that's not in the Canadian legislation. In Canada, you can think about the options as far as treatments go, but you don't have to go through them, and there have been significant concerns internationally about people dying in some of those countries.

Again, internationally, the International Association for Suicide Prevention, the American Psychiatric Association and the vast majority of countries in the world do not allow MAID for mental illness.

[Kristopher Wells]

If I could follow up, the countries I mentioned do, in some forms. Do you not think there are important lessons that we could learn here in Canada, should an extension be lifted, to provide those safeguards and have those regulatory processes in place? I'm saying that we have lessons to learn from. Why can't we apply some of those here in Canada?

[Jitender Sareen]

I think that's why in 2025 the American Psychiatric Association had a position paper on this issue, and the International Academy of Suicide Research.

Legally, Canada is one of the outliers among countries that allow MAID, with people having to only consider treatment options rather than go through them. That is a big difference that has already been an issue in Canada, but if you allow that for MAID for mental illness, it goes back to differentiating MAID from suicide and mental disorders.

Again, consensus on this topic is not there, and the international guidelines really do not support it.

[The Joint Vice-Chair, Hon. Pierre Dalphond]

Thank you very much, members of the panel. I know we kept you waiting for longer than expected, but you can be assured that it is quite appreciated.

I wish to thank our witnesses, the interpretation team, all of the staff assisting us tonight and all of you for your collaboration. Thanks to the collaboration of all, we were able to make it, despite some adjustments.

Tomorrow night, we're not sitting in this room. We're sitting in the floor below, in room 025-B here in the West Block. Make sure you come to the right place.

I now declare this meeting adjourned.