Medical Assistance in Dying Committee on May 5th, 2026

[Helen Long, Chief Executive Officer, Dying with Dignity Canada]

Good evening, everyone. Thank you for the opportunity to appear.

My name is Helen Long, and I am the CEO of Dying with Dignity Canada. We are a national human rights charity that advocates for end-of-life options that respect the Canadian Constitution and the Charter of Rights and Freedoms.

We support the right of a competent adult with a mental illness as their sole underlying medical condition to apply for and receive medical assistance in dying if they meet the rigorous eligibility criteria under the Criminal Code.

The legalization of MAID for mental illness would allow access to MAID for a small group of people afflicted with acute treatment-resistant mental disorders who, despite many interventions over long periods of time, have experienced suffering that cannot be relieved.

This committee has heard from many physicians, psychiatrists, professors and other experts who have contributed invaluable testimony to the committee's study. Some experts have stated that mental illness cannot be considered grievous and irremediable. Their illness and outlook may possibly improve one day in the future, but certainty about the future is not a requirement to access MAID. There is plenty of uncertainty in many medical conditions, but people with physical disorders are informed about the uncertainties and engage in dialogue with clinicians to talk about risks and their own values. It is to only people with mental illness that we say, “Your views do not matter.”

I remind you that 80% of Canadians support access to MAID for individuals with a mental illness as the sole underlying condition. There are physicians who are confident in their ability to assess and provide MAID for mental illness. Their ability and willingness to do so is based in fact, backed by robust academic literature and affirmed by countless hours of experience in clinical settings. They are prepared to honour the wishes of the very few Canadians who would be eligible to receive MAID for debilitating, irremediable mental disorders.

Today I would like to highlight a glaring gap in the evidence collected by the committee. The voices of everyday Canadians with lived experience facing grievous and irremediable medical disorders have been largely excluded from your study. No other patients have been erased from a conversation about them the way persons with mental illness have been. I am here as an advocate for them, to bring their voices to you with the limited time I have. However, my testimony should be the start, not the end, of a conversation with Canadians who have been consistently calling for the legalization of MAID for mental illness.

John Scully has said:

I suffer from severe mental illness including incurable depression, incurable post-traumatic stress disorder, and incurable anxiety disorder. I was first diagnosed 30 years ago and since then I have been admitted to seven psychiatric hospitals, I have undergone every possible treatment and taken every medication known to science, including all the drugs developed since 1950. To this day, none have had any positive effects on me, and some have had dangerous effects.

Here is Savannah Meadows:

I’m sure you can understand that some mental health issues are so severe and the pain they cause so great that they cannot be effectively treated or cured. When a person is in immense mental pain and no treatment can help them, under the current system people are left to suffer grievously, which is cruel and unusual punishment.

Clemie said:

I do understand the concept that there’s always hope, that my life could get better, but my anguish won’t. I will always be mentally ill. I will always be depressed. My heart can’t handle this pain anymore, my soul is exhausted, and I deserve equal access to assisted dying.

Claire Elyse Brosseau said this:

I’ve been treated for 35 years. Some people don’t respond to treatment. That’s a medical reality, not a philosophical debate. Broad assumptions...and guess work isn’t protecting us, but rather people’s feelings. It excludes us. Equality doesn’t mean special restrictions. Speculation isn’t lived experience.

At its core, the decision to access MAID is a deeply personal one. Canadians simply want the autonomy to make medical decisions for themselves in consultation with the medical professionals they trust. It is incumbent upon the government of Canada to allow them to do so.

I urge this committee and the government to go further in listening to their voices, and ensure their realities are meaningfully reflected in the recommendations you put forward.

Thank you.

[The Joint Chair, Liberal, Marcus Powlowski]

Thank you.

Mr. Schadenberg, go ahead for five minutes.

[Alexander Schadenberg, Executive Director, Euthanasia Prevention Coalition]

My name is Alex Schadenberg. I'm the executive director of the Euthanasia Prevention Coalition. I work in Canada, but I also work with people worldwide who oppose euthanasia and assisted suicide.

Canada is increasingly seen internationally as a cautionary example. The rapid growth of euthanasia deaths and the expansion of the types of cases are being closely watched abroad. Developments in Canada have influenced debates in other countries, including the defeat of assisted dying bills in Scotland, the U.K. House of Lords, and Slovenia, where assisted suicide was overturned through a referendum.

Rather than extending assisted dying to persons whose sole underlying condition is a mental disorder, Parliament needs to examine how Canada's euthanasia law is actually functioning. How has the law been implemented? Is it achieving its intended outcomes? Are there abuses of the law based on its original intention? Does the law require amendments? These questions have never been addressed. We've only actually talked about expansions.

Dr. Ramona Coelho, in her article, dated January 5, 2026, published by the Macdonald-Laurier Institute, as a commentary on the “Sixth Annual Report on Medical Assistance in Dying”, stated:

Although the report emphasizes self-identified disability, all MAiD recipients are disabled by definition. Disability refers to any long-term impairment that limits participation in life. MAiD is legal for individuals with a “grievous and irremediable” condition, an incurable illness causing irreversible decline in capabilities. Anyone meeting these criteria is by definition disabled, though not all disabled people should qualify for MAiD.

Common conditions listed for Track 2 MAiD reinforce this point. Diabetes appears frequently, and Ontario's MDRC documented a man who received MAiD for an essential tremor. These are disabilities, yet they do not usually cause the serious decline that MAiD is intended to address. By emphasizing self-identified disability, the report obscures the real story: MAiD eligibility targets disabled people, a concern highlighted by the disability community, the United Nations and human rights watchdogs, and most recently, the United Nations Committee on the Rights of Persons with Disabilities.

That UN committee has called for the repeal of track 2 MAID, increased oversight of the law and no further expansion, including the scheduled expansion of MAID for the sole criteria of mental illness.

For instance, Kiano Vafaeian, who was 26, died by euthanasia in Vancouver on December 30, 2025. Kiano was seeking assisted dying in Ontario where he lived, but his requests for MAID were rejected by multiple doctors in Ontario. He then contacted Dr. Ellen Wiebe in Vancouver, British Columbia, who assessed him and approved him for euthanasia.

Margaret Marsilla, Kiano's mother, was shocked that her son, who was living with type 1 diabetes, which did result in his becoming legally blind, was also living with significant mental health issues, which should have been assessed in his approval for MAID. Kiano was approved as a track 2 candidate for MAID. Kiano's family was never consulted, which is important, since he was living with depression and suicidal ideation.

If Kiano's death is the only disturbing MAID death, then one might suggest his death is an outlier. However, in fact, there have been many controversial MAID deaths.

Instead of expanding MAID further, Parliament needs to examine how the current law has led to outcomes such as the death of Kiano. Parliament needs to have a complete review of the law.

More broadly, Canada's assisted dying law is vague. While Health Canada provides guidance, the legal framework allows for wide interpretation, and it lacks effective oversight.

Because of the time constraints, I'll only highlight one key issue. Section 241.2(3) and section 241.2(3.1) of the Criminal Code state that medical practitioners or nurse practitioners are only required to be “of the opinion” that the eligibility criteria are met. Now, we're talking about life and death decisions here. That, in practice, makes accountability extremely difficult, and it makes it impossible to prosecute a medical or nurse practitioner in Canada, even when the MAID death is clearly wrong or deeply disturbing.

The MDRC reports from Ontario and cases that have already been submitted to you speak to that reality.

Canada should not be considering the expansion of MAID or of assisted dying to include people with mental illnesses alone, but rather, Parliament needs to fully review the law.

Thank you.

[The Joint Chair, Liberal, Marcus Powlowski]

Thank you, Mr. Schadenberg.

We go now to our first round of questioning with Ms. Jansen for five minutes.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

My questions are for Alicia Duncan.

Previously at this committee, Jocelyn Downie said in her testimony that nobody who applied for MAID didn't want it. What do you think of that statement? Did your mom really want MAID?

[Alicia Duncan]

My mom told me in the week before her death that she did not want to die, but she just couldn't live like that anymore. She felt she had not received appropriate care.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

You also tried to tell MAID assessors your concerns about your mom, her not eating due to mental illness, and that she wasn't actually dying, just malnourished. What did the MAID assessor tell you in response?

[Alicia Duncan]

I actually have a text message from the MAID assessor, Dr. Grace Park, who said to us that her health had declined with significant weight loss, which put her on a trajectory to foreseeable death. Some blood tests show signs of malnourishment, but they have to be requested specifically. She ended by saying, “If Donna wishes to proceed, there's not much any of us can do to prevent her from accessing her legal option to do so.”

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

What did the blood work from the MAID assessor show?

[Alicia Duncan]

She said that specific blood work would need to be requested. Blood work was actually done in the hospital, and it said—and I'm reading from her medical records right now—“Donna has had a full panel of blood work recently, including a CBC, lytes, liver and renal function, thyroid function, B12 level and a toxicology screen. All her results were normal.”

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

In your previous testimony in 2022, you also spoke to the fact that your mom's GP refused to assess her, because he didn't believe she'd follow through with his recommendations for treatment, but felt obligated to refer her. Was your mom's diagnosis ever diagnosed by someone with expertise?

[Alicia Duncan]

No. My mother's vital statistics death certificate listed MAID, and then the underlying conditions were frailty, cachexia and central sensitivity syndrome. My mother was actually waiting for an appointment with a chronic disease specialist, and that appointment was for two weeks after her death. She never made it to the specialist.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Your mother was euthanized only hours after being released from a psychiatric unit following a suicide attempt. If Canada cannot safely navigate a case like that under the current regime, how can Parliament seriously claim it's ready to expand MAID to mental illness alone?

[Alicia Duncan]

It's completely irresponsible to be expanding this. In a case like this, my mom should have been stopped at many different periods throughout the legal and medical system, and there was nothing that anyone could do to stop it.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

I understand that despite obtaining a Mental Health Act warrant and raising direct concerns with the MAID coordination centre, your family still could not stop your mother's death. What does that say about the ability of families to raise urgent mental health concerns if this regime is expanded to solely underlying mental illness?

[Alicia Duncan]

It goes back to the questioning in our first panel, actually. We are so focused on autonomy that we forget that there's also mercy in this as well. My mom was deemed capable to make this decision for herself, but she was clearly in a mental health crisis. If you can't determine the two of those, then there is absolutely no way we should be expanding this.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

In your mother's case, disordered eating and severe caloric restriction were effectively treated as evidence that death was near. Does that show that behaviour rooted in mental distress can be converted into MAID eligibility, and why should that alarm this committee before 2027?

[Alicia Duncan]

Most concerning, any young person with an eating disorder, or in my mom's case, a 61-year-old who had a lifelong pattern of disordered eating, can restrict their calories so they become frail. For anyone who is frail, under our current regime, their death can be found to be reasonably foreseeable, and they can die now within 24 hours.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

One of the most striking parts of your testimony is that after a MAID death, there's still no reliable way to verify whether the law was followed, because families, police and regulators cannot access the necessary records. If Canada cannot account for the deaths it has already approved, why should it expand eligibility to mental illness as a sole condition?

[Alicia Duncan]

I wish I knew the answer. I have no idea why people think this is a reasonable expectation when we cannot verify deaths are legal currently.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Since your mother's death, many families have contacted you with similar experiences, I understand, showing that her case was not an outlier. What's your assessment of the risk of more of these cases occurring in Canada if we allow MAID for mental illness?

[Alicia Duncan]

There are many points that have been brought up by experts. For me, my biggest concern is that we aren't considering the third party impact for families. I know many people who have been diagnosed with PTSD. My sister and I were diagnosed with PTSD, which, ironically, would qualify us for MAID if this should expand. The studies just haven't been done properly for us to actually understand the full effects of what is going to happen should this expand.

[The Joint Chair, Liberal, Marcus Powlowski]

Thank you.

Mr. Schiefke, you have five minutes.

[Peter Schiefke, Liberal, Vaudreuil, QC]

Thank you, Mr. Chair.

First, I would like to say that I'm happy to be here with my colleagues from the Senate and the House of Commons for this crucial study.

Chair, I'm going to start my questions with Ms. Long.

Ms. Long, first, I want thank you for your work and your advocacy. I was a supporter of medical assistance in dying when our government was faced with the challenge of moving this forward back in 2016. I think that we found the necessary balance in order to provide Canadians with the right to do so.

In this particular instance, though, based on the research that I've done and looking at the testimony received so far including in the last panel as well, we heard Dr. van Os say that the UN Committee on the Rights of Persons with Disabilities, the International Association for Suicide Prevention and lived experiences in Holland say not to move forward with an expansion of MAID in Canada. We heard Dr. van Rooij say that euthanasia requires certainty and we simply do not have certainty when it comes to mental illness. We have had psychiatric associations and many other practitioners who have appeared before committee over the last 15 hours or so of testimony who have said that there is no consensus and that we should not move forward. As recently as just a couple of days ago, the Province of Quebec, where I call home—I represent the community of Vaudreuil in that province—shared a letter with us reiterating the fact that the province has not moved forward or given their support for an expansion. They had conducted their own study, which came to the consensus that they should not move forward. It did not have the public support necessary to do so as well.

Whatever I say here doesn't count. It's your testimony that will make its way into our report and will determine whether we recommend to move forward or not. What are we missing? What are all of these experts, provincial governments, etc., missing? What would be your strongest arguments against what they have said?

[Helen Long]

You've heard from many experts. I would point to testimony from professors Downie and Gilbert around the constitutional challenges. I would point to testimony from psychiatrists like Mona Gupta and the Canadian Psychiatric Association, which has provided guidelines in Quebec and across Canada to move this forward.

I would think about consensus. Before MAID became legal, palliative care physicians argued that palliative care could alleviate all suffering. We now know that isn't the case, and I can point to papers that support that. Others disagreed, but the Supreme Court didn't let that lack of consensus stop the first assisted dying laws.

Consensus is not a requirement. This government is formed and acts without consensus all the time. I think there is a lot of evidence on the table. Canadians support assisted dying. We see numbers for the Carter decision in the 85% range and for medical assistance in dying specific to mental illness in the 80% range. That's across all demographics. Track 2 is supported by Canadians, including those living with a disability. I think there's a breadth of evidence.