Manitoba supports MAID delay: Asagwara

The number of Manitobans receiving medical assistance in dying in 2026 is on track with previous years while the plan to extend it to those suffering from mental illness is delayed indefinitely by the federal government — a move Manitoba’s health minister supports.

“There’s so much more work that needs to be done,” Uzoma Asagwara said.

The parliamentary committee that issued its recommendation in June was the third special committee of Parliament struck to assess the eligibility of people with mental illness since 2021, when MAID eligibility was expanded to include people who were not at the end of their lives.

A key condition for MAID eligibility is that a patient must be suffering from a grievous and irremediable medical condition.

Witnesses who appeared before the committee — including psychiatrists — argued there is no consensus in the medical field on how to determine whether a patient has any prospect of getting better. Disability organizations, mental-health advocates, clinicians, researchers and people with lived experience consistently raised concerns about the risks associated with the expansion.

In 2024, when the federal government announced that MAID for mental illness was being delayed until 2027, some — including Brandon’s Cathy Van Buskirk, who has long suffered with an obsessive-compulsive disorder that includes major depression and anxiety — spoke out about her disappointment.

At the time, she said that decades of treatment and medication had stopped working for her illnesses. After learning that MAID has now been delayed indefinitely, Van Buskirk this week declined an interview.

Dying With Dignity Canada called the indefinite delay “extremely disappointing and discriminatory.”

“We believe it is time for the government to eliminate the exemption from MAID eligibility for persons whose sole underlying medical condition is a mental illness,” chief executive officer Helen Long said Thursday.

So do most Canadians, the non-profit advocacy group’s leader said in an email. Polling has shown that 80 per cent of people across the country support MAID eligibility for people with grievous and irremediable mental illness, with appropriate safeguards in place, Long said.

The Canadian Psychiatric Association released a “comprehensive, thoughtful, evidence-based guideline for how to put MAID for mental illness into practice,” she said.

Long also pointed to Health Canada testimony earlier this year to the parliamentary committee. It said that all provinces, except Alberta and Quebec, were expecting to be in a position by 2027 to offer MAID to people whose sole underlying medical condition is a mental illness.

However, Manitoba would not have been ready, the province’s health minister said in an interview.

“We are not in support of MAID being in place for mental-health reasons at this time without a substantial amount of work being done at all levels of government to ensure that Canadians who are navigating mental-health issues have the full breadth and scope of mental-health services that they need in order to take care of their mental health and well-being,” Asagwara said.

During the first six months of this year, 111 Manitobans received medical assistance in dying, Shared Health said. Cancer was the most common reason, cited in 82 of the 111 deaths. Assisted deaths in Manitoba have averaged about 220 per year since 2019.

“We are not in support of MAID being in place for mental-health reasons at this time without a substantial amount of work being done at all levels of government.”

That number was expected to increase in 2027 with the expansion of eligibility for those with mental illness — until the parliamentary committee recommended in June that the federal government indefinitely exclude them.

“I think the delay reflects how difficult this decision is,” said Max Rady College of Medicine instructor Salina Pirzada. The clinical researcher in the psychiatry department at the University of Manitoba is the lead author of a study published in the International Review of Psychiatry in June. It found that requests for hastened death are often linked with psychological distress, social vulnerability and unmet psychosocial needs rather than physical pain alone.

“My study is the first Canadian study to try and understand why Canadians, particularly patients in palliative care, are requesting MAID,” Pirzada said in an interview.

The study asked patients sweeping questions about their lived experiences and psychological distress while measuring suffering when it comes to anxiety and depression.

She believes her findings could help Canada’s approach to MAID for mental illness.

“I think what we need to really apply when it comes to MAID for mental illness is this broader, more holistic approach,” she said Thursday.

“Let’s understand the whole person behind this request, not the person who’s sitting in front of you saying at that time they want MAID; what led them to making this request? I think that my results will be highly informative for health policy, but also for end-of-life care.”

Asagwara, who remains a registered psychiatric nurse, says the province is focused on “doing everything we can to support people living with mental-health challenges and making sure that we have a robust mental health-care system in place that is universal and serves the needs of all people in all communities everywhere.”

carol.sanders@freepress.mb.ca