Canadians deserve clearer conversation about MAID

When Canada legalized medical assistance in dying in June 2016, the public debate focused largely on one situation: people facing the end of life and suffering intolerably.

For many Canadians, that remains their understanding of the law today.

But Canada’s MAID framework has evolved significantly since then. In 2021, Parliament expanded the law through Bill C-7, creating two pathways for assisted death. The first pathway applies to people whose natural death is imminent and expected soon (reasonably foreseeable).

The second — known as “Track 2” — allows separate access to MAID for individuals with disabilities who are not dying.

This expansion fundamentally changed the scope of assisted dying in Canada.

Track 2 means that assisted suicide may be available to people living with disabilities even when they are not nearing the end of their lives. Thousands of Canadians have already accessed MAID through this pathway. Between 2021 and 2024, a total of 2,050 people died from Track 2 MAID.

This shift raises profound questions about how Canada responds to suffering.

People with disabilities and disability organizations across the country have warned that Track 2 creates serious risks. Many individuals seeking MAID have described suffering related not to medical conditions alone but to poverty, housing insecurity, social isolation or lack of disability supports.

These are not medical failures. They are social failures.

For people with intellectual disabilities and many others in the disability community, the concern is straightforward: no one should feel that assisted suicide is easier to access than the support needed to live with dignity.

Canada continues to struggle with persistent gaps in disability supports. Many people with disabilities live in poverty. Accessible, affordable housing remains scarce. Access to mental health care and community support is lacking across the country.

Against this broken backdrop, expanding assisted death beyond end-of-life situations risks sending a troubling message — that the suffering created by social inequality can be addressed through assisted suicide rather than social reform.

And now Parliament is once again debating whether to expand MAID further to also include mental illness. But what happened to suicide prevention? Are people with disabilities not entitled to the same suicide prevention as everyone else?

The Special Joint Committee on Medical Assistance in Dying (which includes Manitoba senator Gigi Osler) has heard testimony from witnesses against the expansion of MAID to those whose sole underlying condition is a mental illness. It heard overwhelming evidence about the multitude of problems with Track 2 MAID. The chairs of psychiatry at Canadian medical schools have urged an indefinite pause. The Centre for Addiction and Mental Health told the committee there are no established criteria for determining when a mental illness is irremediable.

Legitimate questions have been raised about whether Canada’s current framework adequately protects people who are living with structural disadvantage.

These questions are now before the courts. A coalition of disability organizations, including Inclusion Canada, has launched a Charter challenge arguing that Track 2 violates equality rights and the right to life guaranteed under the Canadian Charter of Rights and Freedoms.

The case asks whether Canada’s laws are discriminating against people with disabilities by allowing assisted death in circumstances where death is not imminent.

Canadians should agree on one principle: people with disabilities deserve the same commitment to dignity, support and opportunity as anyone else.

Persons with disabilities deserve the same response other Canadians receive when they are suffering: investment in supports, housing and mental health services, not a faster path to death. Our politicians should be helping people live meaningful lives, not end them.

Krista Carr is chief executive officer of Inclusion Canada. She was a witness before the Parliamentary Special Joint Committee on Medical Assistance in Dying.