‘Rushed process’: Experts clash on whether medically assisted dying system ready for expansion by March

OTTAWA — Leading experts involved in developing an expansion of Canada’s medically assisted dying regime to people whose sole underlying condition is a mental disorder are at odds over whether the expansion should be delayed.

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One expert says a delay would ease pressure on the “rushed process” of developing practice guidelines for the complex cases, saying that training modules for practitioners won’t be ready until the end of this year or early next year at the earliest. But another expert says more waiting is not necessary.

The system was slated to include such patients beginning next March after a two-year sunset clause built in to a 2021 update to the medical assistance in dying or MAID law.

Despite an expert panel determining that the proper safeguards are in place, the federal government announced last week that it intends to legislate further delay. It has not indicated for how long.

“Not everybody is ready,” Justice Minister David Lametti said when he made the announcement.

Madeline Li, a cancer psychiatrist who sits on several MAID-related panels, says the Liberal government is still working on developing the practice guidelines around cases with patients whose only underlying condition is a mental disorder.

She said she was pleased with the decision to delay the expansion, and the delay will allow her and others to “properly develop” the guidelines.

“We really didn’t start preparing for this until fairly recently,” she said, adding the government didn’t convene its panel to develop the guidelines until the fall. “They’ve very quickly put it together. It was just a few months ago that this panel was convened to have a first draft.”

“We needed to get the whole thing done by March, so it’s been a rushed process, but we haven’t actually gone through the evidence-based rigor,” she said.

Once they are finalized, Li said the guidelines will be sent to provincial and territorial bodies to be incorporated into regulations, and then built into professional practice through medical colleges.

“All of that was supposed to be done before March, which would never have happened,” said Li. “Now we have the time to do that.”

Li said that training modules for the expansion are still being developed.