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Suicide prediction remains deeply unreliable, raising concerns about MAiD assessment.

Mental suffering often reflects social isolation, trauma, poverty, and hopelessness.

Determining irremediable suffering involves more than diagnosis or symptom severity.

In recent years, Canada’s Medical Assistance in Dying (MAiD) law has changed rapidly in its application. When Bill C-14 came into force in 2016, MAiD was limited to persons with grave and irremediable medical conditions whose natural death was “reasonably foreseeable.” In practice, the law often meant that persons whose suffering was only from psychiatric disease were excluded.

But the situation changed after the Quebec court case Truchon v. Procureur général du Canada, which found the “reasonably foreseeable death” condition unconstitutional. That led to Bill C-7 in 2021, which created two tracks for MAiD. The first track is for individuals whose death is anticipated. The second pathway is for people whose death is not predicted but who “experience a grievous and irremediable medical condition” and who have “voluntarily requested MAiD in the absence of external pressure or influence.” Similar legislation has already been passed in parts of Europe, though how such laws will be applied in Canada is difficult to predict.

While federal politicians continue to wrestle with the implications of these expanded guidelines, the controversy generated can be heard across the political spectrum and has even been........

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