Claire Brosseau has been watching parliamentary committee hearings, telecast from Ottawa, for the past couple of weeks, and despairing.
The Special Joint Committee on Medical Assistance in Dying is considering the question of whether people with mental illness, such as Ms. Brosseau, ought to have the same access to physician-assisted death as Canadians with physical diseases.
Medically assisted dying is becoming a standardized part of health care in Canada, according to the federal government’s latest report on the practice. One in five Canadians say they know someone who has had an assisted death, and opinion polling shows broad public support.
But the debate about whether people with mental disorders should be excluded continues. The parliamentary hearings have been dominated by psychiatrists who argue that it is impossible to assess if a mental illness is incurable, and unethical to offer assisted death to a person whose suicidal impulse may be a symptom of their illness.
Ms. Brosseau wrote to the committee and asked to be a witness herself. She was not invited.
“The perspective that they’re not hearing is that of people who live with irremediable mental illness, people who tried everything,” she told me this week. “There are people, like me, who don’t get better. When people with cancer have tried 10 treatments we don’t tell them they have to keep living, in pain, in case something else comes along. The witnesses they’re hearing from are not talking about the reality that this exclusion to the law creates.”
[Read: Claire Brosseau Wants To Die. Will Canada Let Her?]
Ms. Brosseau, 49, is a former actor and standup comic who has had a life of adventure, glamour and deep friendships. She has also, since she was a small child, lived with profound emotional pain and a desire to die. She has bipolar disorder and a long list of other mental health illnesses. She has tried two dozen different medications and as many kinds of therapies and treatments, none of which brought her more than fleeting relief. These days, she rarely leaves her small Toronto apartment; she has cut herself off almost entirely from the world.
I got to know Ms. Brosseau several years ago, when I was in the early days of reporting a series of stories about assisted dying around the world and the challenges that have emerged in jurisdictions where the practice has been legal for some time.
From the Netherlands, I told the story of Irene Mekel, a woman with Alzheimer’s, and the health system reluctant to handle her request to die. From Colombia, I told the story of a cancer patient determined to get her country to talk about her assisted death.
[Read: She’s Trying To Stay Ahead of Alzheimer’s, in a Race to the Death]
In Canada, the challenging issue is assisted death for mental disorders. The public debate has been largely led by psychiatrists who say these patients must be excluded on the basis of their diagnosis — Canada is the only country which allows assisted death for people at the end of life to make this exclusion — and by disability-rights activists who say people are choosing assisted death because the health and social welfare systems fail them.
For my Canadian story, I talked to many experts, advocates and people living with mental illness. In the end, I told Ms. Brosseau’s story. In addition to more than 40 hours of interviews with her, I had access to her journals, her family and, critically, her psychiatrists. They have treated her for years and are divided about whether assisted death is her best choice. Through them, I saw the most complex and nuanced — and human — aspect of this issue.
In 2021, when Canada legalized assisted death for people with intolerable suffering who are not at the end of life, Ms. Brosseau thought she would finally be able to avoid a self-inflicted and painful death. However, people with mental disorders were excluded from eligibility for two years. That initial delay was extended by one year, and then two more. The exclusion is now set to expire in March 2027.
After the review currently underway, the parliamentary committee could recommend that the government permanently ban access for people with mental health disorders by passing new legislation; or recommend that it delay access longer; or that it allow the current ban to lift automatically as scheduled. It seems like a low priority for the Carney government, which is focused on trade, infrastructure, energy and defense issues.
The courts may decide the issue before next March in any case. Three years ago, Ms. Brosseau joined the advocacy organization Dying With Dignity, asking the Ontario Superior Court to end the mental health exclusion on the grounds that it is discriminatory to bar some people from access to medically assisted death on the basis of their diagnosis.
The new Health Canada data shows that 16,499 Canadians had a physician-hastened death in 2024. That’s an increase in the total number over the previous year, but the overall rate of growth has slowed, suggesting that the number of requests for the procedure is stabilizing. As in previous years, the vast majority of assisted deaths — 96 percent — were for people at the end of life, most of them cancer patients.
But the issue continues to be litigated. Ms. Brosseau’s is one of three major legal cases underway regarding assisted dying — and recent events in Alberta are likely to spur a fourth.
The Smith government has passed a law that restricts access to assisted death in Alberta to anyone who has a life expectancy of 12 months or fewer — explicitly eliminating what’s called Track 2 access, for people with chronic, incurable and intolerable conditions who might otherwise live for years. Because the bill emphasizes penalties for providers, it is expected to create a chill that sharply reduces access to the procedure.
Alberta’s new bill clearly contradicts federal law, and it creates a complicated situation for Prime Minister Mark Carney, who only recently mended fences with Alberta’s premier, Danielle Smith. (The assisted-dying law is part of the Criminal Code.) Someone will most likely challenge the Alberta bill in court, but there are no signs yet that the challenge will come from the federal justice ministry.
The Supreme Court of British Columbia recently heard arguments in a Charter challenge against the provincial government and Providence Health Care, a Catholic-run organization that operates publicly funded facilities including St. Paul’s Hospital in Vancouver. The case was brought by the family of a young woman with cervical cancer who was forced to make a painful transfer from St. Paul’s to a hospice in the last hours of her life, because the hospital refused to allow her doctor to provide an assisted death on site.
[Read: A Cancer Patient Chose Assisted Death. It Wasn’t Her Last Hard Choice.]
Lawyers for her family argued that allowing faith-based publicly funded facilities to refuse patients access to assisted dying violated their Charter rights to life, liberty and security of the person. Lawyers for Providence — and the provincial government — argued that the Charter also protected religious freedom for religious institutions.
The outcome of this case will have national ramifications and may well end up in front of the country’s highest court. If the B.C. court finds that religious health care institutions cannot opt out of allowing the provision of medically assisted deaths by willing providers on their premises, there are implications for abortion and other services those institutions currently refuse to provide.
A third major case, also before the Ontario Superior Court, has been brought by a coalition of disability rights groups, who want Track 2 access repealed. They argue that by creating a specific pathway for people with disabilities to end their lives when they are not dying, the federal government has violated the Equality Rights section of the Charter.
For Ms. Brosseau, watching a debate about how she will be permitted to die, the timelines seem impossible. “I won’t make it,” she said to me this week. “I wish I could, but I can’t.”
If you are having thoughts of suicide, call or text 988 to reach the National Suicide Prevention Lifeline, or go to SpeakingOfSuicide.com/resources for a list of additional resources.
Trans Canada
This section was compiled by Shawna Richer, the Canada editor at The Times.
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Stephanie Nolen is the global health reporter for The Times. She lives in Nova Scotia.
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