A leaked internal memo from Canada’s health ministry has exposed a fresh crisis in the nation’s assisted dying regime. The document, obtained by this newspaper, details the case of a 34-year-old woman with a history of severe depression and anxiety who applied for medical assistance in dying (MAID) citing her mental suffering as “intolerable.” Her plea: a “safe death” free from the stigma of suicide. The case has reignited a furious debate over the expansion of Canada’s euthanasia laws, which now permit assisted death for people with mental illnesses as their sole underlying condition.
Sources close to the review board confirm that the woman, identified only as ‘Patient K’ in the memo, was deemed eligible under the revised criteria that took effect in March 2023. The law, once restricted to those with a “reasonably foreseeable” natural death, now covers individuals with “grievous and irremediable” medical conditions, including mental disorders. Critics argue this is a dangerous expansion. “We are effectively telling the mentally ill that their suffering is best ended by a doctor’s needle,” said Dr. Ellen Thompson, a psychiatrist at the University of Toronto who has publicly opposed the law. “We have failed to provide adequate mental health care, and now we are offering death as a solution.”
The memo reveals that Patient K had been in treatment for nearly a decade, including multiple hospitalisations and electroconvulsive therapy. Yet her condition was deemed “irremediable” by two independent assessors, a requirement under the law. The assessors’ reports, summaries of which are included in the memo, note that she had “exhausted all reasonable treatment options.” But it is this very determination that has sparked outrage. Advocacy groups for the disabled and mental health survivors argue that the concept of “irremediable” is subjective and fails to account for future medical advances. “How can you say someone’s condition is irremediable when we don’t know what treatments might emerge in five years?” asked Maria Sanchez, director of the disability rights group Not Dead Yet Canada.
The woman’s application was ultimately approved, though it is unclear if she proceeded with the procedure. The memo warns of a “potential spike” in similar cases and calls for an urgent review of safeguards. It notes that since the law expanded, applications for MAID on mental health grounds have increased by 40% compared to the previous year. The Ministry of Health declined to comment on the memo, citing privacy concerns. But a spokesperson issued a statement reaffirming the government’s commitment to “compassionate end-of-life options” while ensuring “robust safeguards.”
The controversy places Canada at the centre of a global debate on euthanasia. Belgium and the Netherlands allow assisted dying for mental illness, but Canada is the only country without a mandatory waiting period for psychiatric patients. Opponents point to a 2023 report from the Canadian Institute for Health Information that found 3% of MAID recipients cited mental illness as the sole reason for their request. That figure is expected to rise.
Patient K’s case has undeniably struck a nerve. It raises uncomfortable questions about the limits of autonomy and the duty of the state in providing hope, not just an exit. As one senior psychiatrist involved in the case confided, “We are crossing a line from which there is no return. The question is not whether this woman had the right to die. It’s whether we have the right to let her.”
