Questions and responses 45th Parliament, 1st session May 26, 2025, to present

With regard to the government’s medical assistance in dying policy and preparations to expand eligibility to individuals whose sole underlying condition is a mental illness by March 2027: (a) what internal committees, working groups or advisory bodies are currently responsible for developing the framework for this expansion; (b) what consultations have been conducted since 2023, including, for each, the (i) dates, (ii) participants, (iii) summaries of written submissions received; (c) what draft guidelines, risk analyses or policy options have been circulated within the government or to external stakeholders; (d) what plans exist for formal parliamentary scrutiny prior to 2027, and will those plans include the tabling of all analyses and documents so Parliament and the public can review the work undertaken; (e) what safeguards, assessment criteria and clinical protocols is the government considering, particularly given the lack of consensus regarding the irremediability of mental illness; (f) since 2023, has the government consulted independent experts, including human rights experts, regarding potential impacts on vulnerable Canadians; (g) what concerns, warnings or dissenting opinions have been raised by federal officials, external experts or researchers; (h) what recommendations have been made to mitigate the risks identified in these analyses or consultations; (i) have any government analyses assessed the policy option of not proceeding with the expansion, in light of evidence that medical assistance in dying for mental illness cannot be implemented safely within an acceptable margin of risk to vulnerable Canadians; (j) how is the government working to protect the conscience rights of physicians who oppose medical assistance in dying, in light of recent Health Canada guidance encouraging clinicians to raise medical assistance in dying as an option; and (k) what complaints, reviews or appeals has the government received regarding medical assistance in dying delivery, and how it is addressing ongoing transparency concerns surrounding medical assistance in dying cases?

With regard to federal oversight of medical assistance in dying: (a) how many cases of medical assistance in dying where safeguards were found not to have been followed have been reported to Health Canada since 2016, broken down by year and province; (b) what corrective or enforcement actions were taken in each case; (c) what audits or spot reviews, if any, has Health Canada conducted of medical assistance in dying case files to verify compliance with Criminal Code safeguards; and (d) what measurable outcomes or indicators does the government use to assess whether medical assistance in dying safeguards against coercion are effective, particularly for persons with disabilities, those in poverty and Indigenous Canadians?

With regard to federal health funding and medical assistance in dying: (a) how much federal funding has been allocated annually since 2016 to expand palliative care services, in total, and broken down by province or territory; (b) how much federal funding has been allocated annually since 2016 to administer or support medical assistance in dying; (c) what measures has the government taken to track the number of medical assistance in dying requests where the applicant cited lack of access to mental health care, palliative care, or disability supports as a motivating factor; (d) how has the government evaluated whether insufficient access to care is driving vulnerable Canadians toward medical assistance in dying rather than recovery-oriented supports; (e) what tangible steps, with dollar figures, has the government taken to ensure that access to adequate mental health treatment, including timely psychiatric care, counselling, and community supports, is guaranteed for Canadians before medical assistance in dying is considered as an option; and (f) what measures has the government taken to track the number of medical assistance in dying requests where the applicant cited lack of access to mental health care, palliative care, or disability supports as a motivating factor?

With regard to medical assistance in dying and Veterans Affairs Canada, since September 2022: (a) how many times has a (i) Veterans Affairs Canada employee, (ii) third-party contracted by Veterans Affairs Canada, advised, suggested, or discussed medical assistance in dying with a veteran; (b) what is Veterans Affairs Canada's current policy regarding its (i) employees, (ii) contractors, suggesting medical assistance in dying to veterans; and (c) on what date did the policy in (b) come into effect?

With regard to government statistics on medical assistance in dying: (a) what is the projected release date of (i) the sixth annual medical assistance in dying report for the calendar year of 2024, (ii) the report on the key findings of the national conversation on advance requests consultation, which ran from November 2024 to February 14, 2025, (iii) the report of the Engagement on Indigenous Perspectives on Medical Assistance in Dying consultation, which ran from August 17, 2023, to June 30, 2024; and (b) what (i) are the total number of requests and outcomes (withdrawn requests) for Track 1 and Track 2 medical assistance in dying cases in (a)(i), (ii) are the results from the round tables hosted by the government to discuss advanced requests in a(ii), (iii) is the breakdown of views shared by participants in the online questionnaire open to the public in (a)(ii), (iv) are the results from the report in (a)(iii)?

With regard to government statistics on the Medical Assistance in Dying Program and human organ donation, since June 2016: (a) how many individuals that applied for medical assistance in dying included a referral for organ donation, broken down by (i) year, (ii) province or territory, (iii) age, (iv) gender; (b) of the referrals for organ donation in (a), how many were excluded for the following reasons (i) being medically unsuitable, (ii) consent for donation not being obtained after medical assistance in dying, (iii) patient withdrawing from the medical assistance in dying process, (iv) the patient dying before medical assistance in dying, (v) other reasons; (c) of the referrals for organ donation retained in (a), how many individuals become actual organ donors, broken down by (i) year, (ii) province or territory, (iii) type of organ, (iv) age, (v) gender; (d) how many organs from Canadian medical assistance in dying donors are sent abroad, broken down by (i) year, (ii) province or territory of the donor, (iii) age of the donor, (iv) gender of the donor, (v) country of the recipient, (vi) type of organ; (e) what is the percentage of all deceased organ donors that involved medical assistance in dying, broken down by year and province or territory; (f) does the government require export permits for human organs being transported out of the country, and, if so, how many have been issued each year since 2016; and (g) is the government aware of any cases of organ donation involving medical assistance in dying that contravened section 240.1 of the Criminal Code, and, if so, what are the details of each, including whether or not charges were laid?

With regard to Health Canada and the Public Health Agency of Canada, and any policies, programs, agreements, or initiatives related to organ and tissue donation, including where medical assistance in dying is involved: (a) is the government planning to request or recommend that the provinces and territories make changes or amendments to their Human Organ and Tissue Donation Acts (or equivalent legislation), including, but not limited to, (i) introducing or expanding deemed consent including opt-out systems, (ii) changing consent requirements or procedures for organ or tissue donation in the context of medical assistance in dying, (iii) modifying any provisions relating to next-of-kin consent, substituted decision-making or informed consent; (b) if the answer to (a) is affirmative, for each province or territory, what changes have been requested or proposed, and on what dates, and through what mechanism (letters, working groups, federal- provincial-territorial tables); (c) does the medical assistance in dying assessment or consent process, including any federal medical assistance in dying guidance or model forms, include an explicit opt-in or opt-out provision regarding organ or tissue donation; (d) are there any current or planned changes to the forms, guidance, or processes referenced in (c) that would alter how consent for organ or tissue donation is sought from medical assistance in dying patients (for example, making donation discussion mandatory, changing timing, or changing who raises the topic); (e) at what point in the medical assistance in dying process (before final consent, after final consent, during eligibility assessment) are patients first informed about the possibility of organ or tissue donation, and by whom; (f) what safeguards, if any, are in place to ensure that (i) medical assistance in dying eligibility and decision-making are fully independent from any organ or tissue donation considerations, (ii) medical assistance in dying patients are not unduly influenced, coerced or incentivized to consent to donation, (iii) health care providers and organ donation organizations avoid conflicts of interest; (g) since January 1, 2020, broken down by calendar year and by province or territory, what is the (i) number of medical assistance in dying patients referred for organ or tissue donation, (ii) number of referred medical assistance in dying patients assessed as eligible for organ or tissue donation, (iii) number of eligible medical assistance in dying patients who were approached regarding organ or tissue donation, (iv) number of medical assistance in dying patients who provided consent to organ or tissue donation, (v) number of organs recovered and utilized for transplantation from medical assistance in dying donors, by organ type (kidney, liver, lung, heart, pancreas, etc.), (vi) number of tissues recovered and utilized from medical assistance in dying donors, by tissue type (corneas, heart valves, bone, skin, etc.), (vii) average number of organs transplanted per medical assistance in dying donor, by year, and, where data is not available or not collected, for which variables, years, or jurisdictions is this the case and why; (h) starting in 2020, broken down by calendar year and by organ and tissue type, (i) how many Canadian organs and tissues were exported outside Canada for transplantation, research, or any other purpose, (ii) for each exported organ or tissue type, what was the destination country and intended use category (therapeutic transplant, research, education, commercial use), (iii) how many of these exported organs or tissues originated from medical assistance in dying donors, if known; (i) for the exported organ and tissue donations identified in (h), (i) what fees, charges, or other financial or in-kind consideration were associated with each organ or tissue type (cost-recovery, procurement fees, transport, logistics charges, processing fees), (ii) for each fee or charge, who or what entity received the payment, (iii) does the federal government have any policies, agreements or guidance regarding cost-recovery, commercialization or prohibition of profit in relation to organ and tissue export, including those from medical assistance in dying donors; (j) what policies, guidelines or ethical frameworks does Health Canada or the Public Health Agency of Canada rely on to ensure that organ and tissue donation practices, including those involving medical assistance in dying patients, comply with the Canadian Charter of Rights and Freedoms, international human rights obligations, and the principle of free and informed consent; (k) since 2020, have there been any internal reviews, audits, complaints or investigations (including by ethics bodies, ombudspersons or human rights commissions) related to (i) organ and tissue donation in the context of medical assistance in dying, (ii) the export of Canadian organs and tissues; (l) if the answer to (k) is affirmative, what are the details, including the dates, the bodies involved, the nature of the concerns and any findings or corrective actions taken; and (m) are there any federal agreements, memoranda of understanding or funding conditions with provincial and territorial organ donation organizations or transplant programs that reference medical assistance in dying, organ or tissue donation from medical assistance in dying patients or export of organs and tissues, and, if so, what are the details and the dates?

With regard to Track 2 medical assistance in dying provisions under section 241.2(3) of the Criminal Code since the passage of Bill C-7 on March 17, 2021: (a) how many Track 2 medical assistance in dying provisions occurred in each calendar year from 2021 to 2024, broken down by province and territory; (b) what categories of underlying medical condition are recorded in the federal medical assistance in dying monitoring data for Track 2 provisions; (c) for each category identified in (b), how many Track 2 medical assistance in dying provisions occurred from 2021 to 2024, broken down by year and by province or territory; (d) of the Track 2 medical assistance in dying recipients from 2021 to 2024 who self-identified as having a disability, how many were women, broken down by year and by province or territory; (e) for each year from 2021 to 2024, how many Track 2 medical assistance in dying requests were assessed as ineligible, broken down by province or territory and by reason for ineligibility, including, if tracked, cases in which the irremediability criterion was found not to have been met; and (f) has the government, or any federally-funded body, conducted any audit, review, evaluation, or other assessment of whether the irremediability criterion is being applied consistently in Track 2 cases, including whether treatment and support options have been adequately considered before a finding of irremediability is made, and, if so, what are the dates and titles of those documents and what were the findings or conclusions of those documents?

With regard to the government's response to the Concluding Observations on Canada adopted by the United Nations Committee on the Rights of Persons with Disabilities on March 18, 2025, and the recommendation for the Government of Canada to repeal the 2027 expansion of medical assistance in dying to persons whose sole underlying medical condition is a mental illness, and with respect to any equality rights analysis of Track 2 medical assistance in dying provisions under section 15 of the Canadian Charter of Rights and Freedoms: (a) has the government prepared a formal written response to the Committee's medical assistance in dying related recommendations, and, if so, what is the date of that response or its expected release date, and, if not, why not; (b) what interdepartmental or intergovernmental meetings have occurred since March 18, 2025, to consider the medical assistance in dying related recommendations in the Concluding Observations, and, for each meeting, what was the date, which departments or agencies participated, and what decisions, action items, or next steps were recorded; (c) has the Department of Justice conducted or commissioned any legal analysis of the consistency of Track 2 medical assistance in dying with Articles 10 and 15 of the Convention on the Rights of Persons with Disabilities since March 18, 2025, and, if so, what are the dates, titles, and findings of each; (d) has the Department of Justice conducted or commissioned any section 15 Charter analysis of the Track 2 medical assistance in dying provisions since the passage of Bill C-7 in 2021, and, if so, what are the dates, titles, and findings of each, and, if not, why not; (e) has the Department of Justice or any other federal department or agency produced any internal report, memorandum, briefing note, or evaluation regarding the implications of the decision in Truchon v. Attorney General of Canada for the equality rights of persons with disabilities nationally, and, if so, what are the dates and titles of each of those documents; and (f) since March 18, 2025, what consultations, meetings, or correspondence has the government had with disability organizations specifically regarding the medical assistance in dying related recommendations in the Concluding Observations, and, for each, what was the date, which organizations participated, and what follow-up action, if any, was taken?

With regard to the use of medical assistance in dying by federal inmates: (a) what is the total number of federal inmates who have used medical assistance in dying in each year since legalization; (b) what is the total number of federal inmates who have used medical assistance in dying in each institution and in each province, in each year since legalization; (c) what is the total number of federal inmates who have requested medical assistance in dying in each year since legalization; (d) what is the total number of federal inmates who have requested medical assistance in dying in each institution and in each province, in each year since legalization; (e) for (a), (b), (c) and (d), how many and what proportions were (i) female, (ii) Indigenous, (iii) Black, (iv) a visible minority; and (f) for (a), (b), (c) and (d), how many and what proportions (i) sought or received track 1 medical assistance in dying, (ii) sought or received track 2 medical assistance in dying, (iii) received medical assistance in dying while in prison, (iv) received medical assistance in dying at a location outside of prison?

With regard to the government's commitment to undertake research providing insights into the reasons why people seek medical assistance in dying and the views and experiences of medical assistance in dying among key populations: (a) what studies, surveys, or research projects have been initiated, funded, commissioned, or completed by the government since January 1, 2024, on the reasons for medical assistance in dying requests; (b) for each study, survey, or research project in (a), what were the results or findings; (c) what variables related to social determinants of health and structural vulnerability were included in each study, including, but not limited to, income insecurity, housing insecurity, disability supports, access to mental health care, and social isolation; (d) what research or tools have been developed to detect or assess coercion, inducement, or "choice under constraint" in medical assistance in dying requests, including for Track 2 cases; and (e) what findings exist on the relationship between medical assistance in dying requests and socio-economic deprivation or unmet social needs?

With regard to government information on Canadian and international experiences with medical assistance in dying: (a) what comparative studies has the government conducted on psychiatric medical assistance in dying in Belgium, the Netherlands or other jurisdictions; (b) which safeguards adopted abroad to mitigate risks of premature or inappropriate psychiatric medical assistance in dying have not been implemented in Canada, and why; and (c) how does Canada’s medical assistance in dying regime compare internationally in terms of permissiveness, oversight and eligibility thresholds?

With regard to the government's approach on medical assistance in dying and the term "mental illness" as used in subsection 241.2(2.1) of the Criminal Code, introduced through Bill C-7 in 2021, which forms the basis of the current temporary exclusion from medical assistance in dying for persons whose sole underlying medical condition is a mental illness, and which is scheduled to lift on March 17, 2027: (a) what is the definition of "mental illness" as used in subsection 241.2(2.1), and in which statute, regulation, guidance document, legal instrument, or other authority is that definition established; (b) if "mental illness" is not defined in the Criminal Code or any other federal law or instrument, what clinical, diagnostic, legal, or policy authority does the government rely upon to determine the scope of that term for the purposes of subsection 241.2(2.1); (c) has the government, since the May 2022 final report of the Expert Panel on Medical Assistance in Dying and Mental Illness, adopted, endorsed, or relied upon any formal definition or interpretation of "mental illness" for the purposes of subsection 241.2(2.1), and, if so, what is that definition or interpretation, by what authority was it adopted, and on what date; (d) what specific clinical conditions does the government consider to fall within the meaning of "mental illness" for the purposes of subsection 241.2(2.1), and what clinical or legal source does the government rely upon for each; (e) what specific clinical conditions does the government consider to fall outside the meaning of "mental illness" for the purposes of subsection 241.2(2.1), such that a person whose sole underlying medical condition is one of those conditions would not be subject to the exclusion, and what clinical or legal source does the government rely upon for each; (f) has the Department of Justice, the Department of Health, or any other federal department or agency produced any legal analysis, policy analysis, or formal opinion on the scope of the term "mental illness" in subsection 241.2(2.1), including which conditions are captured and which are not, and, if so, what are the dates and titles of those documents; and (g) before the exclusion is scheduled to lift on March 17, 2027, by what specific mechanism, including whether legislative definition, regulatory guidance, clinical practice standards, or judicial interpretation, will the boundaries of the term "mental illness" be established, and what steps has the government taken, or does it plan to take, to ensure consistent interpretation and application of that term across all provinces and territories?

With regard to the government's decision to make persons with sole mental illness eligible for medical assistance in dying: (a) what evidence has the government reviewed to demonstrate that irremediability in mental illness can be reliably predicted; (b) what studies, data, or expert consultations has the government undertaken or reviewed regarding the long-term outcomes of patients with mental illness who may have wished to seek medical assistance in dying in the past, but later recovered or found effective treatment, and how was this evidence weighed in the decision to expand eligibility; (c) what consultations were undertaken with psychiatric associations, disability advocates, and Indigenous leaders prior to confirming the expansion; (d) how did the government respond to warnings from psychiatric and medical experts that suicidality is a symptom of mental illness and cannot be distinguished from eligibility for medical assistance in dying; (e) what safeguards does the government plan to implement to ensure persons with depression, post-traumatic stress disorder, or other treatable conditions are not prematurely deemed eligible for medical assistance in dying; (f) what analysis has the government conducted to assess whether such an expansion could undermine national suicide prevention strategies; and (g) how does the government plan to reconcile the expansion of medical assistance in dying with its obligations under the Federal Framework for Suicide Prevention?

With regard to the collection and monitoring of medical assistance in dying data under the Regulations for the Monitoring of Medical Assistance in Dying: (a) what specific data elements are collected at the federal level for each medical assistance in dying request and provision, including any data fields related to socio-economic status, access to health services, or social vulnerability; (b) what data elements are collected by each province and territory beyond the federal minimum requirements, including whether each jurisdiction collects any direct measures of social determinants of health such as housing status, income insecurity, social supports, or access to mental health care; (c) what changes, if any, have been made to medical assistance in dying data collection instruments, reporting forms, or guidance documents since January 29, 2024; (d) has the government proposed, drafted, or consulted on further amendments to the monitoring regulations since January 29, 2024, and, if so, what amendments and timelines are being considered; and (e) what assessment has been conducted by Health Canada regarding the adequacy of current medical assistance in dying monitoring to detect coercion, inducement, or structural vulnerability in medical assistance in dying requests, particularly for potential medical assistance in dying where a mental disorder is the sole underlying medical condition cases?

With regard to federal expenditures related to medical assistance in dying, palliative care, and disability supports: (a) beyond the budget 2021 allocation previously disclosed for medical assistance in dying related training, resources, and tools, what federal expenditures have been incurred specifically in connection with medical assistance in dying, including the administration and operation of the federal medical assistance in dying monitoring regime, regulatory administration, secretariat support for the Federal-Provincial-Territorial Assistant Deputy Minister Committee on Medical Assistance in Dying, legal costs related to medical assistance in dying legislation or litigation, and any other departmental expenditures attributable to medical assistance in dying, broken down by expenditure category and fiscal year; (b) of the funding previously cited by the government under the budget 2017 home and community care allocation and the Aging With Dignity bilateral agreements, what portion was directed exclusively to palliative care, as distinct from home care, long-term care, and other continuing care priorities, broken down by fiscal year and province or territory; (c) what total federal expenditure has been directed through Health Canada's Health Care Policy and Strategies Program specifically to palliative care access, hospice infrastructure, and palliative care training since fiscal year 2021-22, broken down by initiative or recipient and by fiscal year, and, separately, what total has been directed specifically to medical assistance in dying related activities through the same program over the same period; (d) what total federal expenditure has been directed specifically toward community-based disability supports and independent living programs since fiscal year 2021-22, broken down by responsible department, program or initiative, and fiscal year; and (e) has the government conducted any comparative analysis of federal investment in medical assistance in dying related infrastructure, palliative care access, and community-based disability supports since 2016, and, if so, what are the dates and titles of those analyses?

With regard to Health Canada's internal policy document entitled "Mental Illness and Mental Disorder", produced in October 2025 in the context of medical assistance in dying: (a) on what date was the document finalized, which branch or directorate prepared it, and for what purpose was it prepared; (b) to whom within Health Canada, the Department of Justice, or any other federal department or agency, was the document distributed, and on what date was each distribution made; (c) was the document shared with any provincial or territorial government, federal-provincial-territorial committee, external expert, federally funded third-party organization, or other non-federal entity, and, if so, with whom and on what date; (d) did the document contain any options, recommendations, or analyses regarding whether the term "mental illness" as used in subsection 241.2(2.1) of the Criminal Code should be defined, clarified, interpreted, or replaced, and, if so, what options, recommendations, or analyses were set out; and (e) what are the details of all briefing notes, memoranda, slide decks, meeting records, decision notes, or other documents prepared which reference that document after its finalization, including, for each, the (i) date, (ii) title, (iii) sender, (iv) recipients, (v) summary of its contents, (vi) type of document?

With regard to Veterans Affairs Canada: (a) how many lawsuits have been brought against the government related to the issue of medical assistance in dying since January 2018; (b) what is the overall cost of these lawsuits that the government of Canada had to pay to settle, in total and broken down by legal fees versus settlement payments; (c) how many veterans have accepted medical assistance in dying from the government of Canada since January 2018; and (d) how many of the settlements involved the recipients signing a non-disclosure agreement to ensure that the government wouldn't be further embarrassed by its actions?

With regard to federal preparations for the planned expansion of medical assistance in dying to cases where a mental disorder is the sole underlying medical condition (MD-SUMC): (a) how many individuals have, as of February 1, 2026, registered for medical assistance in dying-related training programs funded in whole or in part by the government, including the Canadian MAiD Curriculum; (b) of the individuals in (a), how many have completed all training requirements, in total and broken down by profession (physician, nurse practitioner, psychiatrist, other) and by province or territory; (c) how many individuals have completed any training specifically related to MD-SUMC assessment or consultation, in total and broken down by profession and province or territory; (d) what criteria, competencies, or learning objectives does the government use to determine whether a practitioner is adequately trained to assess MD-SUMC requests; (e) how many psychiatrists have indicated willingness to provide consultation for MD-SUMC requests, broken down by province or territory; and (f) what are the details of all federal funding, contracts, or contribution agreements which have been issued since January 1, 2024, to support medical assistance in dying-related training for MD-SUMC, including, for each, the amounts, recipients, objectives, and timelines?

With regard to the government's stated objective that provinces and territories implement standards and enhance coordination and oversight mechanisms related to medical assistance in dying and medical assistance in dying where a mental disorder is the sole underlying condition (MD-SUMC): (a) which provinces and territories have formally adopted the federal Model Practice Standard for Medical Assistance in Dying, in whole or in part, and what jurisdiction-specific modifications, if any, have been made; (b) what mechanisms exist in each province and territory for oversight and quality assurance of medical assistance in dying cases, including any mandatory review processes; (c) which provinces or territories have implemented enhanced oversight specific to complex Track 2 cases, and which have implemented enhanced oversight specific to MD-SUMC cases; (d) for each province and territory, does oversight include prospective case review prior to provision of medical assistance in dying, retrospective review following provision, or both; (e) what coordination mechanisms exist to ensure consistent application of safeguards across jurisdictions, including for cases involving fluctuating capacity or suicidality; and (f) what are the details of all federal-provincial-territorial meetings, working groups, or formal agreements that have taken place since January 1, 2024, on MD-SUMC readiness, including the dates, the participants, the agendas, and any deliverables or decisions made?