Canada's federal government has announced it will indefinitely suspend plans to expand its medically assisted dying programme to people whose sole underlying medical condition is a mental illness.

Justice Minister Sean Fraser made the announcement on Wednesday, saying the government would introduce new legislation in the coming weeks to halt the expansion. "While there is not a perfect consensus on this issue, we believe this is the correct approach at this particular time," Fraser said.

Under current rules, people with mental illness as their sole condition have been barred from accessing medical assistance in dying, known as Maid. That ban had been due to be lifted in March 2027. The government has now delayed the expansion twice previously, in 2023 and 2024, to allow further study of its potential delivery.

A parliamentary committee earlier this year recommended that Canada "indefinitely exclude persons whose sole underlying medical condition is a mental illness" from eligibility for Maid. The committee also flagged a "pressing need for increased and more equitable access to adequate mental health services." Not all committee members agreed, however, and some released a dissenting report arguing the process was "fundamentally flawed" and "biased."

Fraser cited a lack of consensus in the medical community as a key concern. "When I hear that there is a lack of consensus in the medical community about the irremediable nature of certain mental illnesses, that gives me real cause for concern," he said.

According to the latest government figures, the vast majority of Maid deaths — 95.6% — involved people whose natural death was considered reasonably foreseeable. Only 4.4% of cases involved people whose death was not considered reasonably foreseeable, including those with conditions such as multiple sclerosis and incurable neurological disease.

Medically assisted dying became legal in Canada in 2016 for people with terminal illnesses, following a 2015 Supreme Court decision. In 2021, the law was expanded to allow adults to receive an assisted death if two doctors confirmed an irremediable physical condition causing immense suffering that could not be relieved. A temporary exclusion for people with mental illness as their sole condition was put in place at that time.

The proposed new legislation will also move to decriminalise advance requests, allowing patients with progressing incurable illnesses — such as Alzheimer's — to consent to assisted dying before their health deteriorates to the point where they are no longer able to do so. The final decision on whether to permit advance requests will be left to individual provinces. Quebec is currently the only jurisdiction that permits such requests. Alberta has already said it will not allow them. Fraser said the bill aims to ensure that doctors who provide the services "will not be treated as criminals for doing so."

A federal court case challenging the government's earlier decision to delay Maid access for people with mental illness remains before the courts. Fraser acknowledged the Supreme Court could weigh in on the issue in the future. The case is led by advocacy group Dying With Dignity Canada.

Michael Fenrick, a lawyer involved in the federal case, said on Wednesday he anticipates a lengthy legal battle. "People will continue to suffer intolerably while the case goes through the courts," he said.

Dying with Dignity called the government's decision "profoundly disappointing." "We anticipate that a very small number of individuals with severe and persistent mental illness would be eligible for Maid under this criterion, but their suffering is no less real than those who live with physical illnesses," said Helen Long, the group's chief executive.

Supporters of extending the programme argue that excluding people with mental illness violates their constitutional rights and access to medical care. Some experts have also raised broader concerns that Canada's assisted dying programme has become a tool to alleviate suffering among people who would be better served by improved access to affordable housing and healthcare.

The committee's conclusions were reached after members heard from doctors, advocates and experts from countries that do permit assisted dying for people solely with mental illness, including the Netherlands and Belgium.

"These are not easy decisions but we believe they will be the correct ones," Fraser said.