The governments of Manitoba and Saskatchewan say they are concerned about the potential risks of allowing Canadians to seek medical assistance in dying solely on the basis of a mental illness.
Provinces have expressed fears that the country may not yet be ready for the change to take effect in March, federal Health Minister Mark Holland recently acknowledged.
The federal Liberal government passed legislation last year to delay the expansion for 12 months, and will soon have to decide whether to do so a second time.
Liberal ministers say they are waiting to hear from a parliamentary committee that held hearings last fall about whether Canada is ready for the expansion. The witnesses who appeared offered a range of opinions, giving parliamentarians an up-close look at the divisions that persist within the legal and medical communities.
Providers currently trained to administer medically assisted deaths say they are ready and that guidelines and practice standards have been developed. People with mental illness should also be able to access the same care as those with debilitating physical conditions, advocates argue.
Others aren't so sure.
A group of law professors from across Canada has urged the government to take its time, insisting there is nothing in federal law forcing it to take urgent action.
Some psychiatrists, too, have lingering questions: how to determine if someone with a mental disorder is likely to get better, for instance, or what happens if someone is living in poverty and unable to access mental health care.
The Manitoba government says it shares the concerns of clinical experts and other provinces.
"We agree with those calling for further consideration and consultation to ensure appropriate clinical standards and safeguards are in place to protect vulnerable Canadians," a spokesperson wrote in a statement.
Meanwhile, Saskatchewan says it cannot commit to following the expansion "without carefully considering the risk that this may pose to people suffering from mental illness."
"Saskatchewan remains concerned with both the pace and scope of the federal government's proposed expansion," said spokesman Matthew Glover.
Tim McLeod, Saskatchewan's mental health and addictions minister, raised the issue during a roundtable meeting with the federal government last year, Glover added.
Officials in B.C. and P.E.I. declined to comment, citing ongoing talks with Health Canada.
Newfoundland and Labrador said in a statement that the province is working with health care regulators to prepare for the upcoming change.
This report by The Canadian Press was first published Jan. 25, 2024