TORONTO — Claire Brosseau has asked an Ontario court for an exemption from Canada's medical assistance in dying law to gain access to the procedure for treatment-resistant mental illness. Her legal filing argues that the current law, which excludes those whose sole condition is mental illness, is unconstitutional.

Medically assisted dying, known as MAID in Canada, is legal for terminally ill patients and for those whose death is not reasonably foreseeable but who have an irreversible serious illness, disease or disability. The federal government has twice delayed expanding eligibility to people with severe, treatment-resistant mental illness, most recently postponing it to next year over concerns the healthcare system is not prepared.

Brosseau has been diagnosed with bipolar disorder and post-traumatic stress disorder and has been treated by psychiatrists in four major North American cities over three decades. She has tried behavioural therapy, medication and electroconvulsive therapy, and is enrolled in a psychiatric care programme at a local hospital that supports people with severe and persistent mental illness who have exhausted all treatment options. She said her illness is worsening and she cannot afford to wait any longer.

"There's nothing left to try, and I'm at the end of my life," Brosseau said. She said she is no longer able to work, leave the house or speak with her loved ones.

Brosseau said the denial of assisted death to psychiatric patients is rooted in stigma, with physical illnesses viewed as more legitimate. "If I get cancer tomorrow, I can refuse treatment and be eligible for MAID," she said.

A parliamentary committee reviewing the expansion heard from advocates and medical experts over the past two months who warned against it. "None of those issues have been resolved," said Dr Sonu Gaind, former chief of psychiatry at a major Toronto hospital. "Instead, we have even more evidence showing we are not ready to provide MAID for mental illness," he added.

The Netherlands, Belgium and Luxembourg allow assisted dying for people suffering solely from a mental illness. In the Netherlands, individuals seeking assisted death for a mental illness must be assessed by a psychiatrist, and psychiatric approvals account for about 2% of all assisted dying deaths. The number of approved cases for psychiatric suffering there rose from two in 2010 to 219 in 2024.

Dr Sisco Van Veen, a psychiatrist, said assisted dying for psychiatric patients remains rare and that MAID offers "mercy" for those whose suffering can be immense or unbearable. In Canada in 2024, about 96% of assisted-dying requests were granted to people whose death was reasonably foreseeable, mostly terminal cancer patients, while 4% were granted to patients whose death was not imminent but who had a "grievous and irremediable medical condition."