Canada Suspends Expanding Medical Aid In Dying To Mental Illness

On the kill floor of a poultry plant outside Winnipeg, a woman I will call Denise works the night line with a knife in her hand and a depression that has followed her since she was nineteen. She stands in cold water for ten hours. She has been on a waitlist for a psychiatrist longer than she has been on this line. The policy the Government of Canada has just shelved would have decided, come March 2027, whether a doctor could help her die. Start there, with the knife and the waitlist, because the offices in Ottawa did not.

Let me tell you what I am not going to do. I am not going to stand on a crate and cheer the suspension as if the comfortable had suddenly found a conscience. Nor will I spit at the people who wanted the expansion. Some of them are sincere, and theirs is the strongest argument in the room. A woman whose suffering has not lifted after twenty years of pills and therapy has as much claim to mercy as a man with a failing heart, they say, and to tell her otherwise is to tell her that her pain counts for less because it lives in her head. I have sat with miners’ widows whose grief never lifted. I do not wave it away.

But I have also lived in company towns, and I know what a choice looks like when the company owns the store. A miner was free to buy his flour anywhere he liked, so long as he bought it at the company store, at company prices, in company scrip. Nobody held a gun to him. That was the whole trick. Denise is free to choose between living and dying, so long as living means a disability cheque that does not cover rent, a psychiatric waitlist measured in seasons, and a foreman who docks her for the mornings she cannot get out of bed. Call that autonomy if you like. I call it scrip.

Here is what the reporting does not say. The expansion was cheap. It costs the state very little to offer a death. It costs a great deal to put a psychiatrist in rural Manitoba, a roof over a sick woman, a benefit a person can actually live on. When a government makes the cheap thing easy and the dear thing scarce, it is not neutral about which one you will pick, whatever it prints on the form.

So, the suspension. Good, I say. And then I say: watch their hands. “Indefinitely” is a lovely word for a politician. It takes the hard question off the table, and it takes the bill for the hard question off the table with it. The minister gets to look prudent. The provinces keep their waitlists. Denise keeps the knife, the cold water, and the line, with no psychiatrist one inch nearer than last week. Ottawa has declined to help her die and has not lifted a finger to help her live, and it will collect praise for the first while nobody sends it an invoice for the second.

I have seen this play before. After every mine explosion the company halted something. It halted the shift, it halted the hiring, sometimes it halted the inquiry. What it never halted was the rotten timber holding up the roof. A pause is a thing the powerful do with their hands folded.

If you want to know whether this was about care or about appearances, do not read the press release. Watch the waitlist when March 2027 comes and goes. If it is shorter, if the disability cheque covers a room, if a woman can see a doctor about her mind without first losing her job, then they meant it. If nothing has moved, then they closed one door and left her standing in the hall.

And the people who fought for the expansion and the people who fought against it share something neither side has noticed. Both argued long and loud about the end of Denise’s life. Neither marched for the middle of it.

So I put it to you, reading this in a warm room: when did you last fight for the thing that would make the question unnecessary?

Outside Winnipeg, the line starts again at ten.