May 6, 2021‍

Dear Honourable Members,

The Canadian Psychedelic Association is writing to you today on behalf of a coalition of medical/healthcare practitioners, entrepreneurs, counsellors, businesses, and grassroots treatment providers regarding Medical Assistance in Dying (MAID) and the inclusion of psychedelic-assisted psychotherapy in the upcoming MAID Parliamentary Review.

In the debates leading to the passage of Bill C-7, many voices, including parliamentarians, emphasized the need to ensure that eligible patients were provided with excellent and effective palliative care, so that no patient was motivated to choose to precipitate death due to inadequate pain and symptom management.

While the current legislative revisions place clear expectations on MAID providers to be assured that all alternatives to physical and psycho-social forms of palliation are considered, it is not the case that a majority of Canadians have practical access to all or sometimes any of these services. While geographic circumstance might determine whether any particular dying Canadian will have access to palliative care, the only barriers to accessing psychedelics and associated therapeutic interventions are legislative and bureaucratic. While the Committee is powerless to create universal palliative health services for Canadians, it certainly has the power to remove vestigial barriers preventing dying people access to safe and efficacious means of coping with death.

With the legislation now debated, amended, and passed with instructions germane to the “state of palliative care in Canada and the protection of Canadians with disabilities,” and “the mental illness exclusion for assisted dying from people suffering solely from mental illnesses,” the priority is to examine all options now.

With timely action by the Committee, Canadians could have legal access to psychedelic-assistedpsychotherapy by the time the COVID-19 pandemic is over, and the upcoming wave of mental illness becomes apparent.

This is a big task, and one Canadians have entrusted you to exercise with discretion and their interests in mind.

As you begin the review process, we are optimistic that the Committee will examine all interventions of palliative measures available to terminally ill patients. These should be particularly welcome in Canada. Since Canada already empowers dying patients with both the option of eradicating consciousness via palliative sedation and advancing the time of death via MAID, it is reasonable to allow these patients access to psilocybin and other controlled psychedelics for relief of anxiety and depression. Overwhelming clinical and anecdotal evidence shows that psychedelic therapies offer an important additional tool to alleviate the suffering of the terminally ill.

Under the new legislation, Section 241.2 of the Act was amended by adding clauses (g) and (h) after subsection (3). They strongly describe a duty to explore and explain alternatives to MAID, including patients’ being “informed of the means available to relieve their suffering, including, where appropriate, counselling services, mental health and disability support services has been offered…and “hav[ing] discussed with the person the reasonable and available means to relieve the person’s suffering.”

These clauses clearly outline your fiduciary responsibility to explore psychedelic therapies in the context of the MAID review. It is our position that since some dying patients can access medication to facilitate a peaceful death, access to psilocybin and other controlled substances, outside of ad hoc section 56 exemptions granted under the Controlled Drugs and Substances Act, for palliative care needs to be taken seriously.

We find it problematic that in Canada, a physician can legally write a prescription for lethal medications for a terminally ill person but cannot prescribe medications or make a referral for pharmaco-assisted psychotherapy that might alleviate the distress that is making the person want to end his or her life.

As Health Canada begins to modernize specific drug policy regulations by acknowledging “the science, efficacy, safety, and potential therapeutic uses” of certain restricted drugs (December 2020), the MAID amendments could be a critical first step in recognizing the extreme mental and physical health challenges faced by thousands of Canadians each year.

In consideration of Section 241.2 (g) (h); the mandate to examine the state of palliative care in Canada and those suffering from mental illness as a sole underlying cause; and Health Canada’s recent progressive regulatory policies, we respectfully ask the Committee to consider the following requests:

• Agree to hear testimony from psychedelic medical experts and researchers during the Parliamentary Review.
• Agree to hear testimony from the palliative Canadians who have received section 56 exemptions during the Parliamentary Review.
• Recommend to Health Canada and Justice Canada that a psychedelic sub-committee on MAID be appointed to examine the therapeutic and judicial impact of psychedelic medicines.
• Formally introduce amendments to MAID allowing for full legal, therapeutic access to proven psychedelic therapies. We submit that it is vitally important that the Amendments and path to a complete regulatory framework for access to psychedelic therapies be viewed within the context of the COVID-19 pandemic and mental health crisis facing Canadians.

Backed by current treatment experience and volumes of clinical data, we consider your attention to these therapies a matter of life and death. Canadians are asking for solutions, and they are trusting this Committee to examine the available options in their best interest.

We are prepared to work with you at your behest.

Sincerely,

Trevor Millar & Cory Firth
Canadian Psychedelic Association, on behalf of undersigned MAID COALITION Members

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