Sự cưỡng ép không phải là sự chăm sóc, và các luật mới buộc điều trị và giam giữ là nguy hiểm

The Supreme Court of Canada has described the right to refuse unwanted medical treatment as “fundamental to a person’s dignity and autonomy, [including] in the context of treatment for mental illness.”

Nonetheless, legislative and policy shift in multiple provinces in the past year threaten this principle — with little meaningful political resistance. It is important to closely examine the conditions and public narratives that have made this renewed use of psychiatric coercion possible.

A legislative and policy shift

In 2025, in an explicit repudiation of harm-reduction principles, Alberta passed legislation enabling the forced treatment of people with addiction disorders on the basis that they are “likely to cause harm.”

Manitoba now allows authorities to detain people for up to 72 hours if, due to intoxication, they are considered a danger or are causing a disturbance.. In British Columbia, the government has opened involuntary care beds inside prisons for mental health and substance use purposes. The province has also expanded its Mental Health Act to allow longer involuntary hospitalization and compulsory treatment for people with substance use issues.

In March 2026, Québec introduced a bill allowing health data sharing and closer co-ordination between police and health services, with provisions to bypass consent for people deemed mentally “altered” or “distrustful” of institutions.

In all four provinces, professionals operating within these coercive frameworks are afforded immunity from legal proceedings.

‘Compassionate intervention’

These examples highlight an acceleration in overt coercive intervention provisions being added to provincial mental health and addictions legislation.

This acceleration, however, is simply a continuation of mental health and addictions legislation across Canada that makes it easier for citizens to be detained, treated and controlled without their consent (for example, Brian’s Law in Ontario, the Nunavut Mental Health Act and the Maureen Breau Act in Québec) .

Across Alberta, Manitoba, British Columbia and Québec, parliamentary debates and media coverage consistently portray coercive intervention for addiction and mental health as an act of compassionate intervention.

Even governments with differing ideological orientations — like the NDP versus the Conservatives — converge around the argument that the state has a moral obligation to “protect the most vulnerable.”

This is especially true for people deemed incapable of making rational decisions due to severe addiction or mental health. In legislative debates, the notion of compassion is reinforced through narratives of urgency and failure. Existing harm-reduction strategies are described as insufficient or outdated, necessitating a decisive shift toward more interventionist models.

A disregard for science and ethics

Media coverage amplifies this messaging, emphasizing crisis conditions, public disorder and the visible consequences of addiction or mental health. This coverage legitimizes the need for new legal tools.

Coercion is articulated as care and involuntary treatment is presented not as a restriction of liberty but as a necessary response to incapacity and risk.

This appeal to compassion functions as a unifying political language, enabling cross-partisan support despite differing ideological stances.

By portraying these policies as pragmatic, humane and long overdue, policymakers limit opposition. They also reconfigure the boundaries of acceptable state intervention, illustrating how compassion can be mobilized to normalize coercion. After all, who could be against compassion?

This rhetorical focus on compassion allows governments to sidestep deeper ethical and empirical critiques, including the limited scientific evidence supporting forced treatment and the potential harms associated with it.

In fact, whether administered in closed settings or in the community, there is a striking lack of robust evidence, including an absence of Canadian research, that demonstrates clinical benefits. Instead, research points to significant adverse effects, including deaths due to forced treatments for opiate use, raising serious ethical concerns.

Police-medicine hybridization

Furthermore, this compassion-focused public discourse — and the legislation flowing from it — greatly expands the role of policing in medical matters, often with few limits. At the same time, it extends the reach of medicine and social services into policing.

This growing police–medicine hybridization is concerning for everyone, but especially for groups that have long faced disproportionate psychiatric coercion, including women and Black, Indigenous and other racialized communities.

It also signals a modern return of the asylum — not as a single institution, but as a system of confinement, surveillance and control spread across multiple sectors. Indeed, despite being presented as new, recent and proposed legislative changes are anything but. Forced detention, incarceration and treatment reflect older, deeply rooted correctional approaches with origins dating back at least to the 17th century.

These legislative developments do not suggest a novel policy response. Instead, they reconfigure longstanding patterns of confinement and control under the guise of compassion. If left unchallenged, they will normalize coercion as care and erode fundamental rights in the name of protection.

Canadian legislators should resist responding to complex social and health crises with coercive measures that lack a sound scientific basis and risk doing more harm than good.

Jean-Laurent Domingue is a Registered Nurse in Ontario, and receives funding from the Social Sciences and Humanities Research Council and the Law Commission of Canada.

Axel Ounis is affiliated with the federal liberal party.

Emmanuelle Bernheim receives funding from the Canada Research Chair program, the Social Sciences and Humanities Research Council and the Law Commission of Canada.