Howard Breen, 68, who lives in Vancouver, is not terminally ill but is experiencing extreme mental suffering because of his concerns about climate change. In 2017, Breen’s doctor diagnosed him with clinical eco-anxiety and biosphere-related depression. Breen had his initial request for euthanasia turned down in February 2021 because one doctor in his euthanasia assessment did not consider eco-anxiety to be an “acceptable, permissible malady”. Eco-anxiety is not currently recognized as a mental illness by the American Psychiatric Association, whose diagnostic manual Canada uses. Breen however believes that his eco-anxiety is severe enough that he should be eligible for euthanasia now. In March 2023, euthanasia on the grounds of mental illness alone will be permitted.