Euthanasia for the mentally ill has been one of the most contentious aspects of the Trudeau government’s legacy. Though the entire assisted suicide program is frighteningly dystopian, the idea of euthanizing mentally vulnerable people is in a class of its own. Now, in a rare moment of lucidity, the Carney government may be preparing to halt the expansion – or so the Globe and Mail reported, citing unnamed sources within the government.
A parliamentary committee has been tasked with evaluating Canada’s readiness for euthanizing the mentally ill. Originally announced for March 2023, the expansion has been delayed twice, and is currently scheduled for March 17, 2027. That is, unless the parliamentary committee recommends otherwise.
There is no accepted distinction between suicidal ideation and requests for medical assistance in dying
This is because many serious voices are pointing out that the policy cannot be reconciled with the notion of informed consent, nor with society’s duty to hold out support and hope of recovery, especially in the face of despair. The heads of psychiatry at 13 Canadian medical schools, including McGill, University of British Columbia, and McMaster, have written to parliament to ask them not to proceed with the expansion. They point out that “there is no accepted operational definition to clearly distinguish suicidal ideation from requests for medical assistance in dying” – an elusive distinction indeed – and that no consensus exists as to what constitutes an irremediable mental illness. Many people, they say, make a full recovery from prolonged suffering caused by schizophrenia, depression, anxiety and substance abuse, on receiving appropriate treatment and support.
There’s the rub: appropriate treatment isn’t always available, and many doctors are worried that Medical Assistance in Dying (known as MAID) is already being used to fill the gaps in health care and social services. Dr Wilbert van Rooij, a Dutch doctor, was invited to testify before parliament. In the Netherlands, where euthanasia for the mentally ill has been legal since 2002, he said he is seeing more vulnerable and “relatively young” patients asking to die who could in principle be treated. Yet an inadequate mental health care system means they don’t have access to the right support – and Canada’s system isn’t any better.
Socialized medicine is an expensive undertaking, but Canadians are beginning to wonder why the tail should be wagging the dog. During the pandemic large regions of the country spent absurd amounts of time under lockdown in order to save hospitals from being overwhelmed. Those who questioned why the hospitals couldn’t be run better were drowned out by the din of applause for frontline workers. Providing euthanasia to avoid fixing a failing system is even worse. Do we exist to support the health system or does it exist to serve us?
Dr. Peter Blusanovics, a Montreal psychiatrist, said, “Basic needs are currently not being met in our healthcare system. Without [legislation halting the expansion] we are condoning a bypass towards suicide, and blatantly admitting defeat.” Consent is another concern. Dr. Paul Saba, a family physician from Lachine, Quebec, told reporters “From a legal standpoint, those with mental disorders requesting euthanasia… do not meet the condition of free and informed consent, because the desire to die in most cases is a symptom of mental illness.”
Two provinces are already refusing to implement any expansion. Quebec has passed a law banning MAID for mental illness other than neurocognitive disorders. And Alberta has tabled its own legislation excluding MAID for mental illness and limiting it to persons whose deaths are foreseeable within the next 12 months.
Pressure is coming from religious leaders as well, including the Catholic Church. Archbishop Frank Cardinal Leo of Toronto has written a strong letter to Mark Carney, urging him to halt the expansion and instead increase investment in palliative care, mental health services and support for the isolated. Prime Minister Mark Carney has said he won’t take a position on the matter yet. “I like to take informed positions and I’ll wait for the report,” he told journalists.
So far, warning voices have predominated. Jocelyn Downie, a leading MAID activist, has accused the parliamentary committee of bias. The law professor claims the committee has “gone off the rails” and is at risk of making their assessment “based on an incomplete set of evidence.” Downie was invited to testify before the committee in early April, where she made the puzzling argument that the mentally ill must be granted access to euthanasia or they will be at risk of committing suicide. This argument was used in the 2015 Supreme Court decision (in which Downie was also involved) that overturned Canada’s ban on euthanasia, declaring it violated the Charter right to “life, liberty and security of the person.”
It’s an interesting position: how can a right to life be understood as a right to death? As Tristin Hopper explains in the National Post, “it was partially because the Supreme Court accepted the argument that ‘the prohibition on physician-assisted dying had the effect of forcing some individuals to take their own lives prematurely.’”
This sounds like circular reasoning, until you realize that buried in the logic is a presumed distinction between seeking euthanasia and seeking to take your own life. Does such a distinction really exist? As the 13 psychiatrists who wrote to parliament have pointed out, there is no accepted distinction between suicidal ideation and requests for medical assistance in dying. In reality, the only difference is between methods of dying – not in the intention or the result. It is strange to think that such specious reasoning helped Canada’s Supreme Court to send more than 100,000 Canadians to their deaths.
It has been calculated that more Canadians have now died from MAID than in the Second World War. Though the government no longer lists MAID as a cause of death in official statistics, 2024 reports show that medical suicide was the year’s fourth most common cause of death in Canada, coming in between accidents (20,260) and strokes (13,725). If only the people trying so hard to bring death to the mentally ill were willing to work even half as hard at keeping them alive.
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