What the future implications might be

Is it medically assisted death or is it disposal of people with mental illness and no resources? The Globe and Mail:

Canada will have one of the most liberal euthanasia laws in the world, joining only a few other countries that allow assisted dying for mental illness.

It will be the most controversial expansion of MAID since a Supreme Court ruling led the federal government to legalize euthanasia in 2016. At that time, MAID was only for patients with a foreseeable death, but Parliament – with Bill C-7 – removed that requirement in 2021.

The original version of the bill did not allow assisted death for patients with mental disorders as a sole condition because, the government said at the time, there were outstanding questions about how illnesses such as depression could be safely included, and what the future implications might be. The Senate disagreed, removing that exclusion before the bill passed, but with one caveat: Parliament would study the issue for two years before any of those patients could receive MAID.

With four months to go, there is still no consensus in the mental health community – and, in fact, doctors remain deeply divided. There are no finalized national standards, no transparent review process in place to watch for mistakes, and hospitals are still figuring out how they would implement the change.

Toronto’s Centre for Addiction and Mental Health (CAMH), Canada’s largest psychiatric teaching hospital, has said that assisted dying shouldn’t expand without more study. And the Canadian Mental Heath Association has raised serious concerns about expanding MAID without first increasing mental health care funding. In Quebec, after public consultations, a legislative committee has recommended against the province expanding MAID to mental illness at all.

I don’t know what I think about this. It’s very thorny. Is it just brutally disposing of people who don’t fit in well enough or aren’t useful enough? Or is it humanely helping people for whom living is a misery?

Expert dissension, a law without clarity, the arbitrary legislative finish line – all of this would be worrisome, even in normal times. But Bill C-7 passed before the full consequences of COVID-19 were known, before the pandemic ripped through the health care system and left it in tatters.

The law requires patients asking for MAID to be informed of possible treatment options that might alleviate their suffering. But this assumes those are readily available. Instead, wait times to see mental health clinicians have only increased.

Psychotherapy, a recommended treatment for most mental disorders, remains too expensive for many Canadians. In Toronto alone, an estimated 16,000 people are waiting for supportive housing for mental illness and addiction.

In Ontario, nearly 6,000 patients with the most severe mental disorders are on a years-long list for specialist community-based care.

So it becomes a resources issue, a money issue, which is surely a very bad reason to help people kill themselves. Then again there’s still the issue of people whose lives are nothing but misery.

The rising cost of rent and foodis also taking a particular toll on people with chronic mental illness, who are often already the poorest in society – and the very candidates who will qualify for assisted dying under the new law.

Assisted dying for people who can’t afford the rent…no that doesn’t sound good at all.

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