The Canadian government on Monday announced an indefinite delay in its plans to expand Medical Assistance in Dying (MAID) to patients with mental illness, but no physical ailments.
Canada’s long march to assisted suicide seems to have finally stalled with the proposal to provide physician assistance for mentally ill people to kill themselves. Canadian doctors have gone from discussing euthanasia as a last resort to aggressively recommending it, even to patients who desire treatment rather than death. Critics fear that if MAID is extended to the mentally ill, Canada’s overburdened socialist healthcare system will be sorely tempted to use euthanasia to clean up long waiting lists for psychiatric care.
Assisted suicide is spreading faster in Canada than in any other nation in the world, than any other nation in history. MAID deaths quadrupled over the past five years and now account for four percent of all deaths in the country. If current trends hold, Canada might have more assisted suicides by the end of this year than countries like the Netherlands, which legalized the practice decades before Canada did.
The Toronto Star mused on Saturday that since “one in five Canadians are impacted by mental health challenges,” expanding MAID to cover mental illness could lead to a dizzying surge in the already huge number of assisted suicides.
Dr. Cheryl Rowe, a Toronto psychiatrist who supports expanding MAID, ominously described it as a “failure of medicine” that “there are so many doctors that believe that they have to keep their patients alive at all costs.”
Whatever the merits of that philosophy might be for terminal physical illness, expanding it to psychiatry – encouraging doctors to promote suicide to people who are not of sound mind – would almost certainly cause the explosion of MAID deaths to go nuclear.
The Toronto Star observed:
Some experts see the rapid growth as a human rights triumph that allows Canadians to make their own choice about when they wish to die with the full support of the state and their doctors. Others fear that failures in the health-care system and social safety net may be contributing to the surge.
The expansion to cover mental illness was supposed to take effect in 2022, but the nervous government postponed it until March 2024 and has now postponed it again. Polls show only about a third of the Canadian public supports extending MAID to patients with mental illness and most of those supporters want access to mental health care improved before assisted suicide is put on the table.
Conservative MP Michael Cooper said on Sunday that “Canada isn’t ready” to include mental illness in MAID, pointing to expert testimony from psychiatrists who said it was “difficult, if not impossible” to determine if mentally ill patients are making rational requests for assisted suicide or if their conditions are untreatable.
“These Liberals have put ideology ahead of evidence-based decision making,” Cooper said.
Another opposition lawmaker, Alistair MacGregor of the left-wing NDP party, compared the mad dash to assisted suicide to “building the plane while it’s flying mid-air.”
“It all speaks to the Liberals’ mismanagement on this file from the get-go, which has now left us in some kind of legal limbo,” he said.
Health Minister Mark Holland was seemingly persuaded by expert testimony that Canada is not ready for another MAID expansion, although he spoke of delaying the expansion until those practical hurdles could be overcome, rather than canceling it for ethical reasons.
“We certainly recognize that there is equivalency between physical suffering and mental suffering. But we need to make sure that the supports are there, that the training is in place,” Holland said.
On Monday, after the indefinite delay was announced, Holland said, “We’ll be in a position in the coming days to talk about how much time we believe is required.”
“Although the curriculum is present, although the guidelines are set, there has not been enough time for people to be trained on them, and provinces and territories are saying their systems are not ready and need more time,” he said.
Holland added that the provincial governments of Alberta, Saskatchewan, Manitoba, and Quebec all said they were not ready to proceed with expanding MAID eligibility.
Dissenting members of the parliamentary committee on MAID expansion insisted the federal government had met all of the technical qualifications for “readiness,” so the reluctant provinces should not be allowed to halt the program nationwide.
“It also stigmatizes individuals with mental disorders, promoting the myth that individuals with mental disorders are incapable of making informed decisions about their end-of-life choices,” the dissenters said.
Kurt Goddard, legal and public affairs director of Inclusion Canada, argued in the Vancouver Sun on Monday that MAID for mental illness “should never come to pass,” no matter how prepared politicians and morticians claim they are, because it would be a “profound and dangerous shift in our societal values.”
Goddard drew on his own experience with mental illness in his family to contend that serious mental illnesses often seem hopeless and untreatable to those who suffer from them, while suicide – assisted or otherwise – tends to be far more devastating to loved ones than desperate people might believe.
Goddard warned that treating mental illness as a terminal condition treatable by euthanasia would undo years of advocacy for “full inclusion and human rights of people with an intellectual disability” by his organization and others. It would also tip the scales heavily against the already difficult challenge of suicide prevention.
“How can we promote suicide prevention while also endorsing policies that facilitate state-assisted suicide?” he asked.
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