— CONTENT WARNING: Column discusses mental illness and suicide.
Canada has had medical assistance in dying (MAID) legislation in place since 2016.
The legislation came about in 2016 after a Supreme Court of Canada decision the year previous found parts of the Criminal Code which made it illegal to help a person end their life actually in violation of the Canadian Charter of Rights and Freedoms.
When it was initially brought in, MAID legislation was designed so that those suffering from long-term, progressive illnesses which will ultimately lead to death could chose to end their life before their diseases progressed to the end stages.
At its heart, I don’t disagree with the legislation as it allows those who are suffering with severe disease or illness to go out on their own terms; however, plans to expand the program in 2023 have me concerned.
The MAID program was scheduled to be expanded in March 2023 to include those whose sole diagnosis is a mental illness.
While the federal government has announced plans to pause the roll out of this expansion, the fact that it is even on the radar has me questioning the health officials in Ottawa; though it should be noted that it is not all on them.
The expansion is occurring due to a ruling by the Quebec Superior Court in 2019, which said that it is unconstitutional to restrict MAID to only people who’s deaths were foreseeable.
Due to this ruling, and the federal government choice to not appeal it, Parliament forged ahead with expansion of MAID to include those whose deaths were not part of a diagnosis, including those with mental illness.
This is where I have a problem.
I have not been shy in writing about my mental health struggles.
Thanks to past diagnoses of post-traumatic stress disorder, anxiety, and depression, I have spent a significant amount of time between 2013 and 2017 battling my demons through therapy and judicial use of medication.
During that period, I spent a lot of time suicidal due to my mental illnesses. There were times I felt so low, in such mental pain, that if this MAID legislation had been offered I would have thought long and hard about going that route.
One doctor I saw during that period, before the legislation came into effect, even wisecracked one day that I was a little early for that sort of help.
The thing is, I didn’t have that option and I am glad for it, despite the darkness I had to walk through to get to where I am today. It may have taken years, but through hard work, therapy and medication I found hope again.
In the right circumstances, I believe that MAID is a solid piece of legislation that has its place. It can allow those with terminal, debilitating conditions to end their pain and suffering before the disease progresses to the point they become a burden on the health care system and their loved ones, if that is what they so wish.
The problem is, many, myself included for the longest time, who deal with mental illness see themselves as being that burden on the healthcare system and their families.
It scares me that in the depths of my depression, I could see consideration for use of the legislation for much the same reason; when, instead, these individuals, like me, could ultimately do better, and even thrive, through work, medication, and the right community and family supports given enough time.
Another problem comes down to ability to give consent for the procedure in the first place.
When I was in deepest throes of my depression, and suicidal, though MAID could have potentially appealed to me I was in no way, shape, or form mentally competent to be able to make that decision. Over time, and treatment, my suicidality faded and I was able to get back onto a positive path.
Depending on the mental illness a sufferer deals with, such as someone with a fractured grip on reality, they may never be competent to make such a decision; so what happens to them if they express the wish for MAID?
Will doctors just sign off, akin to the old days of getting those with mental illness out of society and into the insane asylums of old. Or will they be protected, because they don’t have the mental competency?
A lot of questions remain to be answered about the potential expansion of the program, and how these already vulnerable patients will be protected from themselves.
The federal government and Veterans Affairs have already taken heat in recent weeks about advisors allegedly encouraging veterans to use MAID. What is the possibility that will happen with those suffering with mental illness if MAID does become more easily accessible?
Again, that is unknown but a concern I carry for all those who suffer from any form of mental illness.
I do applaud the fact that when MAID does expand, it will not be a quick thing.
Those wanting MAID will have to request it, in writing, followed by assessments by two other independent medical professionals. If a natural death is not “reasonably foreseeable,” there is a 90-day cooling off period where the individual can withdraw their request at any time.
Still, knowing the ins and outs of dealing with mental illness that I do, I would prefer to see it completely removed from the legislation expansion.
Mentally ill individuals already find enough ways to kill themselves if they really want to go that route; we don’t need the federal government to sponsor it.
Mental illness doesn’t have to be a death sentence, it can be treated.
— With files from Black Press News Media