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Assisted suicide for mentally ill likely despite lobby group’s efforts

By Deborah Gyapong
Canadian Catholic News

09/13/2017

OTTAWA (CCN) — An effort by the Canadian Mental Health Association (CMHA) to prevent the mentally ill from access to assisted suicide is likely to fail, warns a Catholic psychiatrist.

Dr. Tim Lau, the founding president of the Canadian Catholic Federation of Catholic Physicians’ Societies, said he welcomes the CMHA’s efforts to keep mental illness out of the euthanasia law’s eligibility criteria, and to maintain the current regime that requires a “reasonably foreseeable natural death.”

“However, court challenges will inevitably come, arguing that if suicide is an answer to suffering, why would mental suffering be a just reason to discriminate,” Lau said in an email interview. “Since we had opened this can of worms, it could be argued that it is a violation of the Charter of Rights and Freedoms. Suicide would become a treatment for depression rather than a terrible consequence.”

Lau said he has already had patients request so-called Medical-Aid-in-Dying (MAiD) “but they were depressed, so at the present time there isn’t a pressure for those folks.”

“Things will change, sadly enough,” he said.

On Sept. 7 the CMHA released its position on Bill C-14 on MAiD, which came in advance of World Suicide Prevention Day on Sept. 10.

“As a recovery-based organization, CMHA has announced that the Canadian government should choose to support recovery for mental health patients rather than MAiD, and further invest in services, supports and research regarding mental health,” the organization said in a release.

“Bill C-14 mentions that the illness must be irremediable, grievous and unbearable, and the patient should have a medical condition with a ‘reasonably foreseeable natural death,’ ” it said. “For patients who suffer solely from a mental illness, a natural death would not be foreseeable. This is one reason why CMHA believes that psychiatric MAiD should remain illegal.”

The CMHA reported analysis of policies in Belgium and the Netherlands, where psychiatric euthanasia or assisted suicide is permitted, showed they led to increased requests.

“CMHA suggests that we must be careful to avoid the use of MAiD as a substitute for treatment and supports,” the release said.

The CMHA suggested the government instead report recovery by investing in mental health services, by implementing a national suicide prevention strategy, and better research into mental health and substance abuse.

“Overall, CMHA’s position on MAiD in Canada is that people should be assisted to live and thrive before they are assisted in dying,” it said.

“CMHA correctly wants to combat suicide,” said Lau.

“Even in the context of the current law, what is not mentioned much is the problem of concurrent mental illness and patients who have, say, depression and cancer,” he said “A person with depression will be more likely to want to suicide, and the hope that a capacity assessment would prevent suicide is unlikely.”

“If someone wants suicide badly enough, they will find someone who agrees with them,” he said. 

“Another current problem that is not really talked about is that there are mental health conditions like anorexia where death from malnutrition is foreseeable and a person could easily ask for this ‘treatment’ to ‘end’ their suffering, so the exclusion of MAiD for mental illness is not actually true,” Lau said. 

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