Canada will soon be offering assisted suicide for the mentally ill, alongside the already established medical assistance in dying for people with incurable illnesses.
The Trudeau government in Canada provided the latest ministerial update on the extension of the medical assistance in dying (MAID) statute to cover people with mental problems with all the amplification of a tin whistle.
The Trudeau government’s response to the February report by the special MAID joint committee of MPs was smuggled out in mid-June, when no one was looking, with the kind of fanfare generally reserved for unfulfilled electoral promises.
That should come as no surprise given that its authors — Liberal Justice Minister David Lametti and Liberal Health Minister Jean-Yves Duclos — do not appear to be supporters of Justin Trudeau’s decision to expand MAID eligibility to include persons whose only underlying ailment is a mental disorder.
When the law was revised in 2020 in response to a Quebec Superior Court judgement that limiting assisted dying to persons with “a reasonable foreseeability of a natural death” was unconstitutional, David Lametti was on record as opposing extending MAID to people with mental problems.
He opposed at the time on the grounds that it would endanger the life of someone whose health may have improved – an argument with which Jean-Yves Duclos, that most rational of philosophers, would undoubtedly agree.
Both have agreed to support a law that has been broadened to encompass mental diseases, due to an 11th-hour change from the Liberal-dominated Senate that the administration has opted to adopt without question.
But the Trudeau government’s statement reads like it was crafted by two guys who are embarrassed, if not ashamed, by the law.
Despite the seeming lack of enthusiasm among its supporters, it appears that Canada will begin state-assisted killing of persons who cannot be diagnosed by any medical as suffering from an incurable disease as of next March.
A few months ago, Parliament gave itself an extra year to develop a plan for implementing the next stage of MAID, and much of Lametti and Duclos’ response was devoted to a progress report on the actions being taken to standardise MAID eligibility evaluations.
There is no indication that the Trudeau government intends to reverse course.
The MAID joint committee will issue its final proposal on extending euthanasia to persons with mental problems this autumn, but skeptics should not expect much support from that group given its eagerness to broaden the eligibility criteria.
According to the National Post, Lametti and Duclos appear to be the best chance that a request for medical aid in dying does not always imply that the eligibility conditions will be met.
Last April, veteran Conservative MP Ed Fast filed a private member’s bill to reverse the government’s decision to extend MAID to the mentally ill while keeping the original euthanasia statute in place for individuals with incurable diseases.
According to Fast, the government’s extension “encourages death as a’treatment option’ for those struggling with the difficult challenge of mental illness.”
However, with the Bloc Québécois and the NDP backing the government, his efforts are likely to be in vain.
In that event, Lametti’s vow of “caution and prudence” while the MAID law reform was before the House of Commons becomes critical.
His and Duclos’ reaction to the special committee’s report suggests that any future development of MAID will be cautious.
Two of the committee’s suggestions in its February report — that MAID be expanded to cover “mature minors” and made available to those suffering from degenerative diseases such as Alzheimer’s who provide advance consent — were ignored by the government’s response.
Minors “deemed to have the requisite decision-making capacity,” according to the committee, should be eligible for MAID, however “for the time being,” it should be limited to those whose death is realistically foreseeable.
In response, the government provided little more than tea and sympathy. “(We) need to better understand the voice of youth on this matter, including Indigenous youth,” the letter stated, a reaction criticised by organisations such as Dying with Dignity, which wants MAID to be open to adolescents as early as 12.
Lametti and Duclos voiced worry about circumstances where people are unable to reconfirm their intention for MAID before it is administered.
While the initial euthanasia law was widely supported by Canadians as a means of reducing end-of-life suffering, the government recognises that expanding it to those with mental illness, let alone going farther, puts it on difficult ground.
According to US bioethicist Scott Kim, who spoke before a UK parliamentary committee investigating MAID, Canada currently combines “very open eligibility” with a “very aggressive medical delivery system.” In Canada alone, 10,000 people will die from MAIDS in 2021.
Trudo Lemmens, a bioethicist at the University of Toronto, said he initially supported MAID but now sees it as a sort of “harm reduction,” with the Canadian medical system embracing the idea of delivering medically assisted death “when people don’t have adequate access to social support and care.”
In medical circles, the concept of “incurability” for people with mental problems is still strongly debated. Sharon Kirkey of Postmedia recently reported on the example of a 68-year-old woman who had lived with severe depression and considered suicide for 15 years, twice seeking MAID.
Doctors then gave her ketamine, a medicine used to treat pain and treatment-resistant depression, and her depression was gone in two weeks.
Expert witnesses who testified before the special committee admitted that there is no medical data that can predict which people suffering from mental illnesses will recover.
In that event, Canada will soon offer assisted suicide, in addition to the already existing medical aid in dying for patients with chronic diseases.
It’s no surprise that Lametti and Duclos are uneasy about being the public faces of this new killing regime.
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