Recently, the federal government passed legislation to expand eligibility for Medical Assistance in Dying (MAID) for people solely diagnosed with mental illness. MAID was first enacted into law in June of 2016, with the government recognizing that this procedure allows people to have autonomy. Since then, there have been revisions of MAID as the government and healthcare practitioners see fit. In 2020, the Minister of Justice and Attorney General of Canada introduced a bill altering the law. They found that the “foreseeable end of life” criteria was unconstitutional. The expansion of eligibility was set to come into fruition in March of 2024, but was delayed to 2027. Federal Health Minister Mark Holland announced the setback saying that the Canadian health care system is not quite ready for the change.
While the term mental illness can be broad, the eligibility for MAID is quite specific. According to current legislation, a patient must meet these requirements to be eligible for MAID: be eligible for health services, be at least 18 years old and mentally competent, have a grievous and irremediable medical condition, make a voluntary request for MAID and provide informed consent before the procedure.
Analyzing potential future eligibility for MAID raises concerns for many Canadians. The legislation distinguishes psychiatric conditions—such as depression, schizophrenia and personality disorders— from neurocognitive disorders, with primarily patients with psychiatric disorders being eligible.
Canadians’ attitudes towards MAID, in particular for people with only mental illness, remain conflicted. In a study conducted at Mt. A by professor Stephen Claxton- Oldfield and fourth-year psychology student Emma Mackley, they looked at students’ attitudes towards MAID for mental illness. In their results, they found many students were weary of patients whose only underlying condition was mental illness. In their study, participants responded to different statements about MAID for mental illness. To the statement “individuals who are being treated for mental illness should be able to access MAID,” 42.3% of participants disagreed or strongly disagreed, 29.6% were unsure or neutral and 28.2% strongly agreed or agreed. To the statement “individuals who are waiting to be treated for mental illness should be able to access MAID,” 71.4% of participants strongly disagreed or disagreed, 14.3% of participants were unsure or neutral towards the statement and 14.3% strongly agreed or agreed. The results from the survey demonstrate that many Canadians believe seeking treatment for mental illness is a better option than assisted suicide.
Several experts debate the expansion of MAID for people solely with mental illnesses. While many people have very strong initial reactions to people with mental illness, it is truly a multi-faceted problem. Many advocates for MAID in cases of debilitating mental illness state that the delay is discriminatory and further vilifies those who suffer. While conducting my research into MAID, I found several stories of people who endure crippling mental illness every day. Psychiatrist John Maher of Ontario believes that the legalization of assisted suicide for people solely with mental illnesses will let vulnerable people fall through the cracks. He worries that some people may choose to pursue MAID because of social reasons rather than medical reasons such as poverty and loneliness. Further, several MAID providers like Dr. Stefanie Green are focused on patient centered care, saying that MAID will allow people to make decisions over their lives, and ultimately their deaths. While many people have conflicting opinions towards MAID due to mental illness, most realize that institutions are not providing adequate care and compassion for those who are struggling.
Maybe put suicide hotline number here. Readers of the Argosy reach the Chimo (Canadian Association for Suicide Prevention) helpline at 1-800-667-5005.
