To not get the controversy over Canada expanding assisted dying for mental illness?

[janef001]

I’ve been reading online and watching videos regarding Canada expanding MAID for those with incurable mental illnesses in March of this year. It’s been getting a lot of backlash.

I understand that a lot of mental illnesses can cloud someones judgement but does that really make them inherently irrational? In almost every other case, an adult with depression/bipolar/schizophrenia would be considered competent in other aspects of life when it comes to signing a contract, purchasing a home. If they were to get in trouble with the criminal justice system, they'd be seldom shown any leniency and considered as responsible as someone without mental illness.
In an ideal world, mental disorders would be properly treated so that people wouldn’t resort to dying but the public resources (therapists, psychiatrists) are not easily accessible. Many meds prescribed also take too long to work, don’t work much/at all, or have unpleasant side effects.

It seems fair to allow death in certain cases even if the mental illness might not be terminal itself.

"I want to be able to decide (when to die) while still in my senses and when I think the time is right,"

She was not 'in her senses' when a decision was made for her to die and she was repeatedly, assertively vocal that the time was not right.

People change their mind. This paper suggests around half of terminally ill people change their mind:

jamanetwork.com/journals/jama/fullarticle/193281

So why wouldn't half of people with dementia also change their mind? I don't see how advance directives can be made safe.

My understanding is that the doctor in this case was cleared because he acted in good faith and within the letter of the law. I think that was right. It's not fair to put moral responsibilities like this on individual clinicians, as long as they are following the law and guidance.

Nevertheless, this woman's life was deliberately and forcibly ended when she did not want to die. For her, the experience and outcome were indistinguishable from murder.

I know everyone's keen to talk about dignity and not prolonging suffering and what they would want for themself (or at least what they now think they would want), or what they would have wanted for their loved one, but the bottom line is that in any other circumstances deliberately ending someone's life is murder.

That is the status quo. That is the starting point from which to build safeguards for any assisted dying law.

100% cast iron consent at the time of death is the absolute minimum. If there is the slightest doubt that someone might not want to die then their life should not be ended.

As someone with bipolar who has attempted suicide twice I find this absolutely terrifying. At the depths of a depressive episode you are certainly not in your right mind and I wouldn't say I had capacity so how is this judged? That's before you even start thinking about psychosis possibly being a factor. Being at the height of an episode is like someone else has got in the driver seat of your brain whilst the real you is lying dormant somewhere so this I cant think how this is ethical at all.

I would imagine that this wouldn't (or shouldn't) apply to bipolar disorder, which has a range of treatment options and if all else fails is episodic and will pass. Dor this reason I struggle to see that there would ever be a case where someone in a depressive phase of BPAD would be deemed to have capacity to end their life.

I think the comparison would be someone with a mental health problem which for whatever reason isn't treatable and is unrelenting in nature.

Mental pain can really hurt and there will be some people who won't want to live with it indefinitely without hope of change, just in the same way that people with chronic severe physical pain may want to die. It's a really difficult thing to say, and not a reality I personally want for anyone, but it doesn't feel right to assume all people with MH problems lack capacity - because they don't.

@Felix01 'when you take an animal to the vets they fight and don't want it but we still do it because it's in their best interests.'

I only just noticed this. We have moved from 'consent' to 'best interests'.

If we take a relative to the doctor and they fight and don't want assisted dying, should we still do it because it's in their 'best interests'?

People really need to stop talking about their pets in this discussion. Animals do not have human rights. It's legal to kill animals just because they taste nice. The starting point for ethical pet euthanasia is in a completely different place.

No one will sign off if the person is acutely unwell. If someone is manic or psychotic or in a severe depressive episode then their decision making will be clouded by their illness at that time and they would not meet criteria.

There are issues to overcome but there is a lot of information out there on the facts that people need to read to understand what MAid is or isn't.

Well I do wonder how they're going to ascertain that someone with suicidal ideation isn't in a severe depressive episode, given that suicidal ideation is actually a symptom of serious depression.

And if a person's depression has been alleviated, then I don't see how their illness can be termed "irremediable".

So these supposed safeguards are a nonsense in my opinion (as someone who has recovered from longstanding depression and suicidal ideation.)