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.

It's quite hard to put into words how abhorrent and morally reprehensible MAID is so I'm going to illustrate it with a case that I've heard of recently.

A man in his 50s, chronically disabled with back issues but not terminal, applies to go on the MAID program. He's about to be made homeless due to extreme poverty. His doctor signs him off for the MAID program.The media in Canada gets a whiff of the story and publicises it. A fundraiser is set up and somewhere in the region of $60,000 is raised to help get this man back on his feet. The man on the program who only needed one more signature by the way-comes off it as his actual problem has been aided with help and support that he actually needed.

For all that claim that the checks are robust, impenetrable, are you sure? How did this man slip through the net then? Had he had one more signature, we might be looking at a completely different and tragic outcome. There was a similar case where the outcome was not positive at all.

This is what short-term compassion looks like and why rules and laws should never be based on compassion. For anyone that will say that I don't care about people suffering with terminal illnesses-I do-but we know from doctors and the hospice care field-that pain can be effectively managed. There's a reason why one of the leading hospice care associations in Canada are strongly and vocally opposed to MAID in all of its forms.

You best believe that this is a system ripe for abuse. Objectors to MAID and other forms of assisted suicide have warned how opening the door to it in any form-for cases of terminal illness-will naturally lead to people who are mentally ill wanting it and being allowed it and case in point-here it is. There's your slippery slope. They've plummeted down it at an alarmingly rate of speed.

There will be people who have been bullied and coerced by relatives and other "loved" ones into doing this as they're perceived to be a "burden." It may be dressed up as "Look at this wonderful, kind, compassionate solution to all of your issues," but it's still coercion. For all the will in the world, no doctor or human being will ever be able to weed out those who have been bullied and coerced.

Why are people so happy and willing to see life as something that's disposable? TLDR: I'm opposed to it in all of its forms.

It's very immoral. With some mental health diseases there's a very fine line when someone is well and unwell. Meaning someone is very unwell, may look well to others even doctors and may take the decision to use Assisted Dying when they just needed a different therapy or more time in treatment. When people are in a depression or manic cycle they really can't take conscious decisions but others who don't know them (even doctors) may not realize it.

Only best friends, partners would recognize this type of behavior.

Health care professionals represent a wide range of personal and professional views on death. So it is possible there are health care professionals who feel anyone should be allowed to die at any time and they would be prepared to risk their licenses and professions to not follow MAiD protocols and to sign off on people who don't meet critieria. There are always a small number of humans, even in helping professions, who don't follow the ethics of Do No Harm. The chances of finding two independent practitioners prepared to sign off for someone who doesn't meet eligibility would be very rare.

However you can't believe everything you read in the papers. This is a political and tense issue in Canada and there have been some activitist both inventing, embellishing and misrepresenting stories to try to make their cases and points. The start date for the inclusion of mental health has been postponed due to ongoing concerns by health care professionals about what their responsibilities would be. There have been a few reports trying to clarify this but none yet to the satisfaction of the physicians / psychiatrists / nurse practitioners who would be involved. For a non foreseeable a death, one of the assessments and sign offs has to come from someone with expertise in that specific condition (psychiatry) and to date psychiatrists as a group are pretty resistant to taking responsibility to assess and determine eligiblity of what constitutes greivious and irremdiable, what consitents the required decline, and what constitutes offering of services and consulations with those services. Based on this criteria - a lack of access or resource makes one ineligble unless the resource doesn't exist (versus being difficult to access to long waits or lack of practitioners). The next report is coming out in February.

To date most of the health care professionals involved have been palliative care professionals who are comfortable with their role in assessing and providing comfort measures or MAiD to a dying population. The inclusion of those with non forseeable deaths was not meant to originally be part of the legislation but was eventually legislated after a court order to do so. So far, that has been a minimally accessed route - and primarily for neurological disorders like Huntington's and Parkinson's. To expand this beyond palliative care is of great concern to many health care professionals as well who have responsibility in various ways within the legislation. Even for those who support MAiD, ensuring a process that supports the intended goals is critical.

Of course it should be available. Anyone should have the right to end their life in a dignified way at any point. It is the ultimate in bodily autonomy. The arrogance of anyone thinking that they are a better judge of the situation than the individual themselves is breathtaking. Many people object with the idea of impinging on women’s bodily air when it comes to abortion but are quick to remove the option of a dignified death. Death is not some enormous unknown it is the one absolute certainty for all of us.

100%

I want to be able to say „It’s been a blast folks but I want to get off now, not enjoying this any more“ and be able to get assistance to leave with dignity and prepared support for those who survive me. A process to make opting out viable. None of us opted in, at least let us opt out if life isn’t for us.

No, this is morally reprehensible. We should have the infrastructure in 2023 to be able to sufficiently treat mental health issues and have the moral duty to support those that suffer.

For context, I suffered from severe mental health issues from young childhood into my 30s, I thought that was just life and constantly thought of suicide. I managed to pay for trauma therapy a few years ago and it changed my life, I am happy and thriving now. Would I have considered assisted dying in my 20s when I was at my lowest, absolutely, would it have been a good choice knowing that I am living an exceptionally happy life, no.

Are we all happy when someone dies by suicide? No, we are all horrified that they have been let down by society and the system. Why should state suicide be any different? It just gives an excuse to not help and support those who need it.

Saying all that, I'm not in opposition to assisted dying in terminal cases but I am not sure how to safeguard against possible abuse. We should allow dignified death but if that leads to governments and society being able to offer a way out rather than invest in making society a better place then no, I dont agree with it.

I think it's incredible that they'd sooner kill someone with a mental illness than fast track research into other therapies such as psychedelic therapies which are highly effective.

Canada has been advancing research on psychedelics and they can be accessed in 3 ways.

Clinical trials
Special Access Program
Individual subsection 56(1) exemptions from the CDSA

And no one is killing anyone else. That line just echoes around the echo chamber.

Assisted suicide isn't necessarily pain- free or easy. There's evidence that it can be a horrendous and distressing way to die, with sensations of burning alive, vomiting, taking weeks to die.

Seriously do you think that it’s beyond science to find a painless way for people to end their lives?

www.dailymail.co.uk/news/article-11322105/amp/How-assisted-suicide-23-year-old-woman-created-national-scandal-Belgium.html

A 23 year old woman in Belgium killed by doctors instead of being treated properly for PTSD.

If you do not want this to happen in the UK, then you must never allow any kind of euthanasia.

What? Weeks to die? I don't think so - what is your evidence for this with MAiD?

The Canadian Association of MAiD Assessors and Providers recommends fixed dosing of midazolam (an anxiolytic), 10 mg; propofol (an anesthetic coma-inducing agent), 1000 mg; and rocuronium, 200 mg, or cisatracurium, 40 mg (neuromuscular blockers to stop respiration).

If someone is suffering they should be allowed to die. I have mental health issues and have attempted suicide in the past, obviously unsuccessfully. I’m not actively suicidal anymore but my life is pretty miserable without much joy, my life is pretty pointless and I don’t believe anybody would really miss me if I was gone. I don’t see why anybody should have to keep living beyond a point which they want to. One of the things that scares me most about attempting suicide again is that no method is 100% successful and that there is always the risk of ending up with a life changing injury and being reliant on care from others, if there was an option to end it legally and in a way which was guaranteed and where families didn’t feel the shame or guilt that, is often attached to suicide that would definitely bring me some relief and make the option of ending things feel more achievable. Why should anybody have to live in misery? My life doesn’t mean anything to anybody outside of myself, so why should the views of others stop me from being able to terminate it?

@dollymixtured

There is currently no way to guarantee a pain free death, even with many years of experimenting on unfortunate humans in other countries.

www.ncbi.nlm.nih.gov/pmc/articles/PMC9270985/

That is an interesting article and speaks to issues when the person is self administering without a health care professional though the oral route (swallowing pills or powders). It seems there should be clear guidelines for what medications to use. In one example the person had to swallow 100 pills and in the other, the person who had difficulty swallowing had to drink a large amount of fluid. These seem like oversights in the process.

Yuck.

Drugs used for medical purposes are required to undergo a stringent approval process in order to assess efficacy and safety. But the drugs being used for ‘assisted dying’ have not undergone such process; the safety and effectiveness of previous and current combinations of lethal drugs is largely unknown. Canada’s MAiD protocol concedes this.

The full ‘cocktail’ included two anti-nausea pills, an anti-seizure pill and 100 capsules of Secobarbital. It all had to be ingested within an hour... My attention turned to the kitchen table, where my husband and sister, wearing latex gloves, frantically scraped the powder from 100 capsules with toothpicks, trying to beat the clock... The mountain of powder we poured into more sugar syrup created a half-cup of sludge so bitter it literally burned my tongue. And my aunt, who could barely swallow water, had to drink all of it in <5 min to ‘ensure success.’... When we sat back down at the kitchen table, white powder everywhere, we all had to wonder, ‘Who the hell wrote this law?’ We had been forced to assist in the most bizarre fashion, jumping through seemingly random legal hoops and meeting arbitrary deadlines while my aunt suffered, and finally emptying capsules, making an elixir so vile I cried when I knew she had to drink it. This was death with dignity?

Thank you for sharing this. I have thought about the morals of assisted dying but had always pictured the actual death as peaceful and a gentle drifting off. It’s important to have this info.

It's a big fat no from me. If people were 100% committed to end of life in these cases they would commit suicide. And we fight to stop people doing that because the majority with treatment can have a better life.

Read this and see how it has proliferated from being for those who are staring death in the face such as MND sufferers.
www.thenewatlantis.com/publications/no-other-options

It is and I don't know why this keeps being ignored in this thread. This is and has been allowed in more than one European country for ages. You cannot just go to the doctor with a bout of depression and ask for some suicide pills.

I know I'm in the minority on here, but I'm in favour of assisted suicide and I have a positive experience with seeing a family member go through it. They were not a psychiatric patient, but they were not terminal. It was the best thing for them and a peaceful ending for everyone involved. I'm glad it was an option.

This already happens

www.google.com/amp/s/www.bbc.com/news/stories-45117163.amp

There are other cases as well. A recent one was a very young woman with PTSD.

Ops argument seems to be "MH care is shot so its fine to help people kill themselves"

Imagine if this were cancer.

"Mr Smith you have cancer, its difficult to access care and its an expense we'd like to reduce frankly. Instead of petitioning for better treatment and survival, we'd instead like to offer you euthanasia. Think how much effort you'd be saving people"