Canada’s euthanasia for the mentally ill

[Noicant]

https://globalnews.ca/news/9454089/medically-assisted-dying-bill-mental-disorder/

Canada is in the process of introducing the option of Euthanasia for the mentally ill. It looks like this has been delayed for the time being but AIBU to find this concerning?

Just to be clear I fully support euthanasia as an option for people with terminal or chronic conditions. I think it’s human to offer people a peaceful death when there is no chance of things improving.

BUT this seems utterly mad to me. I’ve suffered from poor mental health in the past and only started feeling better after going through a few therapists and finding the right one. There were many times over 20years where I would have happily signed up for death. If someone is so ill that they are very impaired by their condition are they truly competent to make a decision like this and if it’s milder isn’t there a possibility of recovery?

It seems utterly dystopian. I guess I’m looking for someone to help me understand if I’ve missed something or not understood something that will help me understand why anyone would think this is a good idea.

What concerns me, and I do agree that those with terminal illness should be given assistance to die, is that people who need long term care might be persuaded that an assisted death would be better. In other words, you are costing the state too much, off with you.

It was a disabled athlete asking for a wheelchair lift

That's outrageous

But if the person has not received sufficient or appropriate robust mental health treatment how can you say all avenues have been tried - until a government can prove that their mental health provision is provided to all mental health patients and that that provision is thorough and robust I don't think you could evidence that sufficiently to allow this.

However, I also agree with @pointythings ...sometimes there is no hope, no recovery...I've actually seen people say on here that all mental illness is curable with the right treatment but no, no it isn't...and for those who every caring effort has been made to genuinely help them then I actually do think that to let them go would be the kinder thing....

Good point @maddening ...is there any country that we can say yes, mental health care is top notch and has done all it can?

In the right circumstances it could help the person with mental illness by ending their suffering. Which is kind of the point.

I think that mental illness can be extraordinarily painful and to see someone descend into the abyss and be unable to help is equally disturbing. Are you wanting people to be forced to live with extreme bi polar or schizophrenia. That’s like condemning them to 40 or 50 years of Hell.

My mother died of vascular dementia and if I get diagnosed with it I have absolutely desire to die as soon as it moves to low to medium. Timing will be critical to make sure that I have capacity or maybe a form of living will.

Yes thank you, I’m also talking about my family, bi-polar disorder is common, schizophrenia, personality disorders. There have been sections, drugs, therapy (so much therapy). Many of those people have had down periods that lasted years but then on the up for a bit.

I understand there will be people who are much worse off and never have periods of stability. I’m not saying outright that offering it as an option is 100% the wrong thing to do but it worries me.

Les Landry has disabilities and managed to get signed off from a doctor to be put forward for MAID and clearly said afterwards it’s because he can’t afford to live. He’s very much alive and kicking but the fact that he managed to get it signed off and made it through the screening process is concerning.

Agree. I think this is really good evidence for slippery slope arguments around euthanasia.
However much we might want to allow euthanasia in individual cases, I think it's wrong to legalise it for this reason.

https://www.nationalreview.com/corner/canadian-disabled-mans-euthanasia-request-due-to-poverty-approved/

This is Vile

In the documentary Pru Leith did recently they interviewed a man in Canada, in his 80s who had lived with depression for decades. His wish to die was rational, calm and supported by his wife. Currently he cannot access it whilst a man with Parkinson's who had similarly had enough, could. I agree that there is an inevitable danger of economic factors pushing an agenda but I think we do need to move away from a "life at all costs" approach (figuratively speaking). If a person is able to rationally, calmly and over a period of time express a consistent wish then I'm not sure what the moral basis is for refusing that autonomy.

Do you also think people with cancer should be forced to explore "every last avenue" for a cure, endure anything, because they might get better? If you are quadriplegic do you have to hang on in there because there's bound to be a solution one day?

There are many issues to deal with when it comes to the treatment of mental health but one of these is that not everything treatable and a good quality of life isn't possible for everyone.

I agree. I have a friend who has spent the past 15 years (so pretty much her whole adult life) in and out of mental health facilities, trying every treatment and getting nowhere. She has no quality of life. I would absolutely understand if she or others like her took this decision. Though of course they shouldn't ever feel pressured too. But I think feelings of suicidality can be separated from a logical decision to escape from a seemingly never ending health condition that ruins your life.

I suppose the fear is that instead of offering (often expensive) treatment and day to day support and paying out welfare to vulnerable people this will be the 'prefered' option which just so happens to save the state millions...

This is how the Nazis managed to sell Aktion4 - the mass killing of the mentally ill and the disabled. It as much about cost cutting and burden on the state as genetic purity.
Euthanasia for psychiatric patients and eugenics go hand in hand.
Churchill was a big fan and spoke about putting the wretched creatures out of their misery.
Supporters will try to sell this as progress and compassion.
I call bullshit.

In fact, many assisted suicides are facilitated by doctors who have not treated the patient and only met them briefly for the purpose of obtaining the lethal prescription. These days, assisted suicide can even be obtained in a Zoom call.

Its a very difficult and challenging issue, but at the base of my beliefs (note, I say MY) I agree with this provision being made - with strict controls.
I believe that if we have a legal right to life, we also have a legal right to death. Without that, a right to life means very little. To have a right to death should therefore mean a right to access death through calm, clean, controlled environments. Not by having to do the job in a way that can't guarantee success and risk disability or incapacity. Families should be able to spend their last moments together rather than in secrecy and horror.

That explai s why I support euthanasia in general. If someone is chronically mentally ill to a point where their life is almost permanent misery, then I cannot morally distinguish between it and physical deterioration. If someone is suffering highs and lows, then there would need to be criteria in place to prevent them accessing the services at a time when they are unstable. But if it is a chronic, non-stopping affliction which has shown no improvement through medication or therapy (and these have be supplied and tried), then I don't believe we should be able to prevent access to euthanasia. Chances are they will complete the job anyway, by their own hand.
It's terribly tragic and terribly hard, but I think a civilised society should have an obligation to provide a civilised method of suicide/euthanasia.

I think there was a case of a girl in the Netherlands who had a severe eating disorder who was offered euthanasia (or to be allowed to die). I remember feeling very strongly at the time that this was the wrong decision. I felt it was wrong because I had experienced a serious eating disorder and reached 3 stones ten in weight.. At that weight, I was not capable of making a decision. Indeed, I thought that if I could choose to die, it would be the best thing because I could select the time and place, and it may be cleaner and more respectable than, perhaps dying of a heart attack after vomiting down the toilet. Intervention was taken to save my life and it worked, fortunately for me.

I realise this is my experience, but I think there is a world of difference between offering euthanasia rather than treatment and support for people with some mental illnesses, and offering someone with a terminal illness that will result in a painful and undignified death, the chance to avoid the final stages.

@Noicant and @SwitchDiver I do understand your personal concerns. I've worked in mental health for many years. However, when these threads come up it's always in the light of the Canadian approach to this. The Canadian approach is bad, it has insufficient safeguards, it is ill thought through. But other models are available.

I had a cousin in the Netherlands who had psychosis. Nothing helped him. He killed himself by jumping off a block of flats, to the immense distress of the people who witnessed it. This included children. Is that better than offering a way out? Where I grew up there was a stretch of train track that was notorious for suicides. It was horrific for the train drivers. Is that better than offering a way out?

I think broadly speaking the Netherlands has it right. It isn't perfect, but it's a hell of a lot better than leaving people permanently stuck in a life with little or no hope.

My main concerns about introducing assisted dying in the UK is that we have a government that only cares about money and selling stuff off to their wealthy friends. I'd like to see that change, and then I'd like to see the introduction of PR, before we take action on assisted dying. But I have no issues with AD itself, if done properly.

I’m very much on the fence about this.

I think there is a lot of evidence now to support the slippery slope arguments and it’s all too easy, when health care is commercialised, for the frail and vulnerable to feel pressured by economic factors.

On the other hand, part of taking mental illnesses seriously and imbuing them with the same “value” and seriousness as physical illnesses, is acknowledging that they can cause intense lifelong suffering and occasionally cannot be cured.

As someone who has experienced suicide in my close family, I can’t decide if future generations will look back and think that forcing people to take matters in to their own hands was intensely uncivilised, brutal and medieval? Or will they be dismayed at our lack of ability to treat and cure?

I’m not sure … .

@emanresu000 the anorexia case in the Netherlands was a 30 year old woman who had lived with her illness for 20 years. How much longer did you want her to carry on suffering? This is the sort of patronising attitude that makes me see red. It isn't your lived experience, it's someone else's.

I realise this is my experience, but I think there is a world of difference between offering euthanasia rather than treatment and support for people with some mental illnesses, and offering someone with a terminal illness that will result in a painful and undignified death, the chance to avoid the final stages.

Yes, me too. They are nothing alike and the constant conflation of the two is very disturbing.

Well your pessimistic attitude is worse. How dare you assume that anyone’s life would be nothing but suffering simply because they have anorexia? My DD has anorexia…should I have just smothered her with a pillow at 16 to spare her “suffering”? And what motivation will the government and health service have to help the mentally ill if they can simply tell the person, it’s incurable, you will suffer the rest of your life so sign here and we will kill you humanely.

@emanresu000 ok, you were talking about the case of Noa Pothoven, who was 17.

She did not receive euthanasia.

People get this wrong all the time. She committed suicide by refusing to eat or drink and the decision was taken that she should have palliative care only at this point, so clearly she had capacity.

She didn't just have an ED, she had many other comorbid and serious illnesses.

@SwitchDiver ultimately when your DD is an adult, it will be her decision to make. You want to deny people agency and choice because they have a mental illness. Ultimately this isn't about 'negativity', this is about allowing people to choose their own path. If you really think that the people who have chosen euthanasia in other countries based on mental ill health have done so because it was the easy way out, you need to read their testimonials, because that is a horrific point of view. These are people who have striven and tried and battled for many years and who are done fighting. You disrespect them utterly.

Yeah thats my other concern that people who end their own lives do it in a terrifying painful messy way and the people who find them. If someone is 100% going to do it is it better that they do it at a time of their choosing and peacefully.

How would people feel if it was their child choosing to die because of mental illness. Should there be a minimum age?