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.

So what you are describing is a mathematical algorithm that assesses a patients likelihood of recovery or death based on past patients.

Don't put words in my mouth. What I am describing is a set of evidence based guidelines, like those which are used in physical health. The assessment should always be made by real human beings, in collaboration with the patient and their family, over time. What you've just done is the worst kind of dishonest argument.

Please get a different job @StressedToTheMaxxx . I don't want to be forced to work with mh staff who would be happy to see me euthanised.

@StressedToTheMaxxx never said they'd be happy to see you euthanised. They can understand why some people would choose it, I can understand why some with mental illness would also.

Someone with a wish to die DUE TO a mental health illness should be offered high quality health care. Their judgement is compromised. This is very 3rd Riech. Fascists can use this to clear prisons, get rid of waiting lists and prune benefits claimant numbers. How bloody depressing. So what's the next step, MH patients can't procreate? When is the western world going to wake up. Tranada is a shit show.

I’m not sure that would happen. I am afraid that there would be a if you can’t handle life, then just end it attitude. A we tossed some anti-depressants in your direction and gave you six weeks of online CBT, if you’re not better then just go already no useless no-hoper attitude. People would be afraid to seek help for complex or stubborn mental health conditions because the expectation would be if it’s not an easy and quick recovery, then you get binned as a human being.

Especially, given this governments attitude towards the disabled and mental health. I have zero confidence that offering a final solution would encourage better mental healthcare services. I can envision too that disability benefits for mental would have a time limit based on ‘data’ and ‘studies’ that say anyone not well enough to work after x years should sign up for euthanasia.

I am really conflicted by this.

SENS AND TRIGGERING

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My 15 year old DD is suffering with psychosis and suicide ideation, and keeps trying to kill herself. She frequently begs me to let her die. It is heartbreaking and horrific. I cannot tell you the agony in her face and that's reflected in my heart.

I do not want her to die. I want her to get better and live a life free of the demons that torment her. But she has already read about this and is talking about going to Canada for this express reason if and when she would qualify.

I cannot tell you the constant terror we live with, that today will be the day she succeeds. But I also know how unbearable the torment is for her. She constantly hears voices telling her how worthless she is and to kill herself.

We have been through many meds and weekly psych sessions. None of them work. She is being given every help that's available.

I hope for her that her MH improves once she's through puberty and an adult. But her dad's sister has been living with complex MH all her life and she has never been able to lead a successful and independent life. I see what has happened for her aunt and I dread her future.

I can't imagine life without my gorgeous girl. But what would be worse, finding her after suicide or allowing her a planned and dignified death? And who possibly feels qualified to make that decision?

Oh, so you are describing a highly subjective and individual form of assessment then. Strange you think that is superior to actually using the data in an objective manner.

I see what you mean, a terrifying vision indeed.

Especially, given this governments attitude towards the disabled and mental health. I have zero confidence that offering a final solution would encourage better mental healthcare services. I can envision too that disability benefits for mental would have a time limit based on ‘data’ and ‘studies’ that say anyone not well enough to work after x years should sign up for euthanasia.

This I agree with fully. We should not implement anything until we have not just a change of government but a full change of governance.

I can highly recommend this podcast: https://podcasts.apple.com/gb/podcast/first-person/id1624946521?i=1000610839932
It's a Psychiatrist in the Netherlands wrestling with exactly this question. He starts out as an advocate as his mum was euthanised (although with a physical not mental illness) so in theory he is in favour. But he does research on it, still probably thinks there is a place for it but tellingly has not yet signed off anyone ...

It is worth a listen

I have schizophrenia and have been sectioned many times. While in hospital I have sadly come across a lot of mh staff who clearly think people with psychosis are some kind of different species. We're not, we are people who are unwell. As for people never recovering - have those people received the correct support? Or are they stuck in a system where they are seen as too hard to treat+ too much effort to work with.

Again, I have schizophrenia. If you work in mental health, and think euthanasia is an acceptable response to psychosis, for the love of God, get another job. I don't want you anywhere near me.

I don't need to get a different job, I'm actually very good at it going by feedback from staff and patients alike. I'm not sure if you have problems with reading but that's not what my post said at all. Clearly you're letting your own personal experiences cloud your little outburst there.

And check your arrogance - you don't talk for everyone, ceteinly not everyone with treatment resistant mental illness.

You're still putting words in my mouth!

Using algorithms is bad because computer says no.
Having a panel of qualified people use those guidelines alongside face to face assessment of the patient is bad because it is subjective.

Nothing will ever be good enough for you because your position is 'no, never'.

That's fine and you are entitled to that opinion, but how do you think medical decision making works in the real world? We have the NICE guidelines, which underpin everything. Within those guidelines, medical professionals make decisions. Because they are human beings, those decisions will always contain some kind of subjectivity. That's how the world is!

Your thinking it so completely zero sum it isn't even funny. Medical decision making will never be 100% perfect, just as there is no such thing as a medication that is 100% safe. In your world this means that no decisions should ever be taken, and no medication prescribed, if we take it to the extreme.

It's terrifying.

Do you trust the government? Or politicians in general? I don't.

Imagine a future where upon your diagnosis, you're offered a range of treatments and euthanasia as an option.

Well I wouldn't imagine for 1 moment you are able to make these sort of decisions whilst lacking mental capacity. Surely there's some sort of advanced directive.
I've mixed views about voluntary euthanasia however I don't think physical and mental health should be considered differently. I know people with long term mental ill health and their lives are often full of torment and agony against a background of misery. Many fall into addiction so they can have a 'head holiday'.

Yes , you do seem like a person who has spent years working on inpatient units- the total lack of respect for my concerns about how terrifying this is for a person with schizophrenia to read shows you must fit in really well on the wards. But yeah, reading about how people who I have to "work" with think I should be subjected to their decisions about whether my life is worth living is "arrogant". Thanks for that.

Just so I don’t misrepresent your position you believe that suicide is fine but you can do it yourself? (Just to be clear I don’t think of suicide as a moral issue)

Would you try to stop someone who expressed intent to kill themselves?

Unlike physical health, say terminal cancer, our medical knowledge is too bad, too incomplete for anyone or any computer to make the kind of assessment you are envisioning with any degree of accuracy or confidence. We can tell if cancer is terminal, we can tell if someone is brain dead and no chance of coming out of a coma, but we cannot tell if any mental health condition is the equivalent of terminal.

Yes, in future there may be something good enough, but realistically medicine isn’t there right now imho when it comes to mental illness.

I'm not a supporter except in the last 6 months of life. But they already allow it for chronic illness, mental health can be under this too. I think it's allowed in Belgium too

Yay, it's 1930's Germany again.
Or 1910's Bloomsbury - take your pick: genocide & eugenics, what a heady mix, & the desire to inflict them on humanity yet again so succinctly expressed, one could almost believe Youdoyoubabe is a wannabe mass murderer. Or maybe just hasn't quite thought this one through ...

No, I don't have problems reading, what kind of fucked up response is that? You really really need to get a different job, if your "patients" knew what was going on inside your head, and the contempt you have for people who disagree with you, I doubt they would feel very positively about .

Or as in that appalling article, financial options get involved.

"We can't provide you with what you need/this treatment/this stair lift/this wheelchair/benefits/whatever else you need to cope with your condition, but we'll happily help you die if you want."

There's a path there that's a cheap way to gatekeep services by leaving people to get into dire enough straits that they'll take the only remaining path.

I'm not always actively suicidal but I've never especially wanted to live. The main thing that's stopped me unaliving is not knowing how to do it in a way that's relatively painless and doesn't have a considerable risk of failing and leaving me a vegetable. Why should people be expected to live like this for several decades just to avoid upsetting the living? Now THAT'S the real selfishness.

Having worked in MH for decades, I do believe there is such a thing as ‘terminally’ mentally unwell. I have had patients who have tried every medication and therapy available.

Some patients simply do not get better. That could be because of hugely traumatic experiences which they cannot move on from, their current social problems from which there is no way out or simply due to their genetics. I can certainly imagine a cohort of people who have the capacity to make this decision. And it feels pretty rational to me.

Do I support euthanasia in this group? I honestly don’t know. But the pain of poor mental health is truly unbearable for many.

Personally I'm all for the option of euthanasia, we wouldn't let dogs suffer the way some people have to. I also think it should be available to those with treatment resistant MH issues. However I think where places that have it available are going wrong (especially Canada) is by offering it as a solution that someone hasn't explicitly asked for.

I don't think Euthanasia should ever be offered, obviously everyone will be aware if there are clinics and it is available, but no one should be offered it. It needs to be for them to come forward and say 'I need this'.

I also don't think anyone (apart from their own doctor) has the right to decide whether other people should be allowed to be euthanised or not. Make the decision for yourself of course but you have no right to make blanket decisions for other people.

There are plenty of people who are completely against abortion and think it is very wrong, that doesn't mean they should get to decide that others shouldn't be allowed one. Personally I believe in body autonomy, your body your right to make an informed decision.