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.

People may not get "better", but they may be able to be supported to live an ok life. I am currently not "well" exactly (still some symptoms) but am relatively content. I think if people with schizophrenia were generally treated with more compassion, and more respect, more of us would find the world a comfortable place to live in.

I barely lasted working a few months of my training in a psych ward. It is a tough gig. You cannot fix a mind without a lot of trial and error and massive, unrealistic massive, leaps of faith at times. Some of the treatment plans will prove counterproductive, even downright detrimental. I still don't support euthanasia of the mentally ill. There is already a mechanism which will control the numbers of those who are suffering acutely and constantly and will do their best to release themselves of life. Euthanasia is not required as a back up. It would eliminate too many who would have made it and even thrived later on in their lives. It doesn't matter if it is outwardly less 'messy' or 'kind to family' because cleanliness is not the end goal and death is rarely a kind process.

Although we have NICE guidelines based on cost - so treatments too expensive are off limits, so in the current system I do not believe we can properly evidence that a person has been given access to every possible treatment as it is limited by cost etc as well as competence of the staff -.so a person who has received treatment limited by cost and by potentially long chain of substandard staff in a stretched resourced area could be signed off where they may be able to recover.

Well, I think euthanasia should be legal in any and all circumstances. If I wish to end my life in a civilised way, I think it's barbaric that the state has a right to stop me. So I would prefer a total relaxation of assisted suicide laws. Personal choice matters.

Personally I believe in body autonomy, your body your right to make an informed decision.

Thats all well and good when you have full mental capacity, but if you suffer a mental health condition that periodically takes away your mental capacity so you have no real autonomy, such that you can’t even trust your own decisions. You are also especially vulnerable to coercion regardless of intention, well meaning or no.

When I’m sectioned, I cannot refuse treatment. I lose my right to bodily autonomy. Rightfully so as I am too unwell to have the mental capacity to choose what I want or need.

The thing is, I then have to have absolute trust in whatever doctors are on duty to decide what is best for me while I am psychotic.

If euthanasia is legalised, what is stopping doctors from making that decision for me? There was a case in the Netherlands where a woman was held down and euthanised. They put sedative in her tea. They then went to inject her, she kicked the syringe out of the doctors hand. The doctor had her held down and then euthanised her. All because when unwell the woman had made comments about wishing to die when the time is right. They went by what she said at her lowest moments, but ignored her desperate physical struggles when they went to euthanise her. To me that was murder.

Tell your patients that you think you should be allowed to help them decide whether they would be a suitable candidate for euthanasia, and see how they feel.

Interestingly, it’s not the patients with psychosis that came to my mind. It was the ones with intractable OCD, PTSD and anxiety that I was thinking of. I have met treatment-resistant patients whose inner life is a living hell. And all the support in the world from friends, family and services does not seem to help them escape the pain.

I am not condoning euthanasia but I definitely understand the sentiment. My heart breaks for some of my patients and I lie awake thinking of them.

It's not so much I think suicide fine, it's that I think it's generally a personal choice and sometimes (or in certain circumstances often) an understandable decision.

As to whether I'd try and actively stop someone taking their own life, that would depend on the situation. I can think of many circumstances in which I would try and prevent it and others where I'd be willing to assist (taking someone with muscular dystrophy to Dignitas fe) or at least turn a blind eye.

Sounds like murder from those facts to me too. Shocking.

I can't help wondering if these are the real facts.

I am in favour of assisted dying and I would think it awful to be denied the option due to my mental health.

I completely understand why doctors don't want to do it, but what's described in the article is unclear tbh. Often press reports contain zero information about the actual law so overall, I'm confused.

https://www.theguardian.com/world/2018/jul/25/doctor-netherlands-asked-family-hold-down-euthanasia-patient

https://toronto.citynews.ca/2022/10/13/medical-assistance-death-maid-canada/amp/

you mean this? Where HE asked for MAiD?

I just wanted to comment on this, I think if you have never been sectioned, you won't appreciate how completely vulnerable you are. You have no say over what medication you are given, and cannot refuse to take it, no matter what side effects you get from it (antipsychotics can come with unpleasant ones). You really have to trust that they are acting with your best interests in mind.

It's really in the context of that vulnerability that I have found some of the contributions from MH staff on this thread so terrifying - particularly one who seems to have contempt for a "patient" who dares to disagree with them- apparently I have problems with reading comprehension and have " had a little outburst".

It's made me realise that actually, they could well not care about my welfare when so unwell I am in hospital. I just hope I never get sectioned again, some of these posts have been worrying.

This makes absolutely no sense. By definition, anyone asking for an assisted suicide is suicidal. And suicidal ideation is one of the diagnostic indicators of depression.

Everyone has the right to decline medical treatment, whether fir MH or any other conditions. Everyone has the freedom to kill themselves if they choose. What we don’t permit is anyone “helping” anyone else to kill themselves, or in other words, it is not possible to consent to being murdered. That is an important legal protection for everyone in society, particularly the vulnerable.

Me, too. I would enjoy the rest of my life much more if I knew I had control of when it ended.

Your arrogance to think that you speak for every person with the same diagnosis as you is utterly astounding. You clearly don't have treatment resistant schizophrenia. Some do, including my lovely ex father in law who has spent most of his days in and out of hospitals. Who has had pretty much every treatment and therapy under the sun over the decades. And a person who has suffered from treatment resistant mental illness who has (in their opinion) no quality of life, well I'll take their point of view about how they should be treated over your opinion on how that person should be treated.

Seeing as you're so caught up and unable to see the issue and what I'm saying objectively because of your own lived experience, let me give you a scenario. Do you think that John with late stage motor neurone disease, who suffers greatly and doesn't want to be alive anymore shouldn't be allowed to be considered for euthanasia just because Jane, who also suffers from motor neuron disease, doesn't think that euthanasia should be allowed for their condition?

I don't have any respect for your opinion because my opinion wasn't that you should be euthanized - that's just you trying to play the victim, sitting there with crocodile tears and wide eyes saying 'you think I should die?'. Why do you think you have the right to deny people the consideration of euthanasia if they have suffered for years and years, their whole adult life, when in their opinion, there is no quality of life for them? If you don't want to consider euthanasia for yourself then don't. But don't try and force people to live their lives in accordance with your beliefs and prevent them from making that choice.

YANBU OP.

There is currently a government inquiry going on into assisted dying. You can watch the first evidence session here:

https://committees.parliament.uk/event/17890/formal-meeting-oral-evidence-session/

One thing I learnt from watching this is that those countries which included non-terminal unbearable suffering as a reason for assisted dying are those where there has been a slippery slope effect with questionable decisions being made. Those countries which only legalised assisted dying for terminal illness have not faced the same slippery slope.

It's interesting to note that Dignity in Dying are only campaigning for those with terminal illness and less than 6 months to live.

Also that suicide rates ('ordinary' non-assisted suicides) do not fall in countries with legalised euthanasia so the idea that assisted dying can prevent messy or incomplete suicides is not backed up by evidence.

There's a useful research briefing here which outlines the law in various countries that have legalised assisted dying.

https://post.parliament.uk/research-briefings/post-pb-0047/

Unfortunately I think this is going to be another of these horrifically messy things where some people's personal freedoms and understandable distress and choices.... extends to an awful lot of unplanned slide into harm to others. Followed by an absolute horror story.

Like the poor woman above essentially told 'sorry we can't pay for the service you need to live, but if you want us to pay for you to die (hence ending the issue cheaply for both of us) we can offer that instead?'

The mess of well intentioned trans legalities and policies show, we just don't currently live in a society capable of handling these things ethically or carefully enough to make them safe.

Taking lethal euthanasia drugs is not guaranteed to be “non traumatic.” These deaths can also be painful and distressing for the patients and their families. There is a high risk of complications and failures and little research or agreement on treatment doses.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9270985/

Suicide is legal, and people do have that freedom. What is illegal is murdering someone else.

What on earth is wrong with you. Why are you being so nasty cruel and harsh to a woman that has severe mental illness.

Your father in law is entitled to seek euthanasia if he wants it.

There was no need whatsoever to speak to that poster that way. Im disgusted.

I can't comment about Canada, but on general principles...

There are people who end up spending decades being institutionalised for their MH issues. If they can still find decent quality of life in spite of institutional residence, then that's great. But cruel to keep them alive & miserable when they can't ever even reach the dizzy heights of feeling content.

These threads do seem to bring out the nasty side in some posters.

Isn’t this just equalizing MH with physical health? If you have an incurable physical condition you can choose assisted suicide, so why not with MH?

I personally think people should be able to choose when to go. My mum is at the end stage of dementia. There is no way I want to go through what she has, nor put my children through watching me slowly disappear over a decade and frankly the stare can so without paying the enormous cost of the care of keeping me in a life I do not want.