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.

Wow. So now we have moved from murder with consent to just straight up murder of vulnerable and disabled children, no consent required.

Agreed.

The Netherlands allows Euthanasia for the mentally ill. Psychiactric reasons accout for a small proportion of deaths 1% of 7000ish cases a year. People can find mental illness a source of unbearable suffering.

This

That would also be murder. If you have disappeared into dementia then you have no capacity to consent.

In countries where they do allow euthanasia for dementia sufferers. You have to make up your mind in advance and be very clear about your wishes whilst you still have capacity. I also have dementia in my family and it is an awful prospect.

I think there are too many pitfalls to this many which have been discussed already. The worrying thing is cases like the article upthread, of a man choosing euthanasia over homelessness. If this were to happen in the UK, I can see our current government welcoming people in such situations choosing euthanasia instead of providing the support they need - they don't even do it now as we've seen with people not being able to afford energy prices as well as food.

Then there are people like @SparklyBlackKitten who think it's perfectly okay to have human beings put down because someone else decides their life isn't worth living. I know this word is overused on MN, but I found that post inutterably disgusting. While we have people who will happily come out with things such as euthanising people who cannot consent due to disability is a sort of "blessing" without an inkling of how vile and ableist they are being, it's a dangerous law to introduce.

@user4567890754 i assume it would be like signing a do not resuscitate treatment escalation plan. I don’t know the detail of the Canadian paper so can’t comment. It’s a very tricky area.

Yes, and then if you change your mind and say actually life is fine like this and you want to live after all, they hold you down and murder you anyway.

It looks like that is actually where Canada is headed. What a dystopian future. Once you open the door to murder with consent for adults, you get people pushing for murder without consent for children.

“As of September 2017, both the Federal Act and the Quebec Act clearly prohibit non-voluntary euthanasia for all patients. However, given the human rights framework advanced in Carter v. Canada, the parents of a dying and/or severely disabled child who is deemed to be suffering may, in the near future, be looking to the courts to support a right to end their child’s life.

Decision-making for treatment of never-competent children is based on the ‘best interest standard’: choosing among options that reasonable persons, acting in good faith on another’s behalf, would consider acceptable in similar circumstances [22].

In the foreseeable future, parents may challenge health care decisions in court on the grounds that continued life, as experienced by their dying or profoundly disabled child, is not in that child’s best interests.”

https://cps.ca/en/documents/position/medical-assistance-in-dying

Yep. Especially if the family agrees. Family who would financially benefit from more inheritance if your care home fees come to an abrupt end.

Agree with you - point very well made.

Churchill was keen for others to put out of their misery but funnily enoughnot himself. Even though he suffered terribly from depression.

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

It’s more likely though that doctors will simply sign off on the parents requests to put down their kids. The CPS wouldn’t care if all legal paperwork is signed. Both the parents and doctors can build a case to make their decision look reasonable, kind and so on and no one can counter it, least of all the recently deceased child.

I think the only court cases would be other relatives vs parents. Or divorced couples one vs the other. To try and stop it, or to prosecute for murder/manslaughter if after the fact.

But you can!

You can end it at any time. Many people do - including in my own family.

This is objectionable because it will be promoted . To patients who are viewed as too expensive.

And we know, after watching the surrogacy creep that the poor and vunerable will be hit.

Sorry in advance, this is long:

No, I have no doubt that many, but not all, autistic people have just the same capacity to choose assisted dying as anyone else.

If we had decent levels of medical, social and palliative care in the UK then I would be in favour of legalising AD in the case of terminal illness with ~6 months or less to live, with safeguards in place to ensure patients had made a voluntary, clear and settled decision to end their life, with time to consider all other options. That would mean they had mental capacity to make the decision at the time of death, mandatory counseling, prescribed information, second opinions, high court for difficult cases. I have no doubt that many autistic people could meet those criteria just as well as I could.

That's not at all the same as saying we should allow AD because of autism, or learning disability, or mental distress.

Are you familiar with the swiss cheese model of safeguarding? No slice of safeguarding is foolproof, there are always holes. The more layers of safeguarding there are, the less chance there is that all the holes will line up. The more layers you remove, the more likely the holes will all line up and cause a safeguarding failure.

Allowing assisted dying at all removes a layer of safeguarding.

Allowing assisted dying for people who are not dying removes another layer.

Allowing assisted dying for LD, autism, mental illness etc., conditions which, by their very nature, require close attention to mental capacity removes another layer. And this particular layer seems to have a lot of holes.

A huge issue is doctors' ability to reliably and accurately assess people's ability to consent. Baroness Finlay:

The danger is that it depends on the ability of the clinicians making the assessment. I had the privilege of chairing the Mental Capacity Forum for six years. I have to say that it was worrying to see the inability of clinicians to assess capacity — particularly fluctuating capacity. Another group of patients where there is a real worry is where there is frontal lobe involvement in the brain, where they can appear as if they have capacity but actually they cannot understand the implications of their decision for themselves and others.

Only last week, I came across a clinical case of somebody in ICU, who appeared to have complete capacity to stop treatment. By chance, his girlfriend arrived. I won’t go into the details because it is a long story, but he then decided to marry her. Afterwards, he had absolutely no recall whatsoever of any of the conversations that had taken place when he had said that he did not want to be treated. At the time his clinicians — not just one, but three of them — thought that he was absolutely crystal clear that he wanted to stop treatment, and would have stopped his ventilation, but for the chance arrival of his girlfriend.

The potential safeguarding failure here is that you deliberately cause someone's death who did not want to die, who was coerced or persuaded against their best interests that they wanted to die, or who was not capable of consenting to being killed.

The stakes could not be higher.

How many of those kinds of deaths are acceptable so that you or your loved one can choose the time and manner of your death?

If there's the remotest doubt then the default must be that you do not take active and deliberate steps to end someone's life.

There are just too many layers of safeguarding missing for me to be comfortable with this, before even considering all the other missing layers of poor health care, poor social care etc.

I'd also be interested to hear what in your opinion exemplifies the Netherlands as an example of bad practice.

An example of bad practice in the Netherlands is when they held down a woman and euthanased her against her will. Details have been given upthread. Advance directives are not safe because people change their minds. In one study, 50% of terminally ill patients who said they wanted AD for themselves later changed their minds.

https://jamanetwork.com/journals/jama/fullarticle/193281

Also I think NL decision to allow assisted dying because of LD, autism and or MH issues is bad practice. The only reason they're not in a worse state than Canada is because they have decent health and social care. Long may that continue.

We don't, we're much closer to Canada in that regard.

@LangClegsInSpace
Hear hear
Well said, and 110% agree.

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.

WHAT AM I READING????

You really need to step away.

She had signed an advance directive.

I've seen posters on previous threads actually defending this death and saying that enlisting her family to hold her down and administering the injection while she fought against it was the right thing to do.

Bloody hell.

I don't know what to say.

That country is lost. Trudeau is a very malevolent man.

@SparklyBlackKitten

I read some people on here talking about their severely autistic kids that are causing nothing but suffering and can't go the the toilet themselves. Can't communicate, Cant be taken outside without severe meltdowns. Violence. The mums scared of their own kid. Those People have 0 qualify of life. And their parents /caretakers are jailed for life having to endure the mental illness from a child that brings 0% joy to their lives.

Apart from the rest of your horrifying post, this sums up what is so troubling about how some people think of euthanasia. They are considering how removing a person eases a burden - in this case, a child that brings 0% joy? Remove it! Bring joy back into your life by killing your child!

Rather than using other tools and services to manage the issue, why consider euthanasia for a child? I'm glad a good amount of sensible voices recognise the ableist conversation that has sprung up around AD.

It should also be pointed out that (due to the public sector cuts and other reasons) many ASD sufferers have a single primary carer who is usually their parent. Of course they would be distressed when they lose that carer. They could literally be led by replacement carers down this line of thought with an intractable end result. En masse.
It feels sinister in view of the fact that the media are happy to run daily 'broken NHS' stories as though we should all be resigned to the fact that the system is now unsalvageable when it would have been taboo to even state it on TV only a decade ago.

Belgium, Canada, Netherlands, Switzerland. Why is it the world's most boring countries are such enthusiastic advocates of euthanasia?