Parliament has opportunity to improve suicide prevention
As of March 2024, medically assisted suicide will be available to those with a diagnosed mental illness. Even though that’s half a year away, and a bill is in play in Parliament in an attempt to stop the expansion, doctors are already integrating medical assistance in dying (MAiD) into their patient recommendations. Earlier this summer, a BC woman struggling with suicidal ideation went to the hospital seeking help. In assessing her, the clinician asked if she had considered MAiD. How does this square with World Suicide Prevention Day, which we mark on September 10th?
Short answer: it doesn’t.
Canadians have made great strides in understanding and accepting mental illness. Almost everyone knows someone who has gone to a counselor or doctor for help with a psychological ailment. Memes and articles abound attempting to explain anxiety, panic disorders, and depression from the perspective of the sufferer. Mental illness is still not entirely without stigma, but we have made progress.
And yet, all that progress does not mean we fully understand what we are dealing with. When it comes to the human brain, we never do. A broken leg is understandable, fixable on a measurable timeline. Mental illness and disorder are less so. That lack of a measurable timeline is what is now putting people at risk. There seems to be a belief that if we aren’t 100%-satisfaction-guaranteed sure we can manage someone’s suffering, we should consider killing the sufferer.
We cannot support suicide prevention and suicide assistance as equally viable options for those with mental illness. We either believe in encouraging people with mental illness to find hope and a purpose – or we don’t. Suggesting to someone with suicidal ideation that their doctor can help them by killing them destroys the foundation of trust needed for proper psychiatric care.
Mental illness is different from physical illness in that its trajectory is unpredictable. We hate unpredictability. We like control, a plan, and, apparently, an easy exit strategy. MAiD seems to offer that. But reasonably foreseeable death, a common term in MAiD assessments, does not exist in the world of mental illness. MAiD and mental illness are fundamentally incompatible because MAiD removes hope from the equation. Suggesting MAiD tells a person with mental illness that there is no hope – of a cure, or even of improvement worth living for.
Suicide prevention for those with mental illness needs to remain a priority as we seek to honour the inherent dignity of human beings. Bill C-314, an act to amend the Criminal Code by removing the expansion of MAiD to those with mental illness, is the opportunity our Parliament needs to avert the harm of offering MAiD to those with mental illness.
Bill C-314, introduced by MP Ed Fast, will be debated when Parliament returns to work this month. There is very limited time before the March 2024 deadline for the bill to make its way through the House of Commons and Senate to become law. For that process to happen it will require courage and conviction from our leaders to acknowledge that there is a lack of research, a lack of consensus among mental health care providers, and a lack of support from Canadians.
Expanding MAiD to those with mental illness would make Canada the most permissive euthanasia regime in the world. This isn’t something we want to be known for. We want to know that when our loved ones need help, they can safely go to a hospital without being offered a way to end their lives. We want to know that doctors and researchers think mental illness is worth treating, worth understanding, and worth solving.
In a country that is working to break down the stigma around mental illness, we cannot offer suicide assistance and suicide prevention to the same people. Bill C-314 is an opportunity for the federal government to take a meaningful stand for suicide prevention, not suicide assistance.