Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Tuesday January 16, 2024
Expanding MAID to Mental Health Patients: A Costly Shortcut Amidst Healthcare Failures
In recent discussions surrounding the expansion of Medical Assistance in Dying (MAID) to include patients with mental illnesses as their sole underlying condition, there is a pressing need to reassess the implications of such a move. While proponents argue for inclusivity and compassion, it is crucial to acknowledge the severe drawbacks and potential consequences associated with this proposed expansion.
The first glaring issue lies in the nature of mental illnesses themselves. Unlike physical ailments, mental disorders lack a clear and definitive prognosis of irredeemability. Studies reveal that psychiatrists, tasked with determining the course of a patient’s mental health, are wrong in their predictions nearly half the time. This unpredictability, coupled with the dynamic nature of mental health, makes it impossible to accurately identify individuals who won’t experience improvement over time. The very essence of MAID eligibility, requiring a grievous and irremediable medical condition, clashes with the inherently uncertain trajectory of mental disorders.
Moreover, the push for psychiatric euthanasia overlooks the complexity of differentiating between genuine suffering and suicidal tendencies. The Canadian Association for Suicide Prevention explicitly states that seeking death due to a non-terminal condition, such as mental illness alone, is inherently suicidal. This is a critical distinction that cannot be ignored. Proponents argue that this is a matter of discrimination, but ensuring equal access to proper mental health care should be the priority, not resorting to MAID as a questionable remedy.
A recent parliamentary committee report has rightly emphasized the importance of improving access to palliative care, enhancing financial support for people with disabilities, and addressing the concerns of Indigenous communities and persons with disabilities. The link between the lack of financial and social support and the potential for viewing MAID as an escape from suffering is a glaring issue. It is essential to recognize that prolonging wait times for mental health therapy, general healthcare, and social housing is inadvertently creating an environment where MAID becomes a convenient, albeit misguided, solution.
The current state of mental health care in Canada is dire, with extensive waiting periods for counselling and more intensive treatments. The expansion of MAID becomes particularly problematic when individuals facing prolonged waits for mental health support are presented with an expedited option for assisted death. This perverse incentive not only contradicts the principles of compassionate care but also raises serious ethical concerns.
Advocates of MAID for mental illness often point to legislative safeguards, but history has shown us the inadequacy of such measures. The risk of incentivizing death over proper care, as highlighted by mental health professionals, is a clear indication that the state should not be complicit in presenting a morally and ethically questionable choice to its citizens.
The rush to expand MAID to mental health patients is a misguided attempt to address systemic failures in mental health care, general healthcare, and social support. Rather than offering a respectful and compassionate response to suffering, it threatens to normalize a distressing choice between prolonged suffering and premature death. The federal government must reconsider its priorities, focusing on comprehensive mental health reforms and ensuring timely access to quality care before entertaining the expansion of MAID to mental health patients. (AI)