MAID expansion to mental illness likely to be paused in Canada

[_Gollum_]

Gutting. To me the fact that MAID wasn't available to everyone yesterday is a moral abomination. So messed up. (With the caveat of course that the pause hasn't been confirmed yet and there's still a chance it could go the other way).

Ottawa prepared to halt plan to allow MAID for mental illness

Federal government will follow recommendations of parliamentary committee studying issue, sources say

www.theglobeandmail.com

The federal government is prepared to table legislation that would pause the expansion of medical assistance in dying to people whose sole condition is mental illness if a parliamentary committee that is studying the issue recommends it, three sources told The Globe and Mail. The government expects that the committee will make such a recommendation based on evidence presented in hearings and questions from MPs over the past two months, the sources said. The committee was hearing its final witnesses on Tuesday. It will write a report, with its recommendations, to be tabled in the weeks or months ahead.

The government opened up MAID to people who were not facing imminent death in 2021, but the legislation carved out a temporary exclusion for mental illness. This meant people without physical ailments were still unable to qualify for assisted death. That exemption was extended twice by former prime minister Justin Trudeau and is currently set to end in March of next year. Mark Carney has not spoken about the issue, but the Prime Minister has been under pressure, including from religious figures and disability advocates, to delay it further – or scrap it altogether.

The committee has heard from physicians and Health Canada officials that the country may not be ready to move ahead, that the health care system isn't ready for the expansion and that determining eligibility would be complex. The parliamentary committee's co-chairs, Liberal MP Marcus Powlowski and Conservative Senator Yonah Martin, have both previously spoken out against the expansion.

During the final hearing on Tuesday evening, two Dutch psychiatrists urged parliamentarians not to expand MAID to mental illness alone. Jim van Os, a professor of psychiatry at Utrecht University Medical Center, said the Dutch experience offered "a warning for Canada." Dr. van Os noted that requests for what he described as "psychiatric euthanasia" for people under 30 increased to nearly 900 per year from 30 in the past six years. Completed deaths rose five-fold. Most of those people, he noted, were traumatized, marginalized and living in poverty. Dutch law, he said, requires that a patient exhaust all other options first. No such safeguard is in place in Canada, he added. "That single difference will in our assessments drive Canadian numbers beyond ours."

Wilbert van Rooij, a Dutch psychiatrist with 30 years of experience, spoke of the moral toll on the psychiatry profession. Asking psychiatrists to determine when a patient should die, he said, "is a burden psychiatry was never designed to carry."

A third Dutch psychiatrist, Sisco van Veen, took a more nuanced approach. He argued that it is "hard to justify excluding patients with psychiatric disorders whose suffering can be immense." Dr. van Veen said that psychiatric euthanasia remains relatively rare at about 2 per cent of all cases.

The heads of psychiatry at 13 Canadian medical schools wrote to the committee last week calling for the federal government to halt the expansion to mental illness. They argued that there is no accurate way to determine when a mental disorder is incurable or to adequately protect vulnerable patients.

 

[king_yaroglek]

Of course it was. Imagine how many wageslaves the government and elites would lose.

 

[bucketofcats]

They want to pause this, but also refuse to actually help those with mental illness. Most of the homeless in Ottawa are mentally ill and get laughably little support.

We're too valuable to kill off, but too worthless to be helped.

 

[lachrymost]

Let's hope none of these do-gooders end up with a taste of their own medicine, trapped in decades of treatment-resistant suffering! Anything and everything must be lived through, as long as there's no guarantee it will last forever ("remediable").

Even though intellectually I knew this would happen, I have been living off this weird hopium. It's insane how hope works. It's so evil, but I want more of it I guess. Even though I know an indefinite pause and yet another temporary pause would probably amount to the same thing, I really want that temporary pause so I can keep huffing that hope.

I sort of wish they would just make some insane standards for the mental health route, since that would be better than nothing. Everyone needs to be at least 35, have a net worth of 200k, completely fry their brains with 60 rounds of ECT. Just do something that addresses the most popular objections.

I can't defend the criteria for MAiD; it never should have been "irremediable" in the first place or limited to the disabled, but of course you have to start somewhere. The established rhetoric around it means that the pro-MAiD side usually makes the dumber arguments. They end up saying shit like it "isn't really suicide" or "it will prevent suicide". We are not sending our best. Suicide is so stigmatized that even the pro-suicide arguments have to masquerade as anti-suicide.

There's still the Dying with Dignity lawsuit, although federal lawyers keep putting off their part to respond. That's the last shred of hopium I guess. Fuck me. Indefinite suffering. I don't know how to remotely cope with being so powerless and tortured. Right now I'm making this powerless tortured post. It was so worthwhile and meaningful; I'm so fulfilled and everything is so worth it.

 

[Ashu]

Gutting. To me the fact that MAID wasn't available to everyone yesterday is a moral abomination. So messed up. (With the caveat of course that the pause hasn't been confirmed yet and there's still a chance it could go the other way).

Ottawa prepared to halt plan to allow MAID for mental illness

Federal government will follow recommendations of parliamentary committee studying issue, sources say

www.theglobeandmail.com

The federal government is prepared to table legislation that would pause the expansion of medical assistance in dying to people whose sole condition is mental illness if a parliamentary committee that is studying the issue recommends it, three sources told The Globe and Mail. The government expects that the committee will make such a recommendation based on evidence presented in hearings and questions from MPs over the past two months, the sources said. The committee was hearing its final witnesses on Tuesday. It will write a report, with its recommendations, to be tabled in the weeks or months ahead.

The government opened up MAID to people who were not facing imminent death in 2021, but the legislation carved out a temporary exclusion for mental illness. This meant people without physical ailments were still unable to qualify for assisted death. That exemption was extended twice by former prime minister Justin Trudeau and is currently set to end in March of next year. Mark Carney has not spoken about the issue, but the Prime Minister has been under pressure, including from religious figures and disability advocates, to delay it further – or scrap it altogether.

The committee has heard from physicians and Health Canada officials that the country may not be ready to move ahead, that the health care system isn't ready for the expansion and that determining eligibility would be complex. The parliamentary committee's co-chairs, Liberal MP Marcus Powlowski and Conservative Senator Yonah Martin, have both previously spoken out against the expansion.

During the final hearing on Tuesday evening, two Dutch psychiatrists urged parliamentarians not to expand MAID to mental illness alone. Jim van Os, a professor of psychiatry at Utrecht University Medical Center, said the Dutch experience offered "a warning for Canada." Dr. van Os noted that requests for what he described as "psychiatric euthanasia" for people under 30 increased to nearly 900 per year from 30 in the past six years. Completed deaths rose five-fold. Most of those people, he noted, were traumatized, marginalized and living in poverty. Dutch law, he said, requires that a patient exhaust all other options first. No such safeguard is in place in Canada, he added. "That single difference will in our assessments drive Canadian numbers beyond ours."

Wilbert van Rooij, a Dutch psychiatrist with 30 years of experience, spoke of the moral toll on the psychiatry profession. Asking psychiatrists to determine when a patient should die, he said, "is a burden psychiatry was never designed to carry."

A third Dutch psychiatrist, Sisco van Veen, took a more nuanced approach. He argued that it is "hard to justify excluding patients with psychiatric disorders whose suffering can be immense." Dr. van Veen said that psychiatric euthanasia remains relatively rare at about 2 per cent of all cases.

The heads of psychiatry at 13 Canadian medical schools wrote to the committee last week calling for the federal government to halt the expansion to mental illness. They argued that there is no accurate way to determine when a mental disorder is incurable or to adequately protect vulnerable patients.

Fucking whitecoats, fuck off. What gives you the right to pontificate about the life and death of sufferers from mental states you have no concept of or sympathy with. As if you were experts in anything human.

 

[_Gollum_]

Listened to an interview with two people on the committee


Basically what I gather from that interview is that the committee has been stacked against the pro-MAID side, especially in regards to who they're calling to testify. Apparently they haven't even called the Canadian Psychiatric Association to speak before the committee, despite the CPA requesting to do so. The CPA has been "rebutting" some of the arguments heard in committee via letter because they haven't been able to appear. The committee also has not heard from a single person directly suffering from mental illness who would qualify to receive it if the expansion goes ahead, including a 50-year-old woman who has had bipolar and PTSD for 30+ years, and who has requested to appear.

The anti-MAID side is raising concerns about the difficulty of determining "irremediability" and they worry that some people will receive MAID who could still have gone on to lead "healthy, happy" lives. They claim that "psychiatrists" say that determining irremediability would be like "flipping a coin", which is just absurd on its face; the people who would be eligible for MAID under this expansion would invariably be people who have been suffering for multiple decades and who have run the gamut of the MH system, but they seem to be imagining that the target demographic is 20-year-olds who have been experiencing depression for 6 months.

 

[KuriGohan&Kamehameha]

Listened to an interview with two people on the committee


Basically what I gather from that interview is that the committee has been stacked against the pro-MAID side, especially in regards to who they're calling to testify. Apparently they haven't even called the Canadian Psychiatric Association to speak before the committee, despite the CPA requesting to do so. The CPA has been "rebutting" some of the arguments heard in committee via letter because they haven't been able to appear. The committee also has not heard from a single person directly suffering from mental illness who would qualify to receive it if the expansion goes ahead, including a 50-year-old woman who has had bipolar and PTSD for 30+ years, and who has requested to appear.

The anti-MAID side is raising concerns about the difficulty of determining "irremediability" and they worry that some people will receive MAID who could still have gone on to lead "healthy, happy" lives. They claim that "psychiatrists" say that determining irremediability would be like "flipping a coin", which is just absurd on its face; the people who would be eligible for MAID under this expansion would invariably be people who have been suffering for multiple decades and who have run the gamut of the MH system, but they seem to be imagining that the target demographic is 20-year-olds who have been experiencing depression for 6 months.

The elephant in the room in all these discussions seems to be that the Psychiatry community is incredibly resistant to defining what constitutes as "incurable/irremediable". An exception to this would be acknowledging the poor prognosis of certain eating disorders, which can become physically fatal if a person does not succeed in recovery.

For whatever reason, many in the psychology and psychiatry profession do not seem to acknowledge that a person who is living in misery, with a poor quality of life, for years and years and years, and who has run through the gamut of medical interventions, is unlikely to recover without the aid of some groundbreaking experimental treatment that doesn't exist yet.

I understand that acknowledging a poor prognosis can be viewed as bad for morale, but like you, I think it is completely ludicrous to compare someone suffering from 6 months of depression, who may not have had the opportunity to explore many therapeutic interventions, to people who have been suffering for years upon years with no end in sight. It always blows my mind to see arguments that a person with a condition that has been labeled as "treatment resistant" after a multitude of interventions, and years and years of trying to turn things around, could just randomly one day become happy and healthy out of nowhere, so therefore euthanasia for individuals with mental illnesses should be blanket banned. Where is the evidence based logic there?

It's controversial, but I think a lot of the resistance is ego-driven and unwillingness to admit that a not insignificant amount of people are being failed by the current standards of treatment. Of course, it's not the individual doctors at fault, but they take offense as if it was so, as if the current methods at our disposal for treating mental illnesses are foolproof and their effectiveness is reflective of the physician's own competency. When in reality, it's simply that the research for neurological conditions is lagging far behind all other areas of medicine, the fact that psychiatry and neurology are split as disciplines only further serves to support this.

It shouldn't cause such an outcry to acknowledge when a person has done all they can to help themselves, or seek help from the medical system. However, it is one of the most cognitively dissonanced topics in the modern day political climate, imo. It's funny they describe making such weighty decisions as "flipping a coin", when to those of us who have been suffering for years and years, our lives and our pain should be worth more contemplation than that.

If a professional doesn't have the critical thinking skills and empathy to sit down with a case and attempt to make an educated guess regarding a patient's prognosis, in the context of that individuals's prior medical history, their environment, and if there are any further interventions to consider- rather viewing such a decision as making as a coin toss, I would question if they are truly cut out to be a doctor.

Yet, they have absolutely no shame in lying to patients. In my opinion, constantly feeding a patient false hope is a worse ethical violation than being honest that their situation is outside of your scope, and that there's nothing more you can offer them in regards to treatment. We are a long way away from the psychiatry profession at large taking such a stance though.

 

[ceilng_tile]

Dr. van Os noted that requests for what he described as "psychiatric euthanasia" for people under 30 increased to nearly 900 per year from 30 in the past six years. Completed deaths rose five-fold. Most of those people, he noted, were traumatized, marginalized and living in poverty.

How is this an argument *against* voluntary euthanasia? These seem like pretty legitimate reasons to want to die.

 

[autisticmessiah]

How is this an argument *against* voluntary euthanasia? These seem like pretty legitimate reasons to want to die.

If someone is poor and unable to work due to disability all the provincial/federal safety nets are very lackluster and leave you way below the poverty line so they should really increase the pay they give out a lot before going ahead with MAID for mental illness unless they want people to die only because they're in legislated poverty and they've been traumatized and made mentally ill only from it. A lot of them very likely do want people who can't work to die I bet.

 

[lachrymost]

The anti-MAID side is raising concerns about the difficulty of determining "irremediability" and they worry that some people will receive MAID who could still have gone on to lead "healthy, happy" lives. They claim that "psychiatrists" say that determining irremediability would be like "flipping a coin", which is just absurd on its face; the people who would be eligible for MAID under this expansion would invariably be people who have been suffering for multiple decades and who have run the gamut of the MH system, but they seem to be imagining that the target demographic is 20-year-olds who have been experiencing depression for 6 months.

Yeah "flipping a coin" is stupid; I'm sure there is no good evidence that someone like Clarie Brosseau has a fifty percent chance of recovering.

I also love when people complain about the lack of mental health supports, when the whole point of MAiD is that it's for people who have had extensive mental health treatment already. And if there aren't enough psychiatrists around to treat people, then where are these psychiatrists willing to assess people for MAiD going to come from? They're a very small proportion of psychiatrists.

But MAiD is plagued by its imprecise criteria. What does "irremediable" mean? It's up to the assessors, I guess. How much treatment does someone have to have first? It's up to the assessors. Sure I beleive the spirit of the law is that it's for people who have tried almost everything and almost certainly won't get better, but it really is just up to who you see, and you can doctor shop. Unless the doctors get stopped! I've seen assessor Ellen Wiebe in the news a few times over attempts to thwart her generous interpetation of the MAiD crtieria, so the law sometimes intervenes when they get too trigger-happy.

May the slope be a slip-and-slide. Sigh. Man I wish I had a gun, but you know, I'm Canadian.

 

[ButterflySucideBaby]

Not that I think younger people shouldn't have the peaceful freedom of choice, but I wonder how much of this would no longer be a discussion/debate if they just stopped giving it to people under 30, that seems to be the arbitrary point people get emotionally get hung up over during these conversations.