BRAUN: With Bill C-7, Help for the Dying Becomes Assisted Suicide

Author of the article:Liz Braun
Publishing date:Apr 06, 2022

While you were busy avoiding the pandemic, a very huge can of worms called Bill C-7 was opened in Canada.

This bill allows Canada to expand doctor-assisted death to the chronically ill and eventually, the mentally ill.

Prior to this, MAiD – medical aid in dying – was available to the suffering whose death was already looming: a terminal cancer patient, for example, or someone with Lou Gehrig’s disease. A natural death was “reasonably foreseeable.”

That phrase no longer applies.

To have medical assistance in dying today, you need to be 18 or over and capable of giving informed consent.

You don’t need to be dying, but you do need to have a “grievous and irremediable medical condition” – something terrible that cannot be fixed – whether it’s physical, or, after March 2023, mental.

(On that date, Canada joins Belgium and the Netherlands as one of the few countries that permits MAiD to those with schizophrenia, depression, PTSD or another form of mental illness as a primary diagnosis.)

You can read the government website about MAiD and individual cases, consent and safeguards – but many experts in law and medicine are sounding the alarm on Bill C-7.

For the Institute For Research on Public Policy, Dr. Ramona Coelho, Dr. John Maher, Professor Trudo Lemmens and Dr. Sonu Gaind (chief of psychiatry and physician chair of the Humber River Hospital MAiD team) ask how someone with mental illness can make an informed choice about MAiD, “when experts say any prediction about their illness and future suffering as ‘irremediable’ is meaningless?”

The authors state that the Canadian Mental Health Association, the Ontario Association for ACT and FACT (experts providing frontline care to those with the most severe mental illnesses) and the overwhelming majority of Ontario psychiatrists (who were surveyed) are against MAiD solely on the grounds of mental illness.

“This raises the spectre of people who are not near death, but who have mental illness, being provided physician-assisted death based on unscientific assessments by physicians claiming supposed ‘irremediability’ – at times where they may be suffering despair that is actually resolvable.”

Gaind recently told the National Post that in the Netherlands, it’s often people, “marginalized by poverty and trauma,” who seek psychiatric euthanasia, most of them women.

What they need, Gaind said, is suicide prevention help, but that’s expensive and often unavailable.

Making MAiD available by law for mental illness is a bad look in Canada, where one in three cannot get the mental health care they need. Some would say it’s cheaper to let people check out than to provide whatever supports they need, over however many years, to have a decent life.

Previously, University of Toronto bioethicist Kerry Bowman hit at one of the biggest issues in all this, which is that expanding the laws around MAiD and expanding eligibility eventually warps social perspective.

It will change how we view human frailness, illness, and vulnerability, “because legal structures greatly influence what people consider to be ethical questions.

“As soon as something is legal, people assume it must also be ethical – otherwise, it would never have become law.”

Writing in Policy Options magazine, lawyer and McGill assistant professor Jonas-Sebastien Beaudry calls Bill C-7, “Too little, too soon,” addressing the existing social issues that make C-7 so problematic.

“Bill C-7 opens a normative space in which various social actors, including medical experts and the state itself, can discuss the topic of ‘lives not worth living.’

“This medico-legal space facilitates the cultural emergence of categories of human beings whose lives can be legally and morally disposed of. Since our society and our courts are barely aware of how ageist and ableist our culture is, this is a dangerous door to open.”

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