Canadian Mental Health Association on Medical Assistance in Dying (MAID)

Statement

Toronto, ON February 23, 2021: The Canadian Mental Health Association (CMHA) is deeply disappointed that the government supports allowing those with mental illnesses to seek medical assistance in dying. CMHA’s position, first articulated in a national policy paper in August 2017, and later, in testimony to the Senate in November of 2020, is that until the health care system adequately responds to the mental health needs of Canadians, assisted dying should not be an option—not now and not two years from now.

First, it is not possible to determine whether any particular case of mental illness represents “an advanced state of decline in capabilities that cannot be reversed.”

Second, we know that cases of severe and persistent mental illness that are initially resistant to treatment can, in fact, show significant recovery over time. Mental illness is very often episodic. Death, on the other hand, is not reversible. In Dutch and Belgian studies, a high proportion of people who were seeking MAID for psychiatric reasons, but did not get it, later changed their minds.

Third is the issue of whether this distinction for mental illness vis-à-vis all other types of illness is inherently discriminatory. Denying access to MAID for mental health reasons alone does not mean those with mental illness suffer less than people afflicted with critical physical ailments. What is different about mental illness specifically, is the likelihood that symptoms of the illness will resolve over time. Because the distinction is being made specifically on the likely course of illness and not the degree of suffering, it is not discriminatory.

If this bill passes with a 24-month sunset clause, the government must, at minimum, commit to a substantial increase in its investment in mental health care to help alleviate the suffering of those with mental health issues and mental illness and provide every opportunity to recover and thrive.

While CMHA strongly opposes MAID for those with mental illness as a sole underlying cause, we remain committed to working with the government and the joint committee to ensure appropriate safeguards are put in place to achieve the most responsible and ethical system possible — one that mitigates the risk of suicide for anyone who has a hope of eventual recovery. Mental illness should not be a death sentence.

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