Law proposing assisted dying for mental patients divides opinion in Canada

TORONTO— Canada already has one of the most liberal assisted dying laws in the world, offering the practice to terminally and chronically ill Canadians.

But under a law set to come into force in March, assisted dying would also be accessible to people whose only medical condition is a mental illness, making Canada one of about a half-dozen countries that allow the procedure for that category of people. .

That move has divided Canadians, some of whom see it as a sign that the country's public health care system does not offer adequate psychiatric care, is underfunded and in high demand.

Prime Minister Justin Trudeau's government, which has been criticized for its implementation of the policy, has defended its actions by pointing to a 2019 court decision in Quebec that officials say calls for extending it.

Members of the Conservative Party have accused the Government of promoting a “culture of death”. There has also been opposition from left-wing politicians who would like the Government to focus its health policy on expanding mental health care.

Jason French is among those arguing why a doctor should help you die. He attended an event in Toronto to lobby for assisted dying to be available to people like him. He suffers from severe depression and has twice tried to take his own life, he said.

“My goal from the beginning was to get better,” French said. “Unfortunately, I am resistant to all these treatments and the point is that I can't continue living my life like this.”

But John Maher, a psychiatrist in Barrie, Ont., who specializes in treating complex cases that often take years to improve, said he was concerned about patients opting for assisted dying.

“I'm trying to keep my patients alive,” he said. “What does it mean for the role of the doctor, as a healer, as a bringer of hope, to offer death?”

Canada's current assisted dying law applies only to people who are terminally ill or living with physical disabilities or chronic, incurable illnesses. The country's Supreme Court decriminalized assisted dying in 2015, ruling that forcing Canadians to deal with intolerable suffering infringes on fundamental rights to liberty and security.

Around 13,200 Canadians had an assisted death in 2022, an increase of 31 percent compared to 2021, reveals a report from the Ministry of Health. Of those, 463 people were not terminally ill, but had other medical conditions. Approved patients have the option of ending their lives using lethal medications administered by a doctor or nurse, or by taking medications prescribed to them.

Amid concerns about how to implement the law, Parliament has delayed its passage by three years and could delay it again.

Supporters say denying the mentally ill the same option others have to end suffering is discrimination.

Alexandra McPherson, a professor of psychiatry at the University of Alberta and a provider of assisted dying services, said she treats a small number of patients “with severe, disabling mental health disorders who suffer just like the patients I see in cancer treatment.”

Lisa Marr, a paramedic diagnosed with post-traumatic stress disorder in Nova Scotia, said she is desperate to take advantage of the new law. She has bipolar disorder, depression and picking disorder, or skin picking, due to anxiety and, by her estimate, she has made 15 attempts on her life. “I think the only reason I haven't done it yet is because I'm waiting for this decision in March,” she said.

Canada amended its criminal code to legalize assisted dying for the terminally ill in 2016, and in 2021, in response to the Quebec court ruling, it relaxed the law to add other people experiencing “serious and irremediable” conditions.

Eligible patients must wait 90 days before receiving an assisted death and must be approved by evaluations by two independent doctors. But some psychiatrists worry that they can't always determine whether someone seeking an assisted death could actually get better or not.

“The research we have shows that psychiatrists are no better at identifying who is not going to get better,” Maher said. “The challenge for us is that it is not a short-term process. “When people have been sick for years, it takes years to heal.”

VJOSA ISAI. THE NEW YORK TIMES