Ottawa-
An expert told a special joint committee of the House of Commons and the Senate that people with mental disorders can suffer for decades and that their distress is just as valid as that of someone suffering from physical pain.
People with only mental health conditions are set to become eligible for medical assistance in dying in March, and Dr Justine Dembo, psychiatrist and medical assistance in dying assessor, also warned the committee against perpetuating the stigma related to mental illness.
Mental health advocates warn that it’s harder to predict outcomes and treatments for mental illnesses, and that the desire to die is often a symptom, but a panel of experts earlier this year said the criteria eligibility and existing safeguards in medical assistance in dying legislation would be adequate.
Both arguments were made today by a handful of witnesses appearing before the committee, which is deliberating what policies to recommend to lawmakers before the March deadline.
Ellen Cohen, coordinator of the National Mental Health Inclusion Network, told committee members that Canada needs laws to help patients, not hurt them.
“I don’t believe there were any safeguards recommended,” she said.
She resigned from the federal government’s expert panel on MAID and mental illness in December 2021. She said there was no room to determine how vulnerable people could be protected.
The panel released its report on May 13, concluding that existing eligibility criteria and safeguards would be adequate “as long as they are interpreted appropriately to take into consideration the specificity of mental disorders.”
Dembo, who was one of the panel members, said adhering to these guidelines for people with mental health conditions “would ensure an extremely comprehensive, thorough and careful approach”.
She told the committee that people with mental disorders can suffer for decades.
“To say that someone with mental illness should just not be eligible, with this big sweeping statement, where people don’t even have the chance to be assessed as unique individuals in their circumstances, is for very stigmatizing me,” she said. .
Although the interim report released earlier this year does not make its own recommendations, it concludes by urging the government to take action to implement the panel’s recommendations “in a timely manner”.
A final report from the committee, along with recommendations addressing other areas, including access for mature minors, advance requests, the state of palliative care and protection for people with disabilities, is due Oct. 17.
Cohen called the timeline for extending the legislation by March unrealistic.
“I would like to see this government extend this deadline,” she said.
But Dembo disagreed, telling MPs and senators that evaluators are already gaining experience by following existing guidelines.
“Whether or not March 2023 is a realistic deadline depends on the commitment and effectiveness of the various provincial and local agencies in implementing the guidelines based on the panel report. I hope they can do it,” she said.
The committee’s review was mandated by the MAID Act which required a parliamentary review to be launched five years after the law came into effect in 2016. The committee began its work in 2021 before being dissolved before the federal election last fall.
The panel and committee use the terminology “mental disorder” rather than “mental illness”, stating in their reports that there is no standard definition for the latter and its use could be confusing.
Tory MPs on the committee presented a dissenting interim report earlier this year, saying it would be ‘problematic’ to simply endorse the group’s recommendations.
MPs argued that there were “far too many unanswered questions” on the subject, and there was nothing to prevent the committee from reviewing whether medical assistance in dying should be offered to this category of people.
“Legislation of this nature must be guided by science, not ideology,” the Tories wrote in May, warning that an outcome that could “facilitate the deaths of Canadians who could have been better off” would be totally unacceptable.
This report by The Canadian Press was first published on September 23, 2022