For the Official Paper Released with this position statement please CLICK HERE TO DOWNLOAD PDF.
Key Points on Bill C-14
CMHA believes that requests for medical assistance in dying (MAiD) should not be granted for patients where a mental illness is the sole underlying medical condition. As a recovery-oriented organization, CMHA does not believe that mental illnesses are irremediable, though they may be grievous.
We recognize that people with mental illnesses can experience unbearable psychological suffering as a result of their illness, but that recovery is possible. • The idea that someone with a mental illness could be eligible for MAiD is difficult, in part because psychological suffering and a wish to die ca be symptoms of a mental illness.
The criteria for MAiD suggests that patients are only eligible for MAiD if there is a “reasonable and foreseeable natural death.” CMHA supports the criteria in Bill C-14 and therefore, as mental illness does not lead to natural death, CMHA believes that psychiatric MAiD should remain illegal.
CMHA believes that before we assist people in dying, we should assist people to live and thrive. • With the right supports and resources, research suggests that recovery is possible regardless of the mental health diagnosis.
We need governments to ensure there is access to a full continuum of mental health services and supports for all Canadians, in all communities across Canada.
Facts on Bill C-14
Medical assistance in dying (MAiD) describes an instance of a medical or nurse practitioner administering or prescribing a substance to patient with an irremediable illness to cause death.
Bill C-14 primarily set out to decriminalize medical assistance in dying (MAiD) by amending portions of the Criminal Code that otherwise prohibit it.
Bill C-14 was an Act to amend the Criminal Code surrounding medical assistance in dying (MAiD).
- This made specific personnel exempt from the offences of culpable homicide and assisting in suicide.
- These people include patients who meet the criteria for MAiD, medical professionals and pharmacists, and anyone else assisting the patient.
Bill C-14 consists of safeguards to prevent the misuse of medical assistance in dying such as:
- A person requesting MAiD may withdraw their request at any time
- There must be 10 clear days between the time that a person requests MAiD and the time that MAiD takes place
- A person’s request for MAiD must be made in writing and signed and dated
- If they are unable to sign, someone eligible may sign for them
If a medical or nurse practitioner knowingly fails to comply with the safeguards put in place by Bill C-14, they are guilty of an offence.
CMHA’s Position on Bill C-14
Since Bill C-14 does not explicitly include mental illness in the new eligibility criteria, CMHA has suggested that mental health patients should not be considered eligible for MAiD. As a recovery-based organization, CMHA has announced that the Canadian government should choose to support recovery for mental health patients rather than MAiD, and further invest in services, supports and research regarding mental health.
Bill C-14 mentions that the illness must be irremediable, grievous and unbearable, and the patient should have a medical condition with a “reasonably foreseeable natural death.” For patients who suffer solely from a mental illness, a natural death would not be foreseeable. This is one reason why CMHA believes that psychiatric-MAiD should remain illegal.
In an analysis of existing state policies on psychiatric euthanasia and assisted suicide (EAS) in Belgium and the Netherlands, CMHA found that these policies led to increased requests for psychiatric-EAS. CMHA suggests that we must be careful to avoid the use of MAiD as a substitute for treatment and supports.
As a recovery-oriented organization, CMHA makes the following recommendations to the Government of Canada:
- Support recovery by ensuring that recovery-oriented practices that place the patient at the centre of care are implemented within our mental health and addictions system
- Continue to invest in community mental health and addictions services and supports
- Develop and fund the implementation of a national suicide prevention strategy
- Invest in research to better understand and predict the course of illness in the area of mental health and substance abuse
These recommendations root in three core beliefs at CMHA National:
Belief in recovery
- CMHA believes that recovery from a mental health problem or illness is expected and likely when people get the help they need, where and when they need it. With the right services and support, recovery is not only possible, but expected.
Loss of hope
- Were a medical professional agree to MAiD for a patient solely suffering from psychiatric illness, this could contribute to the patient’s loss of hope. Psychiatric patients often look to their psychiatrist or medical practitioner for answers, and if death, rather than recovery, is considered a medically-viable option, the resulting lack of hope may cost them their lives.
- Non-discrimination means that a patient with irremediable and grievous physical illness should not be denied access to MAiD due to a co-occurring mental illness. That is to say, having a mental illness should not disqualify a person from accessing MAiD if they meet the criteria.
CMHA’s position on Bill C-14 and MAiD is based on the analysis of existing policies in countries such as Belgium and Netherlands. These policies are inclusive of psychiatric euthanasia and assisted suicide (EAS), and have resulted in increases in requests for psychiatric-EAS. CMHA suggests that we must be careful to avoid the use of MAiD as a substitute for treatment and supports.
Overall, CMHA’s position on medical assistance in dying in Canada, is that people with a mental health problem or illness should be assisted to live and thrive.