Mentally ill Canadians have been excluded from medical assistance in dying (MAID) but that is about to change in a few months.
When that option arrives in March, 2023, Canada will have one of the most liberal MAID laws in the world, joining only a few other countries that allow access for the mentally ill.
As it now stands, only those with a “grievous and irremediable medical condition” can apply for MAID; not just if you are about to die from a fatal or terminal condition but if your life is insufferable.
The distinction between a medical and mental suffering is arbitrary and archaic. There is no mental suffering that isn’t physical. To suggest that we live in a world other than the physical is to perpetuate the ancient notion of a mind/body duality.
To prevent mentally ill Canadians with a “grievous and irremediable” from access to MAID is to further discriminate against the mentally/physically ill. Like the notion of a mind/body duality, made popular by Rene Descartes in the 17th century, mental illness has been characterized in voodoo terms, such as possession by demons.
Mental/physical illness is stubbornly difficult to treat and those afflicted pay a price. The mentally/physically ill are often deemed unemployable and, as a result, are often poor and homeless. Their pain often has physical origins outside the body; victims of trauma, childhood abuse and addiction; symptoms compounded by financial stress and loneliness.
In contrast, those who now access MAID come from a position of privilege.
They tend to be wealthier Canadians. More likely, as an Ontario study found, to fall into the highest income bracket. They have been, in other words, people of relative privilege, wanting the same control in death that they had in life.
The same group of wealthy Canadians who have access to health care also have access to MAID, and the numbers are growing.
In 2021, there were 10,064 assisted deaths in Canada – an increase of 32 per cent over 2020. The average age of Canadians who received MAID last year was 76. Two-thirds have a cancer diagnosis, and nearly one-fifth have a heart condition.
Doctors critical of MAID suggest that assisted dying for the mentally/physically ill will become an easy out for a broken health care system, offering death rather than hope and treatment to society’s most vulnerable and marginalized citizens.
Yeah, right. If you happen to be living an insufferable and irremediable life, just wait for us to fix the broken health care system. Shouldn’t take more than a few decades. Meanwhile, just grin and bear it.
Can doctors, a privileged group of people living in a society that routinely stigmatizes people with disabilities, objectively judge what makes life worth living?
Some worry that there will be a flood of new applicants for MAID but if the Netherlands is any example, the number of mental/physical cases will be a tiny fraction of the total. The Netherlands has had psychiatric illness available for MAID for two decades.
Expanding MAID is about not discriminating between mental and physical health, but seeing patients as whole people capable of making their own decisions.