Psychiatrists call for the mentally ill to have access to euthanasia

Parliament is considering a bill which would amend the laws surrounding assisted suicide in Canada, CTV News reports.

The bill, known as Bill C-7, was tabled in response to a 2019 Quebec court ruling which struck down a provision of existing Canadian euthanasia law. The provision declared that only when natural death was "reasonably foreseeable" in the near future was it permissible to subject someone to euthanasia.

In Truchon v. Canada, the court ruled that the euthanasia law was unconstitutional because it would force "people who would otherwise seek MAiD into either prolonging their lives of suffering or resorting to death by other degrading or violent means" and that "it is overbroad and disproportionate to its purpose of protecting vulnerable persons," among other reasons.

The Canadian government worries that removing such a provision would allow those with mental illnesses to be euthanized, as their condition can easily be understood to cause tremendous pain but does not make death "reasonably foreseeable."

As a result, the proposed bill would disallow "persons whose sole underlying medical condition is a mental illness" to be 'eligible for medical assistance in dying."

A number of psychiatrists are criticizing the bill, claiming it discriminates against and stigmatizes the mentally ill.

Vancouver psychiatrist Dr. Derryck Smith is one of those critics, asserting that the provision banning those who solely suffered from mental illness from being subjected to assisted suicide is "a flagrant violation of Section 15 of the charter."

"I mean, this is discriminating against a class of Canadians," he continued.

Smith pointed to a case which he was involved in, wherein a woman in her 40s who was suffering from anorexia, which Smith described as a "severe, intractable eating disorder." According to Smith, the woman intended on starving herself to death if she was not provided access to assisted suicide.

"She was approved for assisted dying and received assisted dying just for a psychiatric illness," claimed Smith.

Dr. Mona Gupta, a psychiatrist from Montreal, also criticized the bill. Gupta argues that stigma and myths surrounding mental illness "that it reflects a character failing, that somehow it's transient or not real" motivates the language of the bill.

Gupta points to a man in her hospital who suffered from obsessive compulsive disorder. The man subjected himself to constant, vigorous handwashing to the point that he had to have his water turned off. "Otherwise he would have literally destroyed the entire skin barrier of his hands from repeated washing," Gupta asserted.

Despite all efforts to alleviate his condition, Dr. Gupta says that "nothing has helped him" and that treatment has "been a total failure." According to Gupta the man, who has since been institutionalized, has requested euthanasia.

Gupta insists that the proposed legislation would exclude "a very, very small group of people" who suffer from debilitating psychiatric conditions.

In a Justice Department charter statement, the government defended the proposed bill. The Justice Department asserts that medical screening for the severely mentally ill to determine their decision-making capacity is "subject to a high degree of error," "mental illness is generally less predictable than physical illness in terms of the course the illness will take over time," and that evidence from foreign countries, particularly from the Low Countries of northwestern Europe, "has raised concerns" when it comes to euthanizing the mentally ill.

While the Justice Department did not provide an example of such "concerns," they did assert that "evidence and research on current and potential future practice, including in relation to mental illness, is still developing."

Conditional euthanasia was legalized in Canada in 2016. Critics of euthanasia have argued that assisted suicide is always immoral and that even in the most dire of conditions it often leads to a slippery slope.