82 percent of Canadians demand mental health reform before expanding assisted suicide

Rebecca Vachon: Assisted suicide expansion for mentally ill prematureFix mental healthcare first. That’s a key takeaway from new poll results, which found that 82 percent of Canadians agree improving access to mental health care should happen before expanding “medical assistance in dying” (MAiD) to those with mental illness as their sole underlying condition.

These findings come from the Angus Reid Institute and think tank Cardus, and indicate a level of agreement that cuts across political backgrounds, regions, income levels, sexes, and ages. They also suggest a clear message for Parliament: The March 2024 expansion of euthanasia and assisted suicide for mental illness is too much, too soon.

The federal government has already delayed making euthanasia and assisted suicide available to those with mental illness, which was first slated to happen this past March. Thanks to objections from many mental health professionals, the government delayed expansion to March 17, 2024.

But that’s still too soon.

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Assisted suicide

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Little has happened since to relieve Canadians’ real concerns. Equitable and timely access to mental health care is still inadequate. According to the latest polling, 41 percent of Canadians who sought professional mental health care in the last year had difficulty accessing it. A majority didn’t even try to access public mental health care before turning to the private system. Even then, affordability was an issue. Three out of four Canadians who received mental health care in the private system describe it as “expensive.” These financial barriers pose even more significant challenges for low-income Canadians needing mental health care.

The problem, however, goes deeper still. A full 65 percent of Canadians agree that “populations with existing challenges in accessing mental health care will be made more vulnerable if MAiD eligibility is expanded”. Indigenous leaders have raised significant objections throughout the introduction of euthanasia and assisted suicide in Canada. They have been particularly concerned about how this practice could worsen already high rates of suicide within their communities.

Simply put, too many Canadians aren’t getting the care they need.

Let’s also not forget that resources, training, education, laws, and policies are designed to prevent suicide. MAiD, by contrast, facilitates self-administered assisted suicide in a small number of cases; it provides it directly as euthanasia in the vast majority of cases. Moving from preventing suicide to facilitating or directly causing suicide is a paradigm shift for society in general and mental health professionals in particular. It’s a shift that a one-year delay has not addressed in any meaningful way.

From a legal perspective, expansion of assisted suicide would also upend mental health law. For instance, in a recently published volume from Springer, lawyer David Shannon and Drs. Alexandra Giancarlo and Elaine Toombs review existing Ontario mental health law in light of the coming expansion. They conclude that MAiD for mental illness “erodes the foundation upon which existing Canadian case law rests: that a person should be vigorously prevented from self-harm”.

Finally, the government must also consider the weakness of current “safeguards” for euthanasia and assisted suicide. There have been media reports about MAiD being offered to those who are suicidal despite this still being illegal to date. Expansion of eligibility to those with mental illness will only worsen this situation. At a recent Cardus event in Ottawa, psychiatrist Dr. Sephora Tang predicted the March expansion will mean “we’re going to have people die who could’ve otherwise gotten better if this law wasn’t there and if we had the social supports.”

“These people are at high risk for being incited into choosing a ‘medically assisted death’ because our society has failed them,” she warned.

Canadians are worried about mental health. More than that, they’re nearly unanimous in agreeing Canada should improve access to mental health care before expanding euthanasia and assisted suicide to those with mental illness. And we know many people struggle to access mental health care already.

Frankly, the next expansion of MAiD is too much, too soon. Parliament needs to pause expansion indefinitely and prioritize the mental health of Canadians immediately.

Rebecca Vachon is health program director at public policy think tank Cardus.

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