In June 2016, the federal government passed legislation that allows adults to request medical assistance in dying (MAID). On 2 February 2023, the federal government introduced legislation to extend the temporary exclusion of eligibility where a person’s sole medical condition is a mental illness for an additional year. In other words, people solely suffering from mental illness will be able to receive MAID after 17 March 2024. The proposed one-year extension would allow more time for preparation to complete and disseminate key resources under development to ensure that MAID providers can address complex requests.
To be eligible for MAID, adults must meet the following criteria:
- Be eligible for health services funded by the government;
- Be at least eighteen years old and mentally competent (meaning you are capable of making health care decisions for yourself);
- Have a grievous and irremediable medical condition;
- Make a voluntary request for MAID that is not a result of outside pressure; and,
- Give informed consent to receive MAID.
I strongly believe that people have the right to choose and make informed decisions for themselves. However, the government introducing the ability for people suffering solely from mental illness to request MAID seems problematic. To be eligible for MAID, adults must provide informed consent and be capable of making health care decisions for themselves. However, people with mental illness may not be in the right state of mind to make informed decisions. The question becomes, “How can we assess whether a person with mental illness is fully capable of making health care decisions for themselves?” Oftentimes, mentally-ill patients are institutionalized for their own safety when they have suicidal thoughts, tendencies, or attempts. These individuals are later released when they do not feel suicidal anymore and are given adequate treatment to attend to their mental health needs. Where do we draw the line between institutionalizing people with suicidal thoughts for their own safety and allowing people with the same suicidal tendencies to fulfill their wishes?
Therefore, it seems unethical to allow MAID for people with mental illness instead of funding more mental health services to treat and find solutions for mental health issues. It is understandable that MAID may be available to patients who have tried everything to treat their mental health but nothing has worked for them. However, more funding should be given to mental health services and treatment to ensure this is not seen as the only feasible option for mentally ill individuals.
In addition, the federal government highlights that the legislation does not force any person to provide MAID. Therefore, health care providers have discretion as to whether they are comfortable participating. However, giving people in power discretion can lead to abuses in power. For example, health care providers could have their own racial biases, and this has been notably shown through the forcible sterilization of Indigenous women in Canada and the mistreatment of Black women in medical settings. Thus, encouraging MAID could disproportionately affect racialized mentally ill individuals. People with mental illness seek help from health care providers to improve their health and well-being. The issue becomes whether they have sufficient decision-making capacity to declare their termination of life.
Ultimately, I believe that the solution comes down to the government providing better resources and funding to support people with mental illness. It seems unethical that MAID can be requested by a person with mental illness who may lack sufficient decision-making capacity. The solution should not be providing MAID to people suffering from mental illness. It requires better investment in resources and more research for mental health issues. I do agree that it is one’s choice to decide whether to receive MAID because it is their body, and they should have the autonomy to do as they wish. However, I believe that instead of using resources to fund MAID for people suffering with mental illness, those resources should be provided to better assist those with mental health issues. There could be more resources given to people with mental illness, such as free therapy sessions, mental health programs, and more holistic outlooks that focus on improvement. Taking into consideration the mental state of individuals suffering from mental illness, it does not seem feasible to offer them solutions that result in detrimental consequences.