Legalization Of Medical Assisted Dying In Canada

There are thousands of people in Canada suffering daily from debilitating pain caused by terminal physical illness as well as crippling mental illness. More countries are getting on board with legalizing what is known as medical assistance in dying. Legally, this is defined as circumstances in which a physician or nurse practitioner can assist with an individual’s dying request by: administering a substance that causes an individual’s death or by prescribing a substance for an individual to administer themselves to cause their own death [1,5].

Medical assisted dying (MAID) in Canada has been legalized as of June, 2016 [2]. This can be seen as an outcome of the Carter v Canada case, in which Carter argued that it’s illegality contradicted his right to life, liberty and security as stated under section 7 of the Canadian Charter of Rights and Freedoms [3]. The Criminal Code that needed to be addressed were paragraph 241(b) which prohibits assisted suicide and section 14, which provides no person may consent to death being inflicted on them [4]. The reasoning behind the provisions and making of bill C-14 that legalized medical assistance in dying in Canada was that it clearly helped to achieve the legislative objective of protecting vulnerable persons from being induced to die by suicide at a moment of weakness. It allows individuals to make decisions concerning their bodily integrity and medical care.

Bill C-14 states that in order for an individual to legally pursue MAID in Canada they must meet the following criteria: be eligible for health care in Canada, be at least 18 years of age and mentally competent, have a grievous and irremediable medical condition, make the decision voluntarily, and give informed consent [3,5]. The criteria that is currently experiencing controversy in favour of individual’s suffering debilitating mental illness is that they must be suffering from a grievous and irremediable physical disease like terminal cancer. Based on the legal reasoning founded in the Carter case, individual’s suffering from debilitating and treatment resistant mental illness should have access to MAID in Canada. As long as these individuals are still evaluated as being capable and able to make an informed decision, they still possess the right to their liberty and security. Bill C-14 specifically does not include this vulnerable section of the population as it is in place in order to ‘protect’ them. The bill does not currently include anybody who’s natural death is not in the foreseeable future. It can be agreed upon that analyzing a patient’s psychiatric illness for irremediability is very difficult, but difficult should not mean impossible. It should not be viewed as of less importance in being addressed in this bill than individuals suffering from a physical illness. Helping a patient die should never be an easy call. This has been a controversial debate in the public as well as in the Senate and the House of Commons, ever since the case of Adam Maier-Clayton. He was an advocate for change to bill C-14 as he had severe suffering due to his mental illnesses and wished to die with dignity. As one of the many people who followed this case, I can say with confidence that he seemed completely competent and rational while making these decisions.

Opponents of assisted death make the argument that those suffering from mental illness cannot make rational decisions, that the government needs to protect them from themselves. However, this would not be an available option for someone who is experiencing delusions or psychosis. The suffering would have to be proven to be persistent and painful, though not necessarily considered lethal. Another argument made by those against it is that treatments are always developing, and one day it may be able to alieve their suffering. This is an understandable argument, one that holds onto hope for loved ones. However, this mild optimism is not an acceptable justification to their suffering. The same argument could be made for individual’s suffering with cancer.

Those qualifying for assisted death will have sought out and exhausted all available medical resources, and further treatment would be of no help as assessed by their long-term physician. With no hope of recovery or improvement, their decision to die would not be rash. Belgium is one of two countries that currently allow assisted dying for patients suffering from mental illness, and it is recognized that this option allows for dignity in dying and comfort. The Council of Canadian Academics are to report on how bill C-14 could be extended to those suffering from mental illness, which is due late in 2018. The bill could be further changed to become more similar to that of Belgium’s, where MAID is legal under conditions including “unbearable and untreatable” suffering.

A proper law for assisted-death in cases of psychological suffering would finally see approval to individuals who undoubtedly qualify while safeguarding the most vulnerable. Other alternative pathways would be encouraged throughout the process, involving mandatory meetings with medical and psychiatric professionals which would offer the proper treatment to those who did not have access to it. This is not to say that the right to assisted death would replace proper mental health funding or treatment. An agonizing voluntarily life cut short is undoubtedly heartbreaking. So too, is continual despair to those afflicted whom have no legal option to die with dignity.