CMHA Position on Bill C-14 on medical assistance in dying (MAiD)

With the passing of Bill C-14, the Canadian Mental Health Association raises concern regarding the criteria eligibility of mental illnesses for medical assistance in dying (MAiD). Specifically, CMHA holds the position that MAiD for psychiatric patients should remain illegal.

CMHA asserts that recovery from mental illnesses is possible.

CMHA has made the following recommendations to the Canadian government:

1. Support recovery by ensuring that recovery-oriented practices, or ones that place the patient at the centre of care, are implemented within our mental health and addictions system.
2. Continue to invest in community mental health and addictions services and supports.
   i. Mental health services are not currently resourced or respected on par with services for physical illnesses.
3. Develop and fund the implementation of a national suicide prevention strategy.
4. Invest in research to better understand mental illnesses and the interventions that work best.

These recommendations root in three core beliefs at CMHA National:

1. Belief in recovery
   CMHA believes that recovery from a mental health problem or illness is expected and likely when people get the help they need, where and when they need it. With the right services and support, recovery is not only possible, but expected.
2. Loss of hope
   Were a medical professional agree to MAiD for a patient solely suffering from psychiatric illness, this could contribute to the patient’s loss of hope. Psychiatric patients often look to their psychiatrist or medical practitioner for answers, and if death, rather than recovery, is considered a medically-viable option, the resulting lack of hope may cost them their lives.
3. Non-discrimination
   Non-discrimination means that a patient with irremediable and grievous physical illness should not be denied access to MAiD due to a co-occurring mental illness. That is to say, having a mental illness should not disqualify a person from accessing MAiD if they meet the criteria.

CMHA’s position on Bill C-14 and MAiD is based on the analysis of existing policies in countries such as Belgium and Netherlands. These policies are inclusive of psychiatric euthanasia and assisted suicide (EAS), and have resulted in increases in requests for psychiatric-EAS. CMHA suggests that we must be careful to avoid the use of MAiD as a substitute for treatment and supports. Overall, CMHA’s position on medical assistance in dying in Canada, is that people with a mental health problem or illness should be assisted to live and thrive.