Dr. John Maher, president of the Ontario Association for Assertive Community Treatment and Flexible Assertive Community Treatment, addressing Parliament’s Special Joint Committee on Medical Assistance in Dying:

The Canadian Mental Health Association, CAMH, the Canadian Association for Suicide Prevention and my own organization, which is the largest professional association of community-based tertiary mental health care in Canada, to name but a few, have  denounced Bill C-7. Anyone who says there is an emerging consensus is grossly misinformed or worse.

The Quebec parliamentary commission listened to the facts. I am hoping you will listen to the facts, because what is happening is tragic. 

I am a psychiatrist, and I’m a medical ethicist. For 20 years I have worked only with adults who have the most severe and persistent forms of mental illness, in cockroach- and bedbug-infested rooming houses and on the streets, where our wealthy society forces them to live in poverty, our sons and daughters treated as social outcasts.

MAID activists say everyone must be able to access MAiD regardless of crushing poverty, the shocking lack of treatment availability, protracted wait times of years or having brain diseases where it is impossible to predict irremediability. The rallying cry is autonomy at all costs, but the inescapable cost is people dying who would get better. What number of mistaken guesses is acceptable to you?

Death is not an acceptable substitute for good treatment, food, housing and compassion. You who voted for this law have not understood vulnerability and what it means for your doctor to offer you death over life. Do you seriously believe you can prevent abuses by the 100,000 M.D.s and nurse practitioners in Canada who now have a licence to kill? Please read the news.

You know Bill C-7 is not consistent with the Supreme Court’s stated principle in Carter to preserve life. The ruling explicitly supported people getting help killing themselves only when they could no longer physically do it themselves... 

I am hearing shock and disbelief from psychiatrist colleagues. When the Ontario Medical Association in 2021 asked Ontario psychiatrists clear questions after Bill C-7 became law, 91 per cent objected to the law, seven per cent were uncertain and only two per cent supported what this bill has done.

Psychiatrists… can’t know who will get better and live decades of good life. Brain diseases are not liver diseases. If guesswork is good enough for you, it is not good enough for psychiatrists who understand the science and respect our duty to abide by a professional standard of care. You have been systematically misled by discriminatory ideology over clinical reality. Passing a law telling psychiatrists to make impossible predictions doesn’t magically make it possible. 

Some of my patients are now refusing effective treatment to make themselves eligible for MAiD. They have been susceptible to the perverse lie it is not suicide. Suicide is always clinically defined as taking the steps to arrange your own death. The Canadian Association for Suicide Prevention has stated all MAiD for mental illness is suicide. The frankly bizarre assertion that suicide is always an impulsive and unplanned act is not rooted in reality…

In European countries that at least require standard treatments be tried before euthanasia, there have been steady and significant rises in overall suicide rates in the last two decades...Women in particular have much higher suicide rates. The false claim the Supreme Court accepted — without evidence — that suicide rates do not go up with MAiD is absolutely contradicted by the data. Suicide contagion should scare you. Do you support suicide prevention or not?

Telling my patients that you will make it easier for them to die has enraged me. They will doctor shop to find the few psychiatrists who fancy themselves defenders of autonomy at all costs, as already happens in the Benelux countries, and they will die because death was offered over full and purposeful membership in the human community. They will die because of the social suffering this law enshrines… They will die because psychiatrists will now have legal permission to give up. They will die because, whether you can see it or not, you have told them they don’t matter.

May 26, 2022