Dr. Tim Lau

CMHA policy ‘inevitably’ bound to fail

  • September 15, 2017

OTTAWA - A Catholic psychiatrist is applauding a position paper by the Canadian Mental Health Association (CMHA) which says the mentally ill should remain ineligible for assisted suicide even though he believes such efforts are doomed to fail.

Dr. Tim Lau, the founding president of the Canadian Catholic Federation of Catholic Physicians’ Societies, said he welcomes the CMHA stand, announced Sept. 7, which supports existing laws that make it illegal to provide a medically assisted death to psychiatric patients.

“However, court challenges will inevitably come, arguing that if suicide is an answer to suffering, why would mental suffering be a just reason to discriminate,” Lau said in an email interview. “Since we opened this can of worms, it could be argued that it is a violation of the Charter of Rights and Freedoms. Suicide would become a treatment for depression rather than a terrible consequence.”

Ottawa has commissioned a review of the existing assisted suicide law, passed in June 2016, to examine whether the eligibility criteria should be expanded to include people with mental illness and mature minors, as well as to allow advance directives for people in the early stages of diseases such as Alzheimers. A report is expected by December 2018.

Lau said he has already had patients request so-called Medical Aid in Dying (MAiD) “but they we r e depressed” and therefore not eligible for the procedure. “Things will change, sadly enough,” he said.

The CMHA believes, rather than making mental illness a criteria for assisted death, the federal government should support psychiatric patients and “further invest in services, supports and research regarding mental health.” The CMHA pointed out that the criteria for assisted death says a patient must have an illness that is “irremediable, grievous and unbearable, and the patient should have a medical condition with a reasonably foreseeable natural death.”

“For patients who suffer solely from a mental illness, a natural death would not be foreseeable. This is one reason why CMHA believes that psychiatric-MAiD should remain illegal.”

The CMHA reported that an analysis of policies in Belgium and the Netherlands, where psychiatric euthanasia or assisted suicide is permitted, showed that opening the window to assisted suicide led to more requests.

“CMHA suggests that we must be careful to avoid the use of MAiD as a substitute for treatment and supports,” the release said.

The CMHA wants the government to invest in mental health services and implement a national suicide prevention strategy.

“Overall, CMHA’s position on MAiD in Canada is that people should be assisted to live and thrive before they are assisted in dying,” it said.

Lau said complications exist when there are “concurrent mental illness and patients who have say, depression and cancer.”

“A person with depression will be more likely to want suicide,” Lau said. “The hope that a capacity assessment would prevent suicide is unlikely. If someone wants suicide badly enough they will find someone who agrees with them.”

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