Recently, the CBC ran an article about a middle-aged Torontonian named Claire Elyse Brosseau.

Brosseau, 48, suffers from a multitude of mental health issues and has done for decades. She has spent the past two years engaged in the push for Medical Aid in Dying (MAID) to be available for people like her: physically healthy but mentally ill.

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The New York Times profiled Brosseau last year. 

The CBC lede reads, “Claire Elyse Brosseau has been waiting years for the Canadian government to let her die,” which is a direct echo of the Times headline, “Claire Brosseau Wants to Die. Will Canada Let Her?”

The timing of the CBC story wasn’t coincidental. The Special Joint Committee on Medical Assistance in Dying (AMAD) convened at the end of March to deliberate, for the third time since 2021, whether the mentally ill should be eligible for Medical Aid in Dying (MAiD). The committee had its sixth meeting on the day the CBC story was published.

Brosseau’s desire for MAID was used as the pointy end for the broader thrust of the story that the AMAD committee hearings were biased against expansion of MAiD for mental illness.

The story notes the absence of witnesses called to the committee hearings who had “lived experience.”  

Brosseau told the CBC, “They need to hear it directly from the people who live with that reality, with severe and persistent mental illness.”

On the day the story came out, health law professor Trudo Lemmens posted on X, “Has @CBC become an outright propaganda tool for zealous promotors of #MAID #euthanasia? Handful of experts frustrated about too much evidence of problems with expansion for mental illness interviewed. No cautious witness. No suicide survivor who wants protection... Shameful” 

In other words, the only “lived experience” the CBC article cited was that of Brosseau and the frustrated Senator Pamela Wallin.

The story notes, “Among the countries that allow MAID for people who are not near death, Canada is the only one that excludes people with mental illness.” Which is true, but the journalist neglected to mention that group of countries is exceedingly small (Canada, Luxembourg, Belgium and the Netherlands) and, in practice, the Netherlands is the only country with a developed program of MAiD for mental illness.

In committee testimony one week after the CBC story appeared, three Dutch psychiatrists, Sisco van Veen, Wilbert van Rooij and Jim van Os, shared their “lived experience” with AMAD committee members.

Van Veen supports the expansion of MAID eligibility to mental illness while the other two issued strong warnings to Canada. 

Questions of life, death and suffering are squarely at the center of the discourse around MAiD, and it is clear from listening to the Dutch psychiatrists that the Netherlands is now floating in the windless waters that the modern, secular mind struggles to navigate. 

In the Dutch system, applicants are regularly denied euthanasia, around 90 per cent, because physicians determine that mental illness, including severe depression, can diminish a patient’s capacity to make a rational death request.

But van Veen told the committee that he believes “mercy” should trump questions of capacity and individual autonomy. 

“I think it's hard to justify excluding patients with psychiatric disorders whose suffering can be immense or in other words, unbearable. MAiD for terminal illness is a way to prevent a terrible death. MAiD for chronic illness can be seen as a way to end a terrible life.” 

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It’s a catchy little formula but unnervingly reminiscent of the rhetoric contained in the source book for the German eugenics movement.

In 1920, prominent jurist Karl Binding and psychiatry professor Alfred Hoche published a short volume entitled, “The Permission to Destroy Life Unworthy of Life.” In it, they argued that ending a Lebensunwertes Leben (“a life unworthy of life”) was both therapeutic and compassionate. 

“A new age will come which, from the standpoint of a higher morality, will no longer heed the demands of an inflated concept of humanity and an overestimation of the value of life as such,” they wrote.

Van Veen does not broach the problem which lies nestled at the heart of his argument: Who decides?

Jim van Os, one of the two psychiatrists critical of the expansion of MAiD in the Netherlands told the committee that “individual clinicians differ wildly in what they think they see before them in terms of suffering, irremediability, futility and autonomy.” 

Van Rooij drew out the problems that result from placing such decisions on the backs of the psychiatrists.

“As a psychiatrist, I'm trained to tolerate despair without endorsing it. To stay present and still say, ‘I don't know the answer yet, but I'm not done with you.’ That stance is not paternalism. It's fidelity. You ask clinicians to decide not only when life can no longer be cured, but when it no longer should continue. That is a burden psychiatry was never designed to carry.”

 One point of unanimity between the three Dutch psychiatrists was their criticism of the role the media played in the debate.

“It is my experience that media and social media play a profound polarizing role in debates surrounding psychiatric MAiD. This worries me a great deal,” said van Veen.

“If there is a media campaign that will sway a group of physicians who really think that they are following their instincts of mercy and then expand their practice, then society is not able to keep up with that and to control and to deliberate and to assess what is happening,” said van Os.

This role of the media is clearly a matter of hot debate in the Netherlands.

A recent story in The Atlantic, which looked at the rise in the numbers of young women asking for MAiD in the country, noted that the specialized euthanasia clinic in the Hague issued a statement last December drawing a direct link between MAID requests at the clinic and euthanasia-positive media stories. The centre said it saw a “spike in registrations” after every positive news story.

It is worth noting that last week Globe and Mail health columnist André Picard, a veritable tête grise having held that position for the past 36 years, came out swinging on the matter of MAiD expansion for the mentally ill. With no trace of concern, Picard declared that the MAID “system works remarkably well, and Canadians have embraced it.”

Picard cites the case of Brosseau and asks, “How long should a person have to suffer?”

“Canada is ready, clinically, legally, and societally. That it is not ready politically is not a justification for denying people who suffer from mental illness dignity in death.”

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Just go ahead and jump, why don’t cha?

Anna Farrow is a Montreal journalist who contributes regularly to the Register. This column first appeared as post in The Rewrite substack.