The joint House and Senate committee studying the expansion of medical assistance in dying (MAID) has recommended a permanent exclusion of those patients whose sole condition is mental illness.
A Welcome Recommendation
It is a recommendation the government should embrace. Given the expert testimony MPs and senators heard in the spring, it was perhaps the only conclusion the committee could reach if it wanted to retain the support of the Canadian public.
Back in March, K. Sonu Gaind, professor at the University of Toronto and chief of psychiatry at the Sunnybrook Health Sciences Centre, told MPs and senators that studies have shown MAID assessors have a 47 per cent accuracy rate when it comes to treatment-resistant depression.
“That is worse than flipping a coin,” he said.
The conclusion that there is no accurate way to diagnose whether mental illness is incurable was endorsed by the heads of psychiatry departments at 13 Canadian medical schools, all of whom called for the expansion to be halted.
The majority on the special committee did not like Gaind’s odds, a feeling reflected in the report tabled late Wednesday afternoon that may halt what Gaind called “the runaway train” that was on schedule to repeal the exclusion on mental illness next March.
Instead, they have accepted the contention that suicidal thinking and suffering can always be reduced, put forward by Dr. John Maher of the Ontario Association For ACT and FACT, which provides community-based mental health interventions.
Committee Findings and Government Response
The committee was asked to undertake a new study looking at the possible expansion of MAID, a decade to the day after the original legislation legalizing it was given royal assent.
It concluded that the government should amend the Criminal Code to indefinitely exclude from access to MAID persons whose sole underlying condition is mental illness.
The government has signalled that it will adopt the committee’s recommendation, effectively putting the expansion on hold, at least until the Supreme Court weighs in on the constitutionality of expanding MAID further. (The Ontario Superior Court of Justice is hearing a case filed by Dying with Dignity Canada that could ultimately end up in the top court.)
Dissenting Opinions
But the committee’s recommendation was not unanimous. Three senators, plus the Bloc Québécois member Luc Thériault, recommended the Liberal government refer the matter to the Supreme Court of Canada.
In their dissenting report, senators Rosemary Moodie, Pamela Wallin and Kristopher Wells said that the committee process was “irregular and flawed” because two-thirds of the 44 witnesses were public opponents of expanding MAID. They said few witnesses with “lived” experience were invited and, consequently, the report lacked “rigour and credibility.”
