Medical assistance in dying: mental distress is valid, too, says expert

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Medical assistance in dying: mental distress is valid, too, says expert

Debates are continuing in Ottawa on the provisions that would govern medical assistance in dying offered to people suffering only from mental health problems.

A psychiatrist told the Federal Parliament's Special Joint Committee on Physician-Assisted Dying that people with mental disorders can suffer for decades and their distress is just as valid as that of someone suffering. physical pain.

People with only mental health conditions should be eligible for medical assistance in dying next March.

Psychiatrist Justine Dembo, who assesses candidates for medical assistance in dying, also warned the all-party committee on Friday against perpetuating the stigma attached to mental illness.

Advocates for people with mental illnesses point out that the outcomes and treatments for these illnesses are more difficult to predict, and that the desire to die is often a symptom. But a panel of experts said earlier this year that the eligibility criteria and safeguards already provided by federal law on medical assistance in dying would be adequate.

Both arguments were made on Friday by a handful of witnesses who appeared before the MPs and Senators on the Select Committee on Physician-Assisted Dying, which is deliberating on policies to recommend to lawmakers ahead of the March 2023 deadline.

Ellen Cohen, coordinator of the National Mental Health Inclusion Network, told committee members that Canada needs laws to help patients, not hurt them.

I don't don't think safeguards were really recommended, she said.

Ms. Cohen resigned last December from the federal government's Expert Panel on Physician-Assisted Dying and Mental Illness. She felt at the time that there was no room to determine how vulnerable people could be protected.

In its report published last May, this group of #x27;experts concluded that the current eligibility criteria and existing safeguards would be adequate as long as they are interpreted appropriately to take into consideration the specificity of mental disorders.

Ms Dembo, who was also a member of the expert panel, said adhering to these guidelines for people with mental disorders would ensure an extremely comprehensive, thorough and careful approach. She reminded the Special Joint Committee on Friday that people with mental disorders can suffer for decades.

Arguing that someone with mental illness should just not qualify, with this big sweeping statement, where people don't even get the chance to be assessed as individuals unique in their situation, it is very stigmatizing for me, she argued.

Although the parliamentary committee's interim report, published in June, does not formulate his own recommendations, he concludes by urging the federal government to work with provinces, territories and other stakeholders to ensure that the recommendations of the expert panel are implemented in a timely manner.

The joint committee's final report is due October 17. It should also make recommendations on other aspects of medical assistance in dying, including access for mature minors, advance requests, the state of palliative care, and the protection of people with disabilities.

Cohen called the March 2023 deadline for implementing law reform unrealistic. However, psychiatrist Dembo disagrees: she argued before MPs and senators that evaluators already gain experience by following existing guidelines.

It will depend on the commitment and effectiveness of the various provincial and local agencies in implementing the guidelines based on the panel report, she explained. I hope they make it.

This work of the special joint committee was provided for in the federal law on medical assistance in dying, which required that a parliamentary review be launched five years after the law came into force in 2016. The committee began its work in 2021, but was dissolved when the federal election was called last fall.

The Conservative MPs on the committee submitted a dissenting interim report, in June, saying it would be problematic to simply endorse the expert panel's 19 recommendations.

Tory MPs argued that there was far too many unanswered questions on the subject, and nothing prevents the joint committee from reviewing it if medical assistance in dying should be offered to this category of people.

Legislation of such a nature must be guided by science, not ideology, the councils wrote. rvers in May, stating that it would be totally unacceptable to facilitate the deaths of Canadians who may have recovered.

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