‘Teeny tiny’ or thousands will die? Psychiatrists divided over how many would get MAID for mental illness

Conservative MP Tamara Jansen is the author of a private members' bill making its way through the House of Commons that would permanently ban assisted suicide where the sole underlying medical condition is a mental illness. Photo by Adrian Wyld /The Canadian Press

Article content

Thousands could choose to die by MAID if euthanasia is opened to people experiencing mental suffering alone, or perhaps only a small handful, parliamentarians heard this week.

Article content

A special joint committee struck to revisit Canada’s readiness for doctor-assisted death for those whose sole underlying condition is a mental disorder heard opposing prognoses from prominent psychiatrists Tuesday, with one side warning any such expansion would be “inappropriate and dangerous,” while the other said those with severe mental illness can experience distress as profound as those with physical illnesses and shouldn’t be treated “like second-class citizens.”

Article content

Article content

Article content

Experts were divided over several core issues, including whether it’s possible to predict with any degree of certainty whether someone will get better or not, and just how many people might seek, and ultimately be granted, MAID for mental illness if it becomes lawful, as scheduled, in March 2027.

Article content

Article content

Dr. Claire Gamache, of the Quebec association of psychiatrists, said a “very, very small percentage” of people have mental disorders severe enough to qualify for MAID such as schizophrenia, severe obsessive-compulsive disorder and recurring depression.

Article content

She described a case involving a 70-year-old woman who has lived with serious OCD since her teens and an “irrational fear of contaminating her family with feces.” She washes herself 15 times daily, has been hospitalized multiple times and has undergone multiple therapies including electroconvulsive therapy.

Article content

“One day she said she no longer wanted to see her grandchildren. She’s too afraid of contaminating them and she refused to come back to the hospital and she requested MAID,” Gamache said.

Article content

“MAID will never be for someone in a temporary crisis, or someone who has lost their job,” Gamache said. “That’s not the situation. There’s a certain dishonesty” to suggest so.

Article content

Article content

Gamache said that, in her 27 years of practice, two patients at most would qualify for MAID. “It’s really a very minimal number of patients.”

Article content

Article content

“Our organization believes that people with mental disorders should not be treated as second-class citizens, deprived of the right to the same health-care options as anyone else,” she said.

Article content

“I don’t know how many MAID evaluations will take place exactly, but in my opinion, like my colleague, this kind of treatment, MAID, would really be reserved for a teeny, tiny percentage of patients, really the most mentally ill patients,” psychiatrist Dr. Guillaume Barbes-Morin, who works in a small community in northwestern Quebec, told the committee.

Article content

Liberal MP James Maloney said the numbers are irrelevant. “It makes no difference to me whether it’s a small percentage or a large percentage. The issue we have to deal with is getting it right.”

Article content

In a brief submitted to an earlier iteration of the special joint committee on MAID, psychiatrist and bioethicist Scott Kim, a senior investigator with the U.S. National Institutes of Health, estimated that, based on Dutch data, Canada could see 2,500 to 5,000 annual requests for MAID for mental illness, and an approval rate as high as 50 per cent.