S07 – Medical Assistance in Dying and Mental Illness: From Legalization to Implementation

S07 – Medical Assistance in Dying and Mental Illness: From Legalization to Implementation

Le jeudi 19 octobre
15:45 – 16:45 (1 hr)
Salle de réunion : Port McNeill (4th floor – North Tower)
Peter Chan*, MD, FRCPC; Peter Chan, MD,FRCPC, FCPA, iSAM; Ashok Krishnamoorthy, MD FRCPC MRCPsych FA

Rôles CanMEDS :

  1. Collaborateur
  2. Communicateur
  3. Leader

À la conclusion de cette activité, les participants seront en mesure de : 1) List key differences between medical assistance in dying (MAiD) for physical illness compared to MAiD for mental illness; 2) Understand how an oversight process regarding MAiD and mental illness can be implemented locally; and 3) Identify safeguards in the assessment and provision of MAiD for mental illness.

With proclaiming Bill C-14 in 2016, Canada became one of the few countries in the world offering euthanasia, as coined by the term “MAiD” (medical assistance in dying), for those with terminal physical illnesses who are suffering grievously and irremediably. Since then, the criteria for MAiD have expanded with Bill C-7 in 2021 to include illness that does not require a reasonably foreseeable death and laid the groundwork for including those with mental illness as the sole underlying medical condition (MAiD-SUMC) by March 2024.
With Bill C-7, debate in the psychiatric community centres on what defines enduring and intolerable suffering, and what constitutes irremediability in the context of chronic mental illness in which symptoms may be potentially remediable with new therapeutic options, social supports, and environmental determinants such as appropriate housing. Recommended safeguards including oversight, as discussed in the 2022 CPA discussion paper and federal expert panel report on MAiD and Mental Illness, have been disseminated.
Within Vancouver Coastal Health Authority, a process is being developed to provide regional oversight over MAiD-SUMC by designated lead psychiatrists as well as education and support for clinicians whose patients have been deemed eligible. Following a brief overview of MAiD in Canada in compared to other countries allowing euthanasia, we will present the results of a survey of regional psychiatrists’ opinions on how MAiD should be implemented. Participants will be invited to share their experience in grappling with the impending legalization of MAiD-SUMC in their region.

Références :

  1. Freeland A, Godkin D, Dembo J, et al. Medical assistance in dying (MAiD) for persons whose sole underlying medical condition is a mental disorder: challenges and considerations. Can J Psychiatry 2022;67(1):71–87.
  2. Health Canada. Final report of the expert panel on MAiD and mental illness. Ottawa (ON): Author; 2022 [cited 26 July 2023]. Available from: https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/expert-panel-maid-mental-illness/final-report-expert-panel-maid-mental-illness.html