Cross Country Checkup1:53:00FULL EPISODE: How do you feel about MAID including those who suffer solely from mental illness?
WARNING: This article contains details relating to suicide and disordered eating.
When Agata Gawron first found out that medical assistance in dying (MAID) was an option in Canada, she says it made her feel empowered.
And that feeling grew, she says, when the federal government began its pursuit of expanding the program to include people solely afflicted with mental illness.
“It was the first time in my life where I felt most of my pain and suffering could end — that I could be in control of that, because I don’t want to go on,” she said.
Gawron, 43, says it gave her peace of mind knowing she wouldn’t become someone else’s burden.
“I don’t want to take away from somebody who can be helped. I’m at the point where I don’t want to be fixed. I feel strength, because it’s me finally showing compassion to myself.”
The Regina resident says she has battled depression and an eating disorder, anorexia nervosa, for 30 years — first diagnosed at the age of 13.
But recently, Ottawa announced plans to delay the expansion of MAID until March 2024.
Federal Justice Minister David Lametti calls the proposal a “prudent path forward,” and says he’s confident the legislation will pass before next month’s deadline, with support already secured by the Bloc Québécois and NDP in the House of Commons.
“We want to have Canadians on the same page,” Lametti told Cross Country Checkup host Ian Hanomansing. “And as one society, to be better prepared. We won’t be backing away from this.”
Gawron says the proposed one-year delay is “beyond hurtful” because it means at least another year of suffering, even before applying or being considered eligible for the program.
“I don’t want to resort to taking my own life. I want to leave on my own terms.”
Over the years of her mental illnesses, Gawron says she’s found it difficult connecting with proper support.
“I think my condition is a little bit different from the norm. People obviously develop eating disorders, and many get over it. But for goodness sake, it’s been over 30 years of this for me.”
The last time she attempted to see a psychiatrist was over a year ago, according to Gawron, and she remains on a waiting list.
“Most of the psychiatrists that I’ve dealt with do not communicate with each other. So every time I see somebody new, I have to keep repeating myself and my background. I don’t see any quality of life going from doctor to doctor, trying to cure me.”
WATCH | The CBC’s Fifth Estate on MAID expansion:
Disability advocate Cassandra Pollock is concerned with the idea of MAID expanding. She says she is reluctant for it to include people solely with mental illness, without first off “expanding and giving liberal access to mental support” to all Canadians.
“When you have a mental health issue, you need that help until you don’t need it,” said Pollock, who lives in Calgary. “There is no time frame. Too often health programs limit what you’re allowed to do, what you can access.”
Pollock says she suffered from post-traumatic stress disorder (PTSD) and anxiety for many years, and was eventually diagnosed and treated for attention deficit hyperactivity disorder (ADHD) — which turned her life around, she adds.
“I always said being a single parent and having a child was what prevented me from taking that final step. Had I been allowed to get MAID, would I have done it? Then I wouldn’t have had the life I have. I’ve done so many things since getting that diagnosis and being able to manage my life a little bit better.”
While Pollock says she doesn’t want to deny people the right to end their own suffering via MAID, she believes more consideration needs to be put into how the program is structured, and what criteria applicants must meet to be eligible.
“You know what? If they end their suffering and two years later, there’s an answer that they didn’t have then. That’s what concerns me.”
We can help most people, but not everyone.– Psychiatrist Justine Dembo
Psychiatrist Justine Dembo says she supports the extension of MAID in Canada, provided there are “rigorous safeguards and protocols.”
Dembo, who works at Toronto’s Sunnybrook Health Sciences Centre, says she’s in favour of it because it centres around human rights.
“I think we shouldn’t exclude an entire group of individuals suffering from a particular type of illness, from a law that is the privilege of the rest of the Canadian population — especially because suffering from a mental illness can be just as unbearable as from a physical illness,” Dembo said.
There are people who — despite the best quality treatment and having financial means to access private psychotherapies — do not find relief from their suffering after decades of treatment, she says.
“We must have humility, as psychiatrists, to recognize that we aren’t able to cure everyone, and we aren’t able to treat everyone to the point that they find their suffering to be more bearable,” she said.
“We can help most people, but not everyone.”
Dembo says there’s no way to predict with certainty whether someone will ever get better, or whether they might learn to adapt to their symptoms of mental illness.
Hospital MAID team chair to step down if expansion occurs
Dr. Sonu Gaind says he’ll walk away as chair of his hospital’s MAID team if the program is eventually opened up to people dealing solely with mental illness.
“If we as a society are providing death to people who are not otherwise dying, it should be done for honest reasons,” said Gaind, who is the chief of psychiatry at Toronto’s Humber River Hospital.
When the program was introduced in Canada in 2016, he says it was for helping relieve end-of-life suffering — something he saw real value in.
Now, adds Gaind, it’s been extended to disabled people who could otherwise have many decades left to live, if they were given an opportunity to live with dignity in our society.
“What we see is people driven by all sorts of social suffering — poverty, housing, insecurity, loneliness. It shifts from MAID being for providing compassionate relief of end-of-life suffering, to essentially meaning that the state provides facilitated suicide to end-of-life suffering. It’s very different.”
Gaind says MAID’s fundamental premise and promise to the Canadian public has been for medical conditions that are deemed irremediable.
“All of the evidence shows that we cannot make those predictions of mental illness. Our best predictions are no better than flipping a coin or worse. The unpredictability is far greater than what we’re talking about with cancers or other neurodegenerative conditions.”
The expansion to include mental illness as a standalone condition is also problematic, according to Gaind, because it’s difficult to tell the difference between people who are suicidal and those who are seeking psychiatric euthanasia.
“You end up falsely telling people they won’t get better, when you can’t actually say that.”
Where to get help if you or someone you know is struggling:
- Talk Suicide Canada: 1-833-456-4566 (phone) | 45645 (Text, 4 p.m. to midnight ET only)
- Kids Help Phone: 1-800-668-6868 (phone), live chat counselling at www.kidshelpphone.ca
- Canadian Association for Suicide Prevention: Find a 24-hour crisis centre
- Hope for Wellness Helpline: 1-855-242-3310 (phone, available in Cree, Ojibway and Inuktitut upon request)
- To learn how to talk to someone about suicide, consult this guide from the Centre for Addiction and Mental Health.
- This guide from the Canadian Mental Health Association outlines the warning signs of suicide.
If you or someone you know is struggling with disordered eating, here’s where to get help: