Toronto Star Classroom Connection

Mental health and MAID a concern

MIRIAM EDELSON MIRIAM EDELSON IS A TORONTO WRITER. HER LATEST BOOK, “THE SWIRL IN MY BURL: ESSAYS,” IS OUT NOW.

At the moment I most needed acute mental-health care, I was lobbing rocks into a bucket in anticipation of drowning myself in a remote, pristine lake. But the line I tied to the pail and to my ankle did not hold and I just bobbed on the surface like a beach ball.

This incident took place two months after I’d spent six weeks in hospital suffering from severe depression.

Although I initially felt optimistic about my discharge, recovery was elusive and certainly not fast enough for my liking.

I consider myself one of the lucky ones. I eventually found help — a reputable psychologist helped me to work through some of the deeply troubling issues. I regained the will to live. Not everyone is so fortunate.

The lack of available mentalhealth services, the high cost of psychotherapy and the lack of access in many parts of the country are but a few of the barriers people with mental-health challenges face.

And now there is another complication to throw into the wash: the possibility of MAID (medical assistance in dying) based solely on mental illness.

At first, I was eager to see the right to die as something people plagued by mental disorders should be able to access on an equal footing with those suffering from physical illnesses.

I still tend toward that position, but I want to see safeguards built into the system, standards that protect the most vulnerable. The promise of autonomy in the face of scarce resources is a false promise.

What safeguards are needed? Some people just don’t respond to the treatments available. What if they’ve tried everything medicine has on offer? Should they have the right to end it all?

It’s not a decision I would want to rush. I am concerned that by March 2023, the law will permit MAID based solely on mental illness, without a full set of standards to govern what are complex cases.

Two specialists to assess the individual instead of one, wherein the second physician would rigorously investigate treatment options, would constitute a more measured approach. So would lengthening the 90-day waiting period.

Interestingly, in the Netherlands 90 per cent of psychiatric euthanasia cases are not accepted. A Quebec government committee studying the issue recommended disallowing MAID based solely on mental illness. Certainly, that is the most cautious route. It bothers me in that scenario, however, that a truly desperate individual who had exhausted all treatment options would not have the right to end their life in a dignified fashion.

I agree with those advocates who maintain that what the patient wants should be supreme, but with the caveat that this right is accessed only once the full slate of care options has been tried.

Finally, MAID must not become a ready alternative for vulnerable people who cannot make ends meet. Many people with serious mental illness are poor, can’t work, have fallen through the cracks. It would be ironic if the one policy that might “catch” them is one that would allow them to kill themselves.

When I stood over that serene lake years ago actively choosing suicide, MAID was not an option. I wouldn’t have been a good candidate for it either. Only two months out of hospital, I was still on my first drug trial. It didn’t turn out to be successful.

It took another few months, another drug and intensive counselling, before I fully re-entered the land of the living.

In response to that kind of situation, I would want policymakers to be parsimonious in the granting of MAID — there were still too many unexplored routes to wellness. Recovery takes time.

When recovery is not possible, assuring the judicious application of MAID means improving the accessibility and depth of mental-health services in this country. And it means extending the safeguards that exist, before widely granting the right to MAID based solely on mental illness.

OPINION

en-ca

2022-11-26T08:00:00.0000000Z

2022-11-26T08:00:00.0000000Z

https://torontostarnie.pressreader.com/article/282729115909220

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