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Canada should delay MAID for people with mental disorders

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Ottawa, December 2: Canada is not ready to expand medical assistance in dying for people with a mental disorder, leaving psychiatrists across the country “incredibly concerned” about patients needing better access to care, including for addiction services, says a group representing the specialists across the country.

The Association of Chairs of Psychiatry in Canada, which includes heads of psychiatry departments at all 17 medical schools, issued a statement Thursday calling for a delay to the change set to be implemented in mid-March.

Lack of public education on suicide prevention as well as an agreed-upon definition of irremediability, or at what point someone will not be able to recover, are also important, unresolved issues, the statement says.

“As a collective organization, we recognize that a lot of work is being done in Canada on this issue,” Dr. Valerie Taylor, who heads the group, said in the statement.

“Further time is required to increase awareness of this change and establish guidelines and standards to which clinicians, patients and the public can turn to for more education and information,” said Taylor, who is also chair of the psychiatry department at the University of Calgary.

A statement from the office of federal Health Minister Jean-Yves Duclos says Canada is committed to implementing MAID for those with a mental disorder by keeping their safety and security at the forefront.

“We will continue to listen to the experts, including those at the front lines and those with lived experience, and collaborate with our provincial and territorial counterparts to ensure that a strong framework is in place to guide MAID assessors and providers before MAID becomes available to those for whom mental disorders is the sole underlying condition.”

The office did not say whether the implementation expected on March 17 would be delayed.

Dr. Jitender Sareen, head of the psychiatry department at the University of Manitoba, said many controversial issues were discussed at the group’s annual meeting in October regarding which patients with a mental disorder could be eligible for MAID, seven years after the practice was legalized in Canada for those with a physical ailment.

“If a person wants MAID solely for mental health conditions, we don’t have clear standards around definitions of who’s eligible. How many assessments and what kinds of assessment would they actually need?” he said.

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