Issues around medically assisted death were examined by working groups created by the independent Council of Canadian Academies and represent some of Canada’s most august intellectuals. (Photo by THE CANADIAN PRESS)

Issues around medically assisted death were examined by working groups created by the independent Council of Canadian Academies and represent some of Canada’s most august intellectuals. (Photo by THE CANADIAN PRESS)

Experts struggle with ethics of assisted death for people with mental disorders

OTTAWA — Experts the federal government charged with looking at whether people suffering only from mental disorders should be eligible for medically assisted death couldn’t even agree on what evidence is relevant to the question, according to reports tabled in Parliament Wednesday.

There was more consensus on two other issues: whether mature minors should be eligible for assisted dying and whether those facing eventual loss of mental capacity should be able to make advance requests for assisted deaths.

The three issues were examined by working groups created by the independent Council of Canadian Academies, representing some of Canada’s most august intellectuals. The government specifically instructed the council to make no recommendations on any of the three issues, so the reports released Wednesday just summarize the “state of knowledge” on the issues and canvass the pros and cons of extending the right to an assisted death to each group.

The government has already indicated it has little intention of expanding the law, which went into effect two-and-a-half years ago.

The reports come just over a month after a Halifax woman with incurable breast cancer, Audrey Parker, opted to end her life earlier than she wanted because she feared she’d eventually lose the mental competence required to seek an assisted death. Parker pleaded with the government to allow people like her to make advance requests for medical assistance in dying.

At that time, Justice Minister Jody Wilson-Raybould said she was satisfied with the law as it is.

“We’re not considering changing something in the legislation,” she said. ”We’re confident in the legislation that we brought forward, that it finds the right balance in terms of being able to access medical assistance in dying, protecting the autonomy of individuals to make the appropriate decisions for themselves as well as protecting vulnerable individuals.”

The law allows medically assisted dying only for incurably ill adults who are suffering intolerably and are already close to natural deaths. It excludes minors and those suffering strictly from mental disorders and does not allow advance requests.

The law is facing constitutional challenges, based on the fact that it is far more restrictive than the assisted-dying regime sketched out by the Supreme Court of Canada when it struck down Canada’s prohibition on physician-assisted suicide.

For Wednesday’s report on mental disorders, members of the working group — psychiatrists, a nursing professor and medical and legal ethicists, among others — could not agree on some of the most fundamental questions.

For instance, some believed permitting mentally ill people to access assisted dying “may reduce mental-health stigma by demonstrating that people with mental disorders have capacity, that their suffering is serious, that mental disorders are not due to character flaws or circumstances within their control and that their right to self-determination should be respected.”

Other members, however, believed that it could “increase mental health stigma because it might bolster the belief that the lives of people with mental disorders are intolerable, not worth living.”

The report says the issue is particularly challenging because a desire to die can be a symptom of a person’s mental disorder, clinicians disagree on which disorders can be considered incurable, and most of those suffering are not near death.

The report on “mature minors” notes that there is already plenty of jurisprudence establishing that someone under the age of 18 can have the mental capacity and maturity to make end-of-life decisions, such as refusing treatment. It says prohibiting mature minors from receiving an assisted death will eventually be challenged in court and suggests the government needs to balance the need to protect youths from exploitation and coercion while ”respecting their rights by avoiding unfair and unethical restrictions.”

The report on advance requests says they could “provide comfort and relieve anxiety” for those facing the end of life with diminished competence. However, removing the requirement for express consent immediately prior to receiving an assisted death also raises the possibility that a person’s life could be ended against their wishes.

It suggests some safeguards could be developed, such as putting time limits on advance requests and requiring the appointment of a substitute decision-maker.

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

The body of 25-year-old Kyler Corriveau was discovered near Red Deer on Sunday. He was missing since Dec. 15. Police are investigating his death as a homicide. (Contrinuted photo).
RCMP are investigating the death of missing Red Deer man as a homicide

The body of Kyler Corriveau was discovered on Sunday

Alberta’s chief medical officer of health Dr. Deena Hinshaw reported 456 new cases of COVID-19 over Tuesday afternoon. (photography by Chris Schwarz/Government of Alberta)
Five new COVID-19 deaths in Central zone, two in Red Deer

Province reports 456 new cases of COVID-19

Community Futures Central Alberta, in partnership with the Central Alberta Regional Innovation Network (CARIN), is behind the SMARTstart initiative for budding entrepreneurs.
New program aimed at helping entrepreneurs succeed

Program offers mentorship, business advice and networking opportunities

A Red Deer man, who has been declared a dangerous offender, lost his appeal of an aggravated assault conviction from 2017. Advocate file photo
Red Deer man who chomped on remand centre inmate’s ear loses aggravated assault appeal

Inmate lost part of his ear in attack at Red Deer Remand Centre in August 2017

Red Deer’s Wiklund vs. Wiklund is celebrating a burst of songwriting creativity during the 2020 lockdown by releasing a new tune to YouTube and multiple digital music platforms in each month of 2021. (Contributed image).
Pandemic lockdown fuels a flurry of songwriting for Red Deer music duo

Wiklund vs Wiklund will release a new single monthly in 2021

Justin Kripps of Summerland and his team have competed in Olympic action and World Cup competitions in bobsleigh. (Jason Ransom-Canadian Olympic Comittee).
QUIZ: Are you ready for some winter sports?

It’s cold outside, but there are plenty of recreation opportunities in the winter months

Karina Gould, Minister of International Development, holds a news conference on Parliament Hill in Ottawa on Thursday, Dec. 10, 2020. THE CANADIAN PRESS/Sean Kilpatrick
COVID-19 vaccines: Canadians torn between helping the world and helping themselves

COVID-19 vaccines: Canadians torn between helping the world and helping themselves

Prime Minister Justin Trudeau listens to a question as he participates in a news conference at Rideau Cottage in Ottawa, Tuesday, Jan. 19, 2021. THE CANADIAN PRESS/Adrian Wyld
No Pfizer-BioNTech vaccine doses to be shipped to Canada next week: Fortin

No Pfizer-BioNTech vaccine doses to be shipped to Canada next week: Fortin

People wear masks as they pass a pharmacy offering flu shots in downtown Calgary, Alta., Friday, Oct. 30, 2020. Experts say a drastic drop in the circulation of the influenza virus this season means signs of flu are more likely to be COVID-19 than another respiratory virus.THE CANADIAN PRESS/Jeff McIntosh
Drastic drop in influenza virus likely result of less international travel: experts

Drastic drop in influenza virus likely result of less international travel: experts

A Subway fast food restaurant's sign is shown in New York on Oct. 24, 2016. A defamation lawsuit by the world’s largest fast-food operator against Canada's public broadcaster over a report on the chain's chicken sandwiches can proceed, Ontario's top court has ruled. THE CANADIAN PRESS/AP, Mark Lennihan
Subway can press $210-million defamation suit against CBC for show on chicken content

Subway can press $210-million defamation suit against CBC for show on chicken content

 A man watches the financial numbers on the digital ticker tape at the TMX Group in Toronto's financial district on Friday, May 9, 2014. THE CANADIAN PRESS/Darren Calabrese
Energy pushes S&P/TSX composite up as TC Energy shares rebound after Keystone worries

Energy pushes S&P/TSX composite up as TC Energy shares rebound after Keystone worries

AltaLink seeks to refund extra $350 million over three years to Alberta customers

AltaLink seeks to refund extra $350 million over three years to Alberta customers

Alberta Energy Minister Sonya Savage speaks during an event to mark the start of right-of-way construction for the Trans Mountain Expansion Project, in Acheson, Alta., Tuesday, Dec. 3, 2019. A government lawyer says decisions about environmental policy should be made by elected officials, not courts. THE CANADIAN PRESS/Jason Franson
Alberta lawyer argues coal policy decisions belong with politicians, not courts

Alberta lawyer argues coal policy decisions belong with politicians, not courts

Prime Minister Justin Trudeau provides an update on the COVID-19 pandemic from Rideau Cottage in Ottawa on Tuesday, Jan. 11, 2021. THE CANADIAN PRESS/Sean Kilpatrick
Trudeau vows to keep up the fight to sway U.S. on merits of Keystone XL pipeline

Trudeau vows to keep up the fight to sway U.S. on merits of Keystone XL pipeline

Most Read