Disability activist and bowel cancer survivor Mohammad Samad understands why people would consider Medical Assistance in Dying (MAID) but views qualifying for it solely on the basis of mental illness is not enough to make that decision independently.
MAID is a process where a doctor or nurse practitioner assists an individual who is undergoing physical or mental suffering to end their life intentionally through drugs that can be taken orally or injected.
Those solely suffering from a mental illness can qualify for MAID starting on March 17, 2024, as long as they are 18 or older, voluntarily request MAID, and are capable of making their own health care decisions which two practitioners will examine.
Samad said MAID is an option for someone who’s been told they’ve got a limited amount of time left, and they don’t have any kind of quality of life and if they’re suffering.
“If I put it to my own situation, having PTSD, suffering from suicidal ideations … I don’t believe that PTSD is enough to say he can make that decision for himself and we shouldn’t intervene,” he said.
Communications Specialist Sarah Dobec with Dying with Dignity Canada, a national charity that focuses on supporting those suffering from mental health, said a person who has lived with mental illness for decades may be seeking relief like a person suffering from a physical ailment.
“Imagine a person who’s lived for 30 years with a mental disorder and has had no relief from it. They may want to apply for MAID because there’s only so many medications, there’s only so many treatments they can try,” Dobec said.
“There’s a lot of stigma around mental disorder and I think if you don’t have it yourself or you don’t live with it or know someone very closely who is a mentalist, we don’t understand it,” she said. “But it’s a disorder of the brain, just like you can have a disorder of a liver or kidneys, and it is a medical condition.
“And so we believe that people who have mental disorders should have the right to be assessed for this end of life option that everybody else in Canada has,” Dobec said.
However, David Kenneth Wright, associate professor of nursing at the University of Ottawa, brought up the concern of MAID being offered to a population of people who do not have access to other means of support.
“We spoke to another person who went on a tour of a hospice, a residential palliative care facility, with her mom who was dying and it was beautiful and her mother would have loved to have died there and the daughter would have loved her to have received end of life care there. But they told them if she had admitted here, there is no question of her ever receiving MAID,” Wright said.
In Alberta and Ontario between 2016 and 2017, only 15 per cent of people received palliative home care, according to the National Library of Medicine.
The Canadian Institute for Health Information stated that about one in five Canadians experience mental illness each year. Many have to wait to receive the needed care, while others receive none or not enough.
“There are concerns, especially within the disabled community, that people will just seek MAID because it’s easier,” said Susan Cadell, a professor at Renison University College in the school of social work.
“It’s easier than fighting for yourself and trying to make ends meet and have a livable wage and make sure that you’re housed and you don’t have to choose between medications and rent and things like that,” Cadell said.
Wright and Cadell are working on an ongoing research project together that began in 2020, involving people who were grieving a MAID death.
“If you’re not able to openly discuss how the person died, then you might shy away from just leaning into conversations about that person,” Wright said.
“When there is stigma or taboo about MAID, which is not always, but when there is, then that affects your ability to receive support,” he said.
Samad said religion can also play a role in seeking support when grieving a MAID death, using him being Islamic as an example.
“Islamicly, MAID is forbidden because it is suggested as suicide, and the person assisting in that would also obviously create the forbidden sin by taking someone’s life,” he said.
“Sometimes doctors often play God. It’s all about saving that person’s life, but not necessarily considering the impact that it could have on them for their remaining days, and so we should be open to that conversation,” Samad said.