Canada

Toronto man shares why MAID should be accessible for those with mental health disorders

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On the heels of the federal government pausing the expansion of Medical Assistance in Death (MAID) to include those with mental health disorders, one man is speaking out about why he feels he and others should be able to access it.

John Scully, who suffers from mental health disorders, is a former war correspondent. He covered 35 warzones, witnessing firsthand the worst of human suffering and has been trying to ease his pain for decades.

“I’ve suffered from severe depression almost all of my life and severe chronic anxiety; I have suffered PTSD for 30 years, which means I have every single night of my life now,” said Scully. “I get nightmares, horrific nightmares.”

He has tried everything to help.

“It doesn’t stop, there is no stopping it … every cure tried. I’ve had 19 shock therapies,” explained Scully. “I have been admitted to CAMH here in Toronto at least eight times … I’ve seen about 16 psychiatrists in my life.

“I present myself as a perfect candidate for MAID for the mentally ill … I am so sick,” said Scully. “The reality is that there’s nothing there to help me. There’s no cure. There’s no research. There’s nothing going on.”

Health Ministers from most provinces and territories wrote a letter on Monday to Federal Health Minister Mark Holland asking for an indefinite pause, saying the expansion of MAID requires further federal-provincial-territorial collaboration to ensure a consistent and safe approach across the country that includes appropriate safeguards.

That expansion was set to take effect in March, but Holland and Justice Minister Arif Virani say they agree it shouldn’t happen so soon.

Speaking to the media on Tuesday, Holland acknowledged the parliamentary committee, which released its report on Monday, concluded Canada was not ready to expand MAID. 

“I thank the parliamentary committee for the work. They heard from an extensive list of witnesses. We followed that process closely by talking with provinces and territories and the time that’s required. We have got to get that right.”

He said at the end of the day, MAID is delivered by the provinces so Holland is relying on them to be able to tell the government their state of readiness.

“It’s clear that we’re not ready at this point in time. So, looking at provinces and territories, what is exactly what to be required to cross that threshold? That’s not something that we have an answer for today.”

Holland added they are not debating whether it will ever happen. “I think that it’s very clear that mental suffering and physical suffering have equivalency. The question here is a state of readiness.”

Psychiatrists are deeply divided on this issue. Some believe people can be assessed properly to determine who qualifies, while others do not.

Dr. Sonu Gaind, the Chief of Psychiatry at Sunnybrook Hospital, is among those who say Canada does not have enough safeguards in place to offer MAID to people with mental health disorders.

“If MAID is meant to be, according to the law, something that’s provided for a medical condition that is irremediable, meaning cannot get better, then we need to have evidence showing that we can make those predictions with some degree of honesty. Right now, we lack that,” said Gaind.

He adds he doesn’t know if we will ever get to that place.

“I think the only honest answer is we don’t know because, as I said, those other conditions that I spoke about, we’d have to make sure that they were addressed properly, and we don’t know if they can be. The problem is that we haven’t spent the last three years even looking at that question,” explained Gaind.

Gaind said a key concern is mental health care is not adequately accessible in Canada.

“If in a country where less than one in three get access to the care they need then we open an easy door to facilitated suicide. You can imagine what is likely to happen.”

“The way that plays out, especially for the most marginalized Canadians, whose mental illness is fueled even more by the higher rates of social distress we know people with mental illness have,” he added. “We think about how that plays out in the whole MAID debate. But on a broader level, I hope what comes from this is more focus and awareness and pressure to say we actually need to help these people live better.”

Close to 45,000 people have accessed MAID in Canada since it was legalized and more people are accessing it every year. The most recent data shows a 31.2 per cent increase in MAID recipients in 2022 over 2021. 

In 2022, just over 13,000 people chose it, which was four per cent of all deaths in Canada. The average age was 77. Sixty-three per cent had cancer.  

When MAID expanded to include people with disabilities in 2021, concerns were raised it was being accessed by people who were falling through Canada’s social safety net.  

“Are we providing it really in some situations for things like poverty or other social distress and the medical condition or mental illness? People already getting [MAID] for things like poverty or housing insecurity in some situations and so before expanding further, I think we really need to understand that,” asked Gaind.

CityNews profiled Amir Farsoud in 2022. He had one doctor’s approval for MAID and was hoping to end his life within a month, not because of a debilitating back injury which made him eligible, but because his landlord was putting his rooming house up for sale and he didn’t make enough on social assistance to pay rent elsewhere. 

“I don’t want to die, but I don’t want to be homeless more than I don’t want to die,” Farsoud said at the time.  

Things turned around after his story came to light and a GoFundMe raised enough money for him to live on while he waits for supportive housing. He is happy and doing well today.

“MAID is for mentally or physically ill, not socially ill, the government should take care of those poor people,” said Scully.

Scully agrees there needs to be stringent safeguards if MAID is expanded, but a decision has to be made.

“For three years now, we’ve sat in committees pondering and wondering and thinking deeply and coming up with nothing, less than nothing … The arguments going on behind closed doors with these decision-makers are horrendous. No one can make a consensus from these so-called deep thinkers.”

He’s angry that his choice could be taken away again.

“For me, what it means is preposterous outrage that these people should take away my option. They are deciding on my life? How dare they? How dare they take away that option? Give me the option. Don’t say you have to do it or you don’t have to do it. Give me the option. Don’t sit behind closed doors and bicker and then delay and put it off until next time.”

He said if the government does allow people with mental health issues to access MAID he won’t use it right away — he just wants to know if he could.

“I want the option to be there to give me some comfort that someone is caring.”

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