Canada legalized euthanasia and assisted suicide in June 2016 under the term: Medical Assistance in Dying (MAiD).
In December 2016, the federal government announced that the Council of Canadian Academies would research and provide recommendations concerning the expansion of euthanasia in three areas: mature minors, people who are incompetent but previously requested MAiD and euthanasia for psychological suffering alone. This article concerns the last group.
The Netherlands and Belgium legalized euthanasia in 2002. The legislation in both of these countries technically allowed euthanasia for “psychological suffering.” In the early years, euthanasia for psychological suffering was rare but in the past few years it is sky rocketing.
A commentary by Dr. Damiaan Denys, the President of the Dutch Society of Psychiatrists, was published in The American Journal of Psychiatry (September 2018) titled: Is Euthanasia Psychiatric Treatment?
Denys commentary is based on a 42-year-old married woman who requested euthanasia for psychiatric reasons while receiving treatment from his team. The Psychiatric team disapproved of her euthanasia death because treatment options existed but the woman died by euthanasia anyway. Denys wrote:
Although we had treated her intensively for 2 years, our advice was disregarded. Eight weeks later we received the obituary of the patient.
Denys outlines the problems with psychiatric euthanasia based on experience in the Netherlands. He wrote:
…whether euthanasia is an option for psychiatric patients, there are medical and ethical dilemmas related to the practical process of decision making and execution. How can we reconcile the daily practice of reducing suicidal ideas and behaviors in patients with respecting a death wish in single cases? How can we distinguish between symptoms and existential needs? How can we decide whether a psychiatrist is sufficiently autonomous to judge euthanasia? Does the fragile therapeutic relationship between psychiatrist and patient not bias judgment? How are differences in opinion between psychiatrist and patient resolved? Although psychiatrists are not legally obliged to approve or execute euthanasia, neither can they interfere once a request is granted by a third party, as illustrated in the aforementioned case.
Dr. Mark Komrad, an American Psychiatrist on the Faculty at John’s Hopkins University examined the experience with euthanasia for psychiatric reasons in the Netherlands and Belgium. He wrote in a commentary published by the Psychiatric Times (Feb 2017) that:
Some remarkable stories have been profiled in the Dutch media. For example, a woman was granted euthanasia for chronic PTSD due to childhood sexual abuse. The arguments based on personal autonomy to justify such access to PAS/E are being pushed even further in the Netherlands. Ministers of Health and Justice have proposed to their Parliament that criteria not be limited to medical conditions, but be extended to average citizens who feel they have lived “completed lives.”
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Prominent cases profiled in the Belgian media include a pair of deaf twins euthanized on request because they were going blind, a man with gender identity disorder who was unhappy with surgical results, and another man who sought euthanasia for ego-dystonic homosexuality.
Canadians were told that euthanasia would be legalized with safeguards to prevent the problems that have occurred in the Netherlands and Belgium. Canada is now considering extending euthanasia beyond the original parameters.
The Canadian law states that MAiD can be done when it is approved by 2 doctors or nurse practitioners when the person fulfills the following conditions:
- The person is at least 18 years old,
- The person has a serious and incurable illness, disease or disability,
- The person has an advanced state of irreversible decline in capability,
- The person has an enduring physical or psychological suffering that is intolerable to them,
- The person’s natural death must be reasonably foreseeable (no definition).
Therefore, Canada’s euthanasia law does not permit euthanasia for psychological reasons alone.
In fact, Canada has gone too far already. Euthanasia for psychological suffering is a bad idea that is abused in other jurisdictions and will be abused in Canada.