Navigating ethics of medically assisted dying
Delaying medically assisted death for mental illness will give us time to find an acceptable place for MAID,
March 13 I take issue with the position and some of the statements by Dr. Harvey Schipper on the postponements in medical assistance in dying (MAID) and what he sees as failures in its provision.
As a geriatric specialist, with experience in palliative care where I am a MAID provider, my perspective differs. I take issue with his statement, “basing decisions on evidence over blind ideology.” I think that the international movement to provide MAID in its various iterations in many European countries and states in the U.S. have responded to the wish to deal with suffering that is not amenable to medical treatments. Although some may believe in the sanctity of life, any life, there is no dictum within the major religions that promotes or extols the sanctity of suffering. As for mental health as the “sole” criteria for MAID, those with years of mental suffering unresponsive to the whole range of treatments including at extremes (electroconvulsive therapy, for example) should not have to suffer until developments in medicine pave the new way for new treatments. Some have waited decades for treatments, and like those whose chemotherapy has failed, may not wish suffering while more attempts are implemented.
I laud Canada for its humane undertaking of human suffering from illness, and hope that it will mirror some of the more progressive programs that exist in the Benelux countries.
Dr. Michael Gordon, M.D., Toronto
It’s unfortunate that there was no contextualization of Dr. Harvey Schipper’s general views of MAID as a backdrop for what is clearly a biased and ideological article. In 2020, he wrote an article titled “Understanding the new epidemic disease of MAIDism,” clearly an ideological position. This warrants a response. Although he states that making MAID available for application by those with a mental illness was reversed “based on evidence and public concern,” this is far from the reality. What evidence? There is none. Standards of practice, a robust curriculum, conscientious preparation provincially and federally has taken place over the period since the last delay. And what is this “public concern?” The government’s special committee did not follow its most recent mandate of simply examining readiness. Instead it rehashed political arguments in opposition to MAID and conflated the lack of adequate supports for people with a mental disorder with their constitutional rights to have the same access to applying for MAID as other people in Canada. His sentence: “…basing decisions on evidence over blind ideology, and the safety of all, especially the vulnerable, stood firm” really should say the opposite if one is concerned about the actual reality of the decision. The committee delayed again based on ideology, not evidence. He also makes quite alarmist comments such as “the direct consequence in MAID is wrongful death.” How can he presume that readers will see his article as anything other than an ideological position opposed to MAID. Bringing in a comparison to capital punishment is really outrageous, more of the same oppositional ideology. Shame on him for using his professional position in this way.