Thank you, Senator Kutcher.
Maybe one of my colleagues from Health Canada can, but off the top of my head I cannot give you an indication of the number of individuals who have a comorbid situation of a physical illness and a psychological or mental condition. If one of my colleagues can answer that, I will ask them to do so, but I think at this point we don't really have that data.
In terms of psychosocial factors, when you look at the explanations given by persons requesting MAID and documented by the providers who complete the reports that are required under the monitoring system, the things they say about what is causing their suffering.... If you have terminal cancer and a very short life expectancy, then the physical pain is clearly going to be very high. When people talk about the fact that they feel they no longer can do the things they formerly did and they need more assistance than they feel it is dignified to receive in order to carry out the normal activities of daily living, I would describe that as falling under the psychosocial dimension.
I think what we want to get at, particularly in the cases that are starting to come into the MAID system now of people whose death is not reasonably foreseeable, is whether those psychosocial circumstances can be alleviated in any way through supports. With people whose death is imminent, we generally see that they are, to be candid, sort of beyond the point where more income support or more social interaction would actually cause them to say that they're not going to proceed with their MAID request.
We are entering a new world in which documenting—and that's why the safeguards are so important—the kinds of support that are offered and then considered by people requesting MAID is going to tell us much more about how psychosocial circumstances and other forms of status in society play into a person's request for MAID. We don't see that now as such a critical factor in cases of MAID for people whose death is reasonably foreseeable.