Evidence of meeting #39 for Medical Assistance in Dying in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was illness.
A video is available from Parliament.
Physician, Department of Psychiatry, University of Manitoba
I need translation, or Dr. Gagnon could answer.
Bloc
Luc Thériault Bloc Montcalm, QC
You have to choose the right channel for interpretation.
Madam Chair, you may have to let the witness know that they need to choose the right channel for interpretation.
The Joint Chair Hon. Yonah Martin
There is an interpretation channel at the bottom of your screen. You can select English as your option.
Physician, Department of Psychiatry, University of Manitoba
Okay, I got it.
Bloc
Luc Thériault Bloc Montcalm, QC
Thank you.
My question was simple. How long have you been a psychiatrist?
Physician, Department of Psychiatry, University of Manitoba
I got my licence in 2000, so 23 years.
Bloc
Luc Thériault Bloc Montcalm, QC
Very good.
After 23 years in clinical practice, are any of your patients still with you?
Physician, Department of Psychiatry, University of Manitoba
I have had some patients who died of either suicide or other causes of death.
Bloc
Luc Thériault Bloc Montcalm, QC
I see.
In your view, no mental illness or disorder is incurable or irremediable.
Physician, Department of Psychiatry, University of Manitoba
Mental disorders are not irremediable, in the sense that recovery-oriented practice.... People have disabilities and people have depression, but there is always.... The desire for death waxes and wanes over time.
We work with patients—
Bloc
Luc Thériault Bloc Montcalm, QC
Sorry to cut you off, but I want to know whether you have treated a patient whose mental disorder was incurable and became chronic.
In your clinical practice, have you never had a patient whose illness was chronic?
Physician, Department of Psychiatry, University of Manitoba
Yes, I've had a chronic patient.
Bloc
Luc Thériault Bloc Montcalm, QC
All right.
I imagine those patients had varying degrees of suffering. You said that some had committed suicide. Is that correct?
Physician, Department of Psychiatry, University of Manitoba
Are you asking me to explain how some people died by suicide?
Bloc
Luc Thériault Bloc Montcalm, QC
When you see a patient with a chronic illness for a long period of time and that person decides to commit suicide, do you see that as a failure of your treatment, or do you think there was nothing you could have done?
From that standpoint, don't you think that when certain individuals reach the point that your patient was at—and I imagine you're an excellent psychiatrist—they would have opted for MAID over suicide, if they could?
If so, in light of your experience, would it not have been preferable for those people to have access to MAID, rather than being driven to suicide after years of receiving treatment from you?
It's a simple question.
Physician, Department of Psychiatry, University of Manitoba
Sir, every single day we admit patients to the hospital with exactly what you're describing. What you're pointing out, sir, is exactly what our psychiatric practice does. Every single day we admit people who've had years of suffering, who then have thoughts about dying and reach out to their psychiatrist.
Bloc
Luc Thériault Bloc Montcalm, QC
I have one last question for you, Dr. Sareen.
In certain cases, don't you think that all psychiatry can do for patients suffering from chronic mental disorders is provide palliative care indefinitely?
Physician, Department of Psychiatry, University of Manitoba
I think what you're saying is that MAID and suicide are the same thing. Isn't that correct?
That's exactly why we're saying that every psychiatrist in the country will need to understand, when somebody shows up with suicidal ideation, whether we should be sending them for a physician-assisted death or admitting them to the hospital.
Physician, Department of Psychiatry, University of Manitoba
I don't understand your question, sir.
Bloc
Luc Thériault Bloc Montcalm, QC
A suicidal state is reversible and can be treated. A patient whose state is reversible should therefore not have access to MAID. Only when a person's state is irreversible can they not be treated.
I would think that after years of care, therapy and best practices, professionals would have developed that certainty.
The Joint Chair Hon. Yonah Martin
Unfortunately, the time has expired.
We will go to Mr. MacGregor for the next five minutes.