Thank you very much.
My name is Sonu Gaind. I'm a full professor, psychiatrist and governor at the University of Toronto, the chief of psychiatry at Sunnybrook, and a past president of the Canadian and Ontario Psychiatric Associations.
My expertise is in psycho-oncology. I work with cancer patients and their families. I am not a conscientious objector. I was the physician chair of my prior hospital's MAID team. My roles inform my expertise, but I'm presenting as an individual, not for any group.
Thank you for the chance to speak. My testimony is not easy to say, nor easy to hear, but it's necessary to be said. Those seeking expansion claim that not providing MAID for sole mental illness is discrimination, echoing claims by Senator Kutcher.
The opposite is true for three reasons. MAID is for irremediable medical conditions. These are ones we can predict won't improve. Worldwide evidence shows we cannot predict irremediability in cases of mental illness, meaning that the primary safeguard underpinning MAID is already being bypassed, with evidence showing such predictions are wrong over half the time.
Scientific evidence shows we cannot distinguish suicidality caused by mental illness from motivations leading to psychiatric MAID requests, with overlapping characteristics suggesting there may be no distinction to make.
Finally, those with mental illness have higher rates of psychosocial suffering. This all means that MAID assessors will be wrong over half the time when predicting irremediability, will wrongly believe they are filtering out suicidality and will instead provide death to marginalized, suicidal Canadians who could have improved. That is the ultimate discrimination.
Those setting policy have reassured us that we're ready to provide MAID for mental illness. I've reviewed our legislation, the Health Canada practice standard and the CAMAP training for MAID for mental illness. As someone who supports MAID in general, I assure you that we are not ready.
Regarding irremediability, Dr. Gupta acknowledged in her 2020 AMPQ report that “It is possible that a person who has recourse to MAID...could have regained the desire to live”, saying this should be an ethical decision each time. Her 2022 expert panel refused to recommend any additional legislative safeguards, despite Canada lacking legislative requirements for due care and no reasonable alternatives before MAID, unlike other countries.
Professor Downie claimed that irremediability is a legal term rather than a clinical concept. Try those mental gymnastics on your constituents. Convince them it was okay that their loved ones with mental illness got MAID, not because of a clinical assessment based in medicine or science, but because of the ethics of the particular assessor.
Regarding suicidality, Senator Kutcher and Dr. Green claim suicidal people won't get psychiatric euthanasia, and Dr. Gupta claims assessors can identify and separate suicidality in MAID requests because they have been doing it—