Right. In every other case, we're looking at future treatments that don't work. What the panel said was that we look at past treatments that didn't work, but that's helpful and critical information for guiding next steps.
Let me quote a line from the panel that I thought was remarkably apropos your question.
This is from the Gupta report: “There is limited knowledge about the long-term prognosis for many conditions, and it is difficult, if not impossible, for clinicians to make accurate predictions about the future for an individual patient.” They said it in their report—they said it right in their report—and then they add that it's an ethical decision. Unlike every other case of MAID in in Canada, where you're trying to gauge the clinical reality of whether treatment will work, they say it's an “ethical choice”. It's in there as well.
This is astonishing to me. This report is astonishing in terms of its abrogation of responsibility for us, as psychiatrists and clinicians, to treat the sickest and most vulnerable. I literally defy anyone...and Dr. Kutcher, I'm going to single you out.
You said that all psychiatrists in Canada who object to MAID for mental illness are selfish and paternalistic. I'm not sure what purpose that comment served, but I defy literally any psychiatrist to say that this particular patient has an irremediable illness, because you can't. I have patients who get better after five years, after 10 years and after 15 years. You cannot do it. It's guesswork. If you're okay with guesswork, if you're okay with playing the odds, or if your position is let's respect autonomy at all costs—if someone wants to die, they can die—call it what it is. It's facilitated suicide.