Thank you very much.
I think there are a few key things. The first is that the legislation doesn't only talk about incurable illness, but also incurable and intolerable suffering. The idea of incurable and intolerable suffering doesn't actually have a scientific definition. There was an article in the Canadian Medical Association Journal just a month ago in which there were calls for a scientific definition for that, which would really be a precursor of being able to study it. It's important to alert the committee that the concept we're trying to treat doesn't even have a scientific definition. That's part of the reason there have been no studies of it.
I think there's a whole host of other things that we need to look into beyond.... There's not only the irremediability of psychiatric disorders but also the irremediability of psychiatric suffering. While I agree with the other witnesses that there are psychiatric illnesses for which we know we can't cure the underlying illness, that's actually somewhat different from the idea of whether we can provide a treatment that may be able to alleviate the suffering that corresponds to that illness. To my knowledge, that has never been the focus of a single psychiatric study or any kind of study.
The large rest of studies that would be necessary are those related to suicide and suicide prevention. We just heard correctly, for example, that there's this question about whether MAID is suicide or not. Some people say it's exactly the same thing. Some people say it's totally different. The reality is probably that it's something in between. Obviously, in the case of mental illness, we have to be concerned that there may be substantial overlap. Trying to quantify the degree to which that overlap exists and the degree to which messaging....
I'll just say that my research mainly focuses these days on public messaging. We find that when you message across society that when you're having difficulty and struggling with mental illness, you can go seek treatment and get help, we see fewer suicides across the population. When you see media reporting about the idea that people will take their own lives when they're in difficulty in life, we see an increase in suicides. The degree to which that media reporting and this sort of cultural change that we have may have an influence is something worth studying, as is the impact on the physician-patient relationship and how people view psychiatry.
I would say the last thing that probably would be worth studying is an economic analysis of whether there are perverse disincentives. Of course, if this goes forward you would want any money that's saved through MAID to then be funnelled back into the mental health system. There is the possibility, of course, that there's a perverse disincentive to invest because if you don't invest, the more people have what appears to be irremediable illness and they die through MAID. Then our health care system just gets worse, which I think we can all agree would be a complete disaster.
All of that research would be helpful to know before going forward.